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International Journal of Environmental Research and Public Health logoLink to International Journal of Environmental Research and Public Health
. 2011 Sep 26;8(10):3821–3843. doi: 10.3390/ijerph8103821

Identification of Occupational Cancer Risks in British Columbia, Canada: A Population-Based Case—Control Study of 1,155 Cases of Colon Cancer

Raymond Fang 1,2,*, Nhu Le 2, Pierre Band 2,3
PMCID: PMC3210584  PMID: 22073015

Abstract

Objective

Cancer has been recognized to have environmental origin, but occupational cancer risk studies have not been fully documented. The objective of this paper was to identify occupations and industries with elevated colon cancer risk based on lifetime occupational histories collected from 15,463 incident cancer cases.

Method

A group matched case-control design was used. All cases were diagnosed with histologically proven colon cancers, with cancer controls being all other cancer sites, excluding rectum, lung and unknown primary, diagnosed at the same period of time from the British Columbia Cancer Registry. Data analyses were done on all 597 Canadian standard occupation titles and 1,104 standard industry titles using conditional logistic regression for matched data sets and the likelihood ratio test.

Results

Excess colon cancer risks was observed in a number of occupations and industries, particularly those with low physical activity and those involving exposure to asbestos, wood dusts, engine exhaust and diesel engine emissions, and ammonia.

Discussion

The results of our study are in line with those from the literature and further suggest that exposure to wood dusts and to ammonia may carry an increased occupational risk of colon cancer.

Keywords: occupational cancer, colon cancer, cancer risk, occupational exposure, carcinogen

1. Introduction

Colon cancer is one of the leading cancer causes of death. In Canada, colon cancer is the third most common form of cancer (after prostate cancer and lung cancer in men and breast cancer and lung cancer in women) and the third leading cancer cause of death (after lung cancer and prostate cancer in men and lung cancer and breast cancer in women) [1].

Despite the common occurrence of colon cancer, its etiology is not well established; age, family history [2], lifestyle factors [36] including daily alcohol use, low-fiber diets, a high consumption of animal fat and red meat, physical inactivity [710], obesity [1113] and smoking [14] are reported risk factors. The evidence regarding occupational exposures related to the occurrence of colon cancer is generally limited and/or not consistent [15]. Exposures to asbestos [16,17], dyes in textile industry [18], hydrazine in rocket fuels [19], pesticides in agriculture [20], engine exhaust and diesel engine emissions [21] and occupations as managers [22], male farmers [23], painters, police, guards and firemen, motor transport workers and clerks as well as exposures in non-metallic mineral products, leather goods, meat, poultry, and fish products industries [24] have been reported to be associated with a higher risk of colon cancer. A consistent relationship, however, has primarily been found for physically inactive occupations [2529].

We have, as part of a program aimed at detecting occupational risk factors in British Columbia, Canada, collected lifetime occupational histories from 15,463 incident cancer cases, of which 1,155 had a diagnosis of colon cancer. Occupational risks for this group of patients are presented in this article by assessing risk difference in comparison with internal controls consisting of all other cancer patients excluding lung and rectum cancer and cancer of unknown primary sites.

2. Materials and Methods

2.1. General Methodology

The general methodology of the study has been described in detail in a previous article [30]. Briefly, male cancer patients aged 20 years and older ascertained by the population-based British Columbia Cancer Registry (BCCR) for the years 1983 to 1990 inclusively, received a self-administered questionnaire requesting lifetime job descriptions, occupation and industry titles, and duration and period of work, as well as information on ethnic origin, education, and lifetime smoking habits. Questions about lifetime consumption of alcoholic beverages, which were initially omitted, were added to the questionnaire during the first year of the study. In the event of a patient’s death, information was requested from the spouse or closest living relative. For the first two years, questionnaires were sent to all cases. Data collection continued until 1,000 completed questionnaires were accrued for each tumor site, or until 31 December 1990, whichever occurred first. The distribution of patients’ usual occupations and usual industries as well as assessments of response bias and of questionnaire validation and reliability was conducted and previously reported [30]. The anatomic site and pathology of the primary tumor were coded using the 9th revision of the International Classification of Diseases [31] and the International Classification of Diseases for Oncology [32], respectively. Occupations and industries were coded according to the Canadian Standard Occupational Classification (SOC) and the Canadian Standard Industrial Classification (SIC), respectively [33,34]. In the SOC, occupations are coded according to two-digit major group codes, three-digit minor group codes, and four-digit unit group codes. In the SIC, industries are coded according to two-digit major group codes, three-digit group codes, and four-digit class codes. During the data-collection period, questionnaires were sent to all 25,726 eligible male cancer cases ascertained by the BCCR and 15,463 (60.1%) were returned. Histological confirmation of diagnosis was obtained in all cases. For colon cancer, questionnaires were sent to 1,768 eligible cases, of which 1,156 (65.4%) were returned.

2.2. Statistical Methodology

A group matched case-control design was used. Cases comprised all 1,156 colon cancer patients. Controls comprised internal controls with all other cancer sites, excluding lung cancer (n = 2,998), rectum cancer (n = 1,095) and cancers of unknown primary site (n = 708), matched to the cases on exact age and year of diagnosis. These were based on a few methodological considerations. First, using other cancers as controls has a few advantages over population controls with regard to recall and interviewer bias when using general population controls, a mixture of live and deceased controls can be expected when selecting other cancer patients as controls and there are logistical and cost advantages in using other cancer patients as controls. Thus the study design using cancers as controls is likely to be used increasingly in the future, particularly in cancer registry settings [35]. Next, since lung cancer is mainly caused by smoking, excluding it from the control group would avoid potential bias of having too many smokers in controls. In addition, matching on age and year of diagnosis is a way to control for major confounders. Including year of diagnosis is a control of time when rapid changes in population structure were happened from 1960s through 1990s.

Data were analyzed using conditional logistic regression for matched sets and the likelihood ratio test [36,37] in a two-step procedure. In step 1, the effect of the following non-occupational confounding variables was assessed: marital status; education (less than 8 years; 8 to 11 years; high school; post-secondary); smoking (starting age at smoking, average number of cigarettes, pipe or cigars smoked per day, total years smoked); alcohol consumption (starting age at consuming alcohol; average of number of bottles of beer, glasses of wine, ounces of spirits consumed per day; total years of consuming alcohol); and person who filled out the questionnaire (self or proxy). Variables were selected in a forward fashion each being examined separately; Potentially important confounders (P < 0.2) were then included in the model and the remaining ones were examined; the process was repeated until no factor with P < 0.2 was identified. In step 2, each occupation and industry was assessed separately using conditional logistic regression in which all significant confounding variables identified in step 1 were taken into account. The cut point of 0.20 was chosen in step 1 to ensure that the process has sufficient power to identify potentially important confounders.

Matched case-control analyses were carried out using PECAN software [38], test of significance of the adjusted odds ratios (ORs), p-values and 95% confidence intervals were calculated and presented. Analyses were performed for the following two different estimates of occupational exposures: ever occupation/industry (whether a job was ever held in a given occupation/industry under consideration) versus never, and usual occupation/industry (job with the longest held lifetime employment in a given occupation/industry). People in either ever or usual occupation/industry categories were always compared to their counterparts who were never in such occupation/industry. Due to all 597 occupation titles and 1,104 industry titles were analyzed and small numbers of cases in many occupation/industry categories, we intended to maximally present results of the analyses in this article with occupations and industries as long as their number of cases is five and over.

3. Results

Matching resulted in 1,155 colon cancer cases having at least one matching control and 7,552 controls, leaving an overall control to case ratio of 6.5:1. Site distribution of controls is listed in Table 1.

Table 1.

Cancer site distribution of 7,552 controls.

Site Controls Percent
lip 99 1.3%
oral cavity 390 5.2%
esophagus 174 2.3%
stomach 343 4.5%
liver 38 0.5%
pancreas 136 1.8%
larynx 280 3.7%
soft tissue sarcoma 101 1.3%
melanoma 458 6.1%
non-melanoma skin 1,050 13.9%
prostate 1,366 18.1%
testis 82 1.1%
bladder 972 12.9%
kidney 314 4.2%
brain 159 2.1%
Hodgkin’s Disease 52 0.7%
non-Hodgkin’s lymphoma 417 5.5%
multiple myeloma 118 1.6%
leukemia 184 2.4%
other sites 326 4.3%
multiple sites 493 6.5%
Total 7,552 100.0%

The characteristics of cases and controls are shown in Table 2.

Table 2.

Characteristics of cases and controls.

Colon Cancer Characteristics Cases (n = 1,155) Controls (n = 7,552)

No. (%) No. (%)
Year of diagnosis
1983 218(18.9) 2,674(35.4)
1984 254(22.0) 1,660(22.0)
1985 259(22.4) 1,302(17.2)
1986 246(21.3) 1,010(13.4)
1987 178(15.4) 906(12.0)
Marital Status
Single 56(4.8) 352(4.7)
Married/common law 958(82.9) 6,269(83.0)
Widowed 74(6.4) 463(6.1)
Separated/divorced 54(4.7) 405(5.4)
Not answered 13(1.1) 63(0.8)
Education
≤7 years 136(11.8) 842(11.1)
8–11 years 511(44.2) 3,336(44.2)
High school 138(11.9) 830(11.0)
Post-secondary 329(28.5) 2,144(28.4)
Not answered 41(3.5) 400(5.3)
Alcohol consumption status
Never drinker 137(11.9) 738(9.8)
Ever drinker 890(77.1) 5,456(72.2)
Not answered 128(11.1) 1,358(18.0)
Smoking duration, years
0 282(24.4) 1,501(19.9)
1–29 379(32.8) 2,026(26.8)
30–44 284(24.6) 2,216(29.3)
45+ 196(17.0) 1,682(22.3)
Not answered 14(1.2) 127(1.7)
Cigarette Pack-Years
0 282(24.4) 1,501(19.9)
1–24 348(30.1) 2,039(27.0)
25–49 271(23.5) 2,012(26.6)
≥50 200(17.3) 1,582(20.9)
Unknown 54(4.7) 418(5.5)
Pipe smoking status
Non-Pipe Smoker 1,098(95.1) 7,053(93.4)
Pipe Smoker 57(4.9) 499(6.6)
Respondent to questionnaire
Patient 930(80.5) 5,955(78.9)
Proxy 199(17.2) 1,403(18.6)
Unknown 26(2.3) 194(2.6)

Statistically significant ORs were noted for the following variables: smoking duration and education level as shown in Table 3; the latter was mainly due to the unknown category.

Table 3.

Odds Ratios (OR) for potentially important confounding variables/effect modifiers.

Confounding Variable Cases Controls OR P-value 95% Confidence Interval (95% CI)
Smoking duration, years
0 282 1,504 1.00
1–29 379 2,026 1.05 0.60 0.87–1.26
30–44 284 2,220 0.69 <0.01 0.57–0.83
45+ 196 1,684 0.57 <0.01 0.46–0.70
Not answered 14 118 0.58 0.06 0.33–1.02
Education
≤7 years 136 843 1.00
8–11 years 511 3,339 0.99 0.92 0.79–1.24
High school 138 830 1.05 0.72 0.80–1.37
Post-secondary 329 2,146 0.98 0.86 0.78–1.23
Not answered 41 394 0.65 0.03 0.44–0.96

Odds ratios by ever and usual occupation and industry categories are shown in Tables 4 and 5, respectively. In the ever occupation/industry categories and for most major groups, a number of occupations/industries had significantly elevated ORs. In many instances, the corresponding ORs in the usual occupations/industries categories were either non-significant or had fewer than five cases. Concordance for statistically significantly increased ORs between ever and usual categories at least at significant level P = 0.10 with a minimum of five cases in each category is shown in italics below.

Table 4.

Odds Ratios for ever and usual occupations.

Code Occupation Title Ever Usual

Case OR P value 95% CI Case OR P value 95% CI
11 Managerial, Administrative and Related 309 1.12 0.163 0.96 1.31 173 1.17 0.122 0.96 1.43
111 Officials and Administrators Unique to Government 40 1.19 0.343 0.83 1.71 17 1.18 0.548 0.69 2.03
1113 Administrators 11 1.35 0.390 0.68 2.68 5 1.37 0.539 0.50 3.74
1116 Inspectors and Regulatory Officers 21 1.17 0.524 0.72 1.90 11 1.33 0.402 0.68 2.59
113/114 Other Managers and Administrators 157 1.13 0.218 0.93 1.37 84 1.24 0.099 0.97 1.58
1130 General Managers and Other Senior Officials 62 1.26 0.130 0.93 1.70 28 1.30 0.226 0.85 1.99
1131 Management, Natural Sciences Engineering 7 0.75 0.486 0.33 1.69 6 1.27 0.616 0.50 3.23
1133 Administrators in Teaching and Related Fields 17 1.32 0.325 0.76 2.29 10 1.96 0.076 0.93 4.12
1135 Financial Management 27 1.33 0.190 0.87 2.04 17 1.59 0.099 0.93 2.73
1137 Sales and Advertising Management 54 0.92 0.597 0.68 1.25 20 0.79 0.331 0.49 1.29
1143 Production Management 31 0.94 0.764 0.63 1.41 11 0.96 0.904 0.49 1.86
1145 Management, Construction Operations 9 0.57 0.109 0.29 1.13 6 0.93 0.873 0.38 2.27
1147 Management, Transport, Communication Operations 25 1.43 0.120 0.91 2.24 9 1.05 0.895 0.51 2.17
1149 Other Managers and Administrators, NEC 48 1.26 0.178 0.90 1.76 17 1.41 0.208 0.83 2.41
117 Occupations Related to Management/Administration 68 1.10 0.504 0.83 1.46 25 0.87 0.538 0.56 1.36
1171 Accountants, Auditors and Other Financial Officers 46 1.15 0.410 0.83 1.60 23 1.02 0.934 0.64 1.63
21 Natural Sciences, Engineering and Mathematics 84 0.94 0.632 0.73 1.21 35 0.79 0.210 0.55 1.14
214/215 Architects, Engineers and Community Planners 25 0.90 0.642 0.58 1.40 13 0.95 0.869 0.52 1.75
216 Other Occupations in Architecture and Engineering 40 1.11 0.555 0.79 1.57 11 0.91 0.781 0.47 1.77
23 Social Sciences and Related 19 1.23 0.429 0.74 2.05 14 1.74 0.077 0.94 3.21
234 Law and Jurisprudence 10 1.47 0.298 0.71 3.04 8 1.56 0.282 0.69 3.51
2343 Lawyers and Notaries 10 1.88 0.095 0.90 3.94 7 1.72 0.221 0.72 4.10
25 Religion 11 1.05 0.886 0.54 2.05 9 1.30 0.505 0.60 2.81
2511 Ministers of Religion 11 1.10 0.785 0.56 2.18 9 1.30 0.505 0.60 2.81
27 Teaching and Related 52 0.88 0.441 0.64 1.22 24 0.79 0.308 0.50 1.24
271 University Teaching and Related 12 1.05 0.879 0.56 1.97 8 1.08 0.847 0.49 2.36
2711 University Teachers 10 0.99 0.977 0.50 1.95 8 1.18 0.680 0.54 2.59
273 Elementary and Secondary School Teaching 28 0.78 0.242 0.51 1.18 13 0.70 0.251 0.38 1.29
2733 Secondary School Teachers 14 0.81 0.473 0.46 1.44 6 0.69 0.408 0.29 1.66
31 Medicine and Health 31 0.81 0.299 0.54 1.21 22 0.83 0.436 0.52 1.33
311 Health Diagnosing and Treating 16 1.19 0.535 0.69 2.06 16 1.24 0.458 0.70 2,19
3111 Physicians and Surgeons 12 1.41 0.297 0.74 2.69 12 1.19 0.286 0.86 1.64
33 Artistic, Literary, Recreational and Related 36 1.02 0.916 0.71 1.47 15 1.36 0.294 0.77 2.42
331 Fine and Commercial Art, Photography and Related 9 0.80 0.539 0.39 1.63 8 1.53 0.290 0.70 3.36
41 Clerical and Related 195 1.00 0.912 0.85 1.21 54 0.99 0.948 0.73 1.34
413 Bookkeeping, Account-recording 65 1.08 0.597 0.81 1.44 20 1.66 0.052 1.00 2.77
4130 Supervisors 10 1.09 0.807 0.55 2.18 5 2.33 0.125 0.79 6.87
4131 Bookkeepers and Accounting Clerks 42 1.19 0.325 0.84 1.68 5 0.86 0.761 0.33 2.28
415 Material Recording, Scheduling and Distributing 61 0.78 0.075 0.59 0.03 11 0.67 0.223 0.35 1.28
4155 Stock Clerks 22 0.64 0.065 0.40 1.03 6 0.95 0.910 0.39 2.31
417 Reception, Information, Mail, Message Distribution 28 0.90 0.611 0.60 1.35 8 0.72 0.398 0.34 1.54
419 Other Clerical and Related 73 1.25 0.100 1.00 1.61 13 0.97 0.920 0.54 1.75
51 Sales 279 1.09 0.264 0.94 1.27 104 0.94 0.585 0.75 1.17
513/514 Sales, Commodities 196 0.98 0.815 0.83 1.16 70 0.81 0.115 0.62 1.05
5130 Supervisors 85 0.85 0.169 0.67 1.07 35 0.85 0.397 0.58 1.24
5133 Commercial Travellers 49 1.25 0.181 0.90 1.73 15 1.30 0.374 0.73 2.32
5135 Sales Clerks and Salespersons, Commodities, NEC 89 0.86 0.196 0.68 1.08 17 0.64 0.099 0.38 1.09
517 Sales, Services 72 1.39 0.021 1.05 1.84 24 1.29 0.273 0.82 2.04
5171 Insurance Sales 31 1.81 0.006 1.19 2.76 9 2.22 0.043 1.02 4.81
5172 Real Estate Sales 26 1.13 0.574 0.74 1.73 9 1.65 0.190 0.78 3.49
519 Other Sales 26 0.88 0.548 0.58 1.34 8 1.19 0.669 0.54 2.64
5193 Route Drivers 20 1.02 0.936 0.63 1.65 6 1.21 0.684 0.48 3.03
61 Services 365 0.96 0.581 0.83 1.11 79 0.95 0.688 0.74 1.22
611 Protective Services 260 0.98 0.815 0.83 1.16 35 0.89 0.542 0.61 1.29
6111 Firefighters 9 0.95 0.889 0.40 2.25 7 1.14 0.756 0.50 2.60
6112 Police Officers and Detectives, Government 16 1.03 0.913 0.61 1.75 6 0.79 0.596 0.33 1.89
6116 Commissioned Officers, Armed Forces 44 0.88 0.465 0.63 1.24 8 0.94 0.876 0.43 2.04
6117 Other Ranks, Armed Forces 195 1.06 0.530 0.88 1.27 7 0.76 0.499 0.349 1.68
612 Food and Beverage Preparation and Related 55 0.91 0.532 0.68 1.22 11 0.67 0.202 0.36 1.24
6121 Chefs and Cooks 24 1.06 0.797 0.68 1.65 5 0.70 0.454 0.28 1.78
613 Lodging and Other Accommodation Services 28 0.82 0.346 0.54 1.24 8 2.00 0.099 0.89 4.56
6130 Supervisors 23 0.81 0.371 0.51 1.29 8 1.90 0.128 0.83 4.34
619 Other Service 63 1.12 0.440 0.84 1.49 18 1.09 0.749 0.64 1.85
6190 Supervisors 13 2.01 0.037 1.04 3.87 5 2.05 0.180 0.72 5.85
6191 Janitors, Charworkers and Cleaners 46 1.09 0.603 0.79 1.51 11 0.81 0.524 0.42 1.55
71 Farming, Horticultural and Animal Husbandry 308 0.92 0.282 0.79 1.07 95 1.06 0.647 0.83 1.36
711 Farmers 182 1.00 0.919 0.83 1.22 79 1.13 0.353 0.87 1.46
7113 Livestock Farmers 46 1.22 0.247 0.87 1.71 19 1.30 0.323 0.77 2.19
7115 Crop Farmers 46 1.09 0.619 0.78 1.53 16 0.96 0.886 0.55 1.68
718/719 Other Farming, Horticulture and Animal Husbandry 63 0.84 0.234 0.63 1.12 6 1.02 0.965 0.43 2.44
7183 Livestock Farm Workers 31 1.00 0.961 0.68 1.51 5 2.58 0.077 0.90 7.36
7195 Nursery and Related Workers 21 1.19 0.485 0.73 1.94 6 1.47 0.420 0.58 3.75
7199 Other Farming, Horticulture and Animal Husbandry, NEC 80 0.86 0.228 0.67 1.10 7 0.88 0.754 0.40 1.96
73 Fishing, Trapping and Related 47 1.20 0.278 0.86 1.67 13 0.93 0.814 0.51 1.70
7313 Net, Trap and Line Fishing 44 1.25 0.198 0.89 1.76 12 0.91 0.766 0.49 1.70
75 Forestry and Logging 121 1.01 0.924 0.82 1.24 31 1.30 0.198 0.87 1.94
7510 Foremen/women 21 1.09 0.724 0.68 1.76 6 1.14 0.778 0.46 2.84
7513 Timber Cutting and Related 64 1.07 0.646 0.80 1.43 13 1.39 0.294 0.75 2.57
77 Mining and Quarrying 71 0.88 0.327 0.68 1.14 16 1.36 0.294 0.77 2.42
7717 Mineral Cutting, Handling and Loading 34 0.79 0.235 0.54 1.17 8 1.40 0.405 0.63 3.09
81/82 Materials Processing 54 0.78 0.096 0.58 1.05 74 1.02 0.881 0.79 1.32
813/814 Metal Processing and Related 18 0.82 0.435 0.50 1.35 5 0.96 0.933 0.37 2.50
821/822 Food, Beverage and Related Processing 47 1.31 0.113 0.94 1.83 12 1.03 0.926 0.55 1.92
8215 Slaughtering, Meat Cutting, Canning, Curing, Packing 25 1.29 0.259 0.83 2.01 11 1.55 0.221 0.77 3.13
823 Wood Processing (Non-Pulp and Paper Production) 132 1.13 0.247 0.92 1.39 41 1.28 0.173 0.90 1.83
8231 Sawmill Sawyers and Related 43 1.19 0.306 0.85 1.66 16 1.77 0.053 0.99 3.15
8238 Labouring 51 1.11 0.520 0.81 1.53 7 0.93 0.861 0.41 2.10
8239 Wood Processing, Non-Pulp and Paper, NEC 40 1.23 0.241 0.87 1.74 8 1.50 0.327 0.67 3.37
825 Pulp and Paper Production and Related 21 0.85 0.504 0.53 1.37 5 0.74 0.524 0.29 1.87
83 Machining and Related 117 1.05 0.650 0.85 1.30 31 0.73 0.106 0.50 1.07
831 Metal Machining 51 1.27 0.145 0.92 1.75 15 1.09 0.771 0.61 1.95
8313 Machinist and Machine Tool Setting-up 37 1.14 0.497 0.78 1.66 6 0.58 0.219 0.24 1.38
833 Metal Shaping and Forming, Except Machining 62 1.08 0.597 0.81 1.44 15 0.71 0.217 0.41 1.22
8335 Welding and Flame Cutting 36 0.99 0.957 0.69 1.42 7 0.49 0.081 0.22 1.09
85 Product Fabricating, Assembling and Repairing 274 1.05 0.508 0.91 1.21 114 1.08 0.487 0.87 1.34
853 Electrical, Electronic Equipment 56 1.36 0.506 1.00 1.85 13 0.69 0.219 0.38 1.25
8533 Electrical Equipment Installing, Repairing, NEC 33 1.38 0.111 0.93 2.05 8 0.80 0.554 0.38 1.68
854 Fabricating, Assembling and Repairing: Wood Products 23 1.30 0.269 0.82 2.07 9 2.29 0.045 1.02 5.15
8541 Cabinet and Wood Furniture Makers 15 1.48 0.195 0.82 2.68 6 2.51 0.063 0.95 6.64
858 Mechanics and Repairers, NEC 159 1.10 0.319 0.91 1.33 69 1.11 0.437 0.85 1.44
8581 Motor Vehicle Mechanics and Repairers 63 1.08 0.597 0.81 1.44 20 0.87 0.572 0.54 1.41
8582 Aircraft Mechanics and Repairers 24 1.35 0.211 0.84 2.16 5 1.15 0.783 0.43 3.10
8583 Rail Transport Equipment Mechanics and Repairers 11 3.84 <0.001 1.82 8.11 6 6.06 0.001 2.04 18.00
8584 Other Industrial Equipment Repairers 64 0.96 0.774 0.73 1.27 28 1.03 0.888 0.68 1.55
8589 Other Mechanics and Repairers, NEC 13 0.98 0.948 0.54 1.79 6 2.02 0.147 0.78 5.22
859 Other Product Fabrication, Assembling, Repairing 49 0.93 0.658 0.67 1.28 11 1.17 0.643 0.60 2.27
8592 Marine Craft Fabricating, Assembling, Repairing 36 1.01 0.958 0.70 1.46 9 1.65 0.198 0.77 3.54
87 Construction Trades 273 0.90 0.184 0.77 1.05 110 0.85 0.137 0.69 1.05
871 Excavating, Grading, Paving 63 0.94 0.671 0.71 1.25 15 0.66 0.130 0.39 1.13
8711 Excavating, Grading and Related 31 1.02 0.922 0.69 1.52 9 0.80 0.539 0.39 1.63
873 Electrical, Wire Communications Installing/Repair 42 1.03 0.867 0.73 1.46 18 1.00 0.999 0.60 1.71
8733 Electricians and Repairers 24 1.07 0.771 0.68 1.69 12 1.37 0.336 0.72 2.60
878/879 Other Construction Trade 112 0.84 0.116 0.68 1.04 50 0.85 0.319 0.62 1.17
8780 Foremen/women 20 0.92 0.728 0.58 1.47 6 0.96 0.927 0.40 2.31
8781 Carpenters and Related 70 0.86 0.260 0.66 1.12 27 0.80 0.303 0.52 1.22
8782 Brick and Stone Masons, Tile Setters 9 1.29 0.493 0.62 2.67 7 2.97 0.018 1.20 7.34
8791 Pipefitting, Plumbing and Related 27 0.99 0.964 0.64 1.52 17 1.20 0.499 0.71 2.04
8798 Labouring 44 0.94 0.717 0.67 1.31 5 0.75 0.550 0.29 1.93
8799 Other Construction Trade, NEC 10 0.80 0.507 0.41 1.55 5 1.79 0.256 0.66 4.89
91 Transport Equipment Operating 246 1.15 0.077 0.99 1.34 86 1.15 0.279 0.89 1.48
911 Air Transport 24 1.51 0.084 0.95 2.41 10 1.39 0.359 0.69 2.81
9111 Air Pilots, Navigators and Flight Engineers 16 1.29 0.368 0.74 2.25 7 1.24 0.618 0.53 2.89
913 Railway Transport 23 1.14 0.570 0.73 1.79 12 1.29 0.440 0.68 2.46
9131 Locomotive Operating 8 0.71 0.387 0.33 1.54 6 1.40 0.480 0.55 3.56
9133 Conductors and Brake Workers, Railway 13 1.79 0.073 0.95 3.38 6 2.05 0.146 0.78 5.40
915 Water Transport 51 1.17 0.325 0.86 1.60 16 1.17 0.573 0.68 2.02
9151 Deck Officers 13 0.88 0.678 0.48 1.61 6 0.94 0.890 0.39 2.26
9153 Engineering Officers, Ship 10 1.56 0.219 0.77 3.17 7 4.80 0.002 1.81 12.71
917 Motor Transport, Other Transport Equipment 157 1.10 0.319 0.91 1.33 46 1.01 0.952 0.73 1.40
9171 Bus Drivers 20 0.84 0.479 0.52 1.36 7 0.80 0.593 0.36 1.77
9173 Taxi Drivers and Chauffeurs 30 1.54 0.045 1.01 2.25 6 2.25 0.088 0.89 5.71
9175 Truck Drivers 124 1.08 0.460 0.88 1.33 32 0.93 0.716 0.63 1.38
93 Material Handling and Related, NEC 101 1.04 0.734 0.83 1.30 26 0.99 0.963 0.64 1.52
9313 Longshore Workers, Stevedores and Freight Handlers 48 1.13 0.462 0.82 1.57 16 1.33 0.320 0.76 2.33
9315 Material Handling Equipment Operators, NEC 21 0.93 0.759 0.59 1.48 5 0.94 0.896 0.37 2.39
95 Other Crafts and Equipment Operating 68 1.11 0.460 0.84 1.46 29 1.02 0.925 0.67 1.55
953 Stationary Engine, Utilities Equipment Operating 37 1.16 0.432 0.80
5
1.68 16 1.22 0.477 0.71 2.11
9539 Stationary Engine, Utility Equipment, NEC 25 1.03 0.892 0.67 1.58 12 1.18 0.612 0.62 2.24
955 Electronic Communications Equipment, NEC 19 1.46 0.158 0.86 2.47 9 1.75 0.159 0.80 3.82

Table 5.

Odds Ratios for ever and usual industries.

Code Industry Title Ever Usual

Case OR P value 95% CI Case OR P value 95% CI
01 Agriculture 296 0.90 0.184 0.77 1.05 87 1.00 0.999 0.78 1.31
011 Livestock Farms (except Animal Specialities) 72 1.13 0.377 0.86 1.48 22 1.53 0.085 0.94 2.48
0111 Dairy Farms 49 1.39 0.046 1.01 1.92 8 1.13 0.757 0.52 2.45
0112 Cattle Farms 13 0.88 0.678 0.48 1.61 6 1.33 0.556 0.52 3.43
0114 Poultry and Egg Farms 17 1.56 0.116 0.90 2.72 6 3.52 0.016 1.26 9.81
013 Field Crop Farms 49 0.96 0.806 0.69 1.33 9 0.98 0.958 0.46 2.09
0131 Wheat Farms 34 0.95 0.792 0.65 1.39 6 0.92 0.861 0.36 2.34
015 Fruit and Other Vegetable Farms 35 1.04 0.837 0.72 1.51 9 0.95 0.889 0.46 1.95
0151 Fruit Farms 32 1.04 0.844 0.71 1.54 9 1.07 0.856 0.52 2.22
017 Livestock, Field Crop, Horticultural Combination Farms 179 0.87 0.157 0.72 1.06 45 0.93 0.674 0.66 1.31
03 Fishing and Trapping 49 1.08 0.631 0.79 1.48 14 0.90 0.725 0.50 1.62
031 Fishing 46 1.15 0.410 0.83 1.60 13 0.91 0.758 0.50 1.66
0311 Salt Water Fishing 42 1.14 0.463 0.80 1.61 12 0.87 0.656 0.47 1.61
04 Logging 135 0.99 0.920 0.81 1.20 38 1.13 0.515 0.78 1.63
06 Mining 95 0.87 0.260 0.68 1.11 21 0.89 0.627 0.56 1.42
061 Metal Mines 71 0.83 0.181 0.63 1.09 17 0.90 0.693 0.53 1.52
0614 Silver-Lead-Zinc Mines 23 1.10 0.682 0.70 1.74 5 0.95 0.920 0.35 2.59
0631 Bituminous Coal Mines 28 1.08 0.719 0.71 1.64 5 1.25 0.662 0.46 3.40
10 Food 86 1.08 0.537 0.85 1.38 22 0.96 0.863 0.60 1.53
101 Meat and Poultry Products 18 0.92 0.748 0.55 1.53 5 0.73 0.514 0.28 1.88
1011 Meat and Meat Products (Except Poultry) 18 1.01 0.970 0.60 1.71 5 0.77 0.599 0.29 2.04
104 Dairy Products 21 1.34 0.239 0.82 2.18 8 2.02 0.091 0.90 4.56
1041 Fluid Milk 13 1.45 0.242 0.78 2.70 5 2.08 0.173 0.73 5.96
11 Beverage 13 1.24 0.482 0.68 2.26 6 2.25 0.084 0.90 5.64
113 Brewery Products 8 1.99 0.090 0.90 4.41 5 3.71 0.015 1.29 10.66
25 Wood 189 1.07 0.461 0.89 1.28 67 1.10 0.504 0.83 1.46
251 Sawmill, Planing Mill and Shingle Mill Products 153 1.02 0.838 0.84 1.23 56 1.15 0.370 0.85 1.56
2512 Sawmill, Planing Mill (Except Shingles and Shakes) 147 1.03 0.773 0.84 1.26 54 1.18 0.295 0.87 1.61
252 Veneer and Plywood 22 1.25 0.356 0.78 2.01 9 1.18 0.656 0.57 2.45
2522 Softwood Veneer and Plywood 20 1.43 0.161 0.87 2.36 9 1.55 0.248 0.74 3.26
26 Furniture and Fixtures 16 1.14 0.639 0.66 1.97 6 1.52 0.366 0.61 3.77
261 Household Furniture 14 1.19 0.569 0.65 2.17 5 1.46 0.450 0.55 3.907
27 Paper and Allied Products 49 0.89 0.451 0.66 1.21 19 0.81 0.393 0.50 1.31
271 Pulp and Paper Production 45 0.87 0.407 0.63 1.21 18 0.80 0.394 0.48 1.34
2711 Pulp Industry 35 0.79 0.210 0.55 1.14 16 0.87 0.617 0.50 1.50
28 Printing, Publishing and Allied 24 0.81 0.348 0.52 1.26 8 0.52 0.082 0.25 1.09
281 Commercial Printing 10 0.93 0.832 0.48 1.82 5 0.89 0.811 0.34 2.31
29 Primary Metal 48 0.77 0.106 0.56 1.06 16 0.78 0.358 0.46 1.33
299 Other Rolled, Cast, Extruded Non Ferrous Metal Products 24 0.92 0.717 0.59 1.45 10 0.98 0.954 0.49 1.95
30 Fabricated Metal Products(Non Machinery, Transport) 69 1.13 0.377 0.86 1.48 19 0.92 0.748 0.55 1.53
308 Machine Shops 28 1.49 0.068 0.97 2.29 6 1.18 0.715 0.49 2.87
31 Machinery (except Electrical) 28 1.63 0.025 1.07 2.50 8 1.57 0.262 0.71 3.46
319 Other Machinery and Equipment 24 1.82 0.012 1.14 2.90 8 1.86 0.135 0.83 4.20
3192 Construction, Mining Machinery, Materials Handling 7 1.88 0.146 0.80 4.41 5 3.66 0.023 1.19 11.22
32 Transportation Equipment 115 0.98 0.852 0.79 1.21 19 0.93 0.777 0.56 1.54
327 Shipbuilding and Repairs 73 0.95 0.705 0.73 1.24 12 1.01 0.975 0.54 1.88
33 Electrical and Electronic Products 21 1.23 0.401 0.76 1.99 6 0.95 0.907 0.40 2.25
36 Refined Petroleum and Coal Products 16 1.29 0.368 0.74 2.24 7 1.61 0.288 0.67 3.88
361 Refined Petroleum Products 13 1.17 0.615 0.63 2.16 7 1.61 0.297 0.66 3.94
3611 Refined Petroleum Products(Non Lubricating Oil, Grease) 13 1.17 0.615 0.63 2.16 7 1.61 0.297 0.66 3.94
37 Chemical and Chemical Products 31 1.42 0.091 0.95 2.13 10 1.15 0.695 0.57 2.31
40 Building, Developing and General Contracting 130 0.93 0.497 0.75 1.15 42 0.94 0.717 0.67 1.31
401 Residential Building and Development 29 0.93 0.728 0.62 1.40 8 1.00 0.999 0.46 2.23
4011 Single Family Housing 26 1.00 0.964 0.65 1.56 8 1.25 0.583 0.56 2.78
41 Industrial and Heavy Construction 53 0.78 0.096 0.58 1.05 15 0.72 0.228 0.42 1.23
412 Highway and Heavy Construction 44 0.82 0.243 0.59 1.14 13 0.78 0.400 0.44 1.39
4121 Highways, Streets and Bridges 29 0.93 0.728 0.62 1.40 9 0.99 0.978 0.48 2.39
42 Trade Contracting 109 0.90 0.342 0.72 1.12 48 0.90 0.514 0.66 1.23
422 Structural and Related Work 20 0.90 0.669 0.56 1.46 6 0.73 0.481 0.30 1.75
423 Exterior Close-In Work 14 1.18 0.582 0.66 2.13 8 1.79 0.150 0.81 3.96
4231 Exterior Close-In: Masonry Work 5 1.10 0.846 0.42 2.88 5 3.02 0.045 1.03 8.89
424 Plumbing, Heating, Air Conditioning Mechanical 23 1.18 0.484 0.74 1.88 12 1.07 0.834 0.57 2.01
4241 Plumbing 13 0.90 0.734 0.49 1.65 6 0.75 0.519 0.31 1.80
426 Electrical Work 23 1.26 0.334 0.79 2.01 10 1.48 0.285 0.72 3.04
427 Interior and Finishing Work 21 0.69 0.112 0.44 1.09 6 0.44 0.051 0.19 1.01
45 Transportation 282 1.21 0.011 1.05 1.40 106 1.08 0.513 0.86 1.36
451 Air Transport 24 1.26 0.320 0.80 1.99 12 1.07 0.834 0.57 2.01
4511 Scheduled Air Transport 16 0.96 0.882 0.56 1.65 10 1.03 0.933 0.52 2.04
453 Rail Transport and Related Service 78 1.10 0.459 0.86 1.42 35 1.17 0.419 0.80 1.71
4531 Railway Transport 77 1.10 0.459 0.86 1.42 34 1.16 0.449 0.79 1.70
454 Water Transport 54 1.36 0.051 1.00 1.85 9 0.70 0.316 0.35 1.41
4541 Freight and Passenger Water Transport 42 1.52 0.020 1.07 2.16 5 0.68 0.419 0.27 1.73
455 Services Incidental to Water Transport 25 1.46 0.109 0.92 2.32 11 1.33 0.413 0.67 2.63
4551 Marine Cargo Handling 15 1.24 0.458 0.70 2.19 10 1.54 0.232 0.76 3.13
456 Truck Transport 72 1.02 0.881 0.79 1.32 22 0.93 0.759 0.59 1.48
4561 General Freight Trucking 50 1.01 0.950 0.74 1.37 11 0.59 0.096 0.32 1.10
4562 Used Goods Moving and Storage 7 1.92 0.133 0.82 4.50 5 7.14 0.002 2.11 24.13
457 Public Passenger Transit Systems 26 0.91 0.659 0.60 1.38 8 0.83 0.629 0.39 1.77
4571 Urban Transit Systems 16 0.82 0.474 0.48 1.41 5 0.78 0.610 0.30 2.03
458 Other Transportation 28 1.58 0.038 1.03 2.43 5 1.90 0.209 0.70 5.17
4581 Taxicab 26 1.52 0.070 0.97 2.39 5 1.90 0.209 0.70 5.17
48 Communications 54 1.06 0.709 0.78 1.44 25 0.91 0.673 0.59 1.41
481 Telecommunication Broadcasting 9 1.30 0.486 0.62 2.72 5 1.55 0.398 0.56 4.29
4821 Telecommunication Carriers 26 1.33 0.203 0.86 2.06 13 1.16 0.629 0.64 2.12
484 Postal and Courier Services 20 0.79 0.354 0.48 1.30 7 0.53 0.122 0.24 1.18
4841 Postal Service 18 0.74 0.253 0.44 1.24 7 0.53 0.122 0.24 1.18
49 Other Utility 34 0.95 0.782 0.66 1.37 18 1.11 0.692 0.66 1.86
4911 Electric Power Systems 19 0.83 0.456 0.51 1.36 10 0.91 0.789 0.46 1.61
51 Petroleum Products, WH 15 0.87 0.631 0.49 1.54 6 0.74 0.492 0.31 1.75
521 Food, Beverage, Drug and Tobacco, WH 29 1.29 0.230 0.85 1.96 7 0.69 0.369 0.31 1.55
55 Motor Vehicle, Parts and Accessories, WH 15 1.40 0.256 0.78 2.50 7 2.92 0.019 1.20 7.13
56 Metal, Hardware, Plumbing, Heating, Building Material, WH 40 1.26 0.211 0.88 1.81 12 0.99 0.975 0.52 1.87
563 Lumber and Building Materials, WH 25 1.24 0.334 0.80 1.92 11 1.44 0.297 0.73 2.86
5631 Lumber, Plywood and Millwork, WH 15 1.37 0.278 0.78 2.42 5 1.23 0.679 0.46 3.28
57 Machinery, Equipment and Supplies, WH 45 1.23 0.223 0.88 1.72 19 1.24 0.406 0.75 2.06
579 Other Machinery, Equipment and Supplies, WH 12 0.99 0.975 0.53 1.83 5 1.26 0.639 0.48 3.31
59 Other Products, WH 25 0.87 0.519 0.57 1.33 6 0.68 0.380 0.29 1.61
60 Food, Beverage and Drugs, Retail 55 0.85 0.291 0.63 1.15 23 1.01 0.966 0.64 1.59
601 Food Stores 48 0.92 0.597 0.68 1.25 19 1.15 0.591 0.69 1.91
6011 Groceries Food Stores 29 0.79 0.260 0.52 1.19 8 0.68 0.319 0.32 1.45
6012 Specialty Food Stores 23 1.29 0.288 0.81 2.06 10 2.58 0.023 1.14 5.84
62 Household Furniture, Appliances, Furnishing, Retail 22 0.98 0.933 0.61 1.57 5 0.59 0.267 0.23 1.50
63 Auto Vehicle, Parts, Accessories, Sale and Service 86 0.95 0.688 0.74 1.22 28 0.81 0.324 0.53 1.23
631 Automobile Dealers 23 1.17 0.497 0.74 1.84 11 1.40 0.333 0.71 2.77
6311 Automobile (New) Dealers 23 1.25 0.341 0.79 1.98 11 1.52 0.227 0.77 3.00
635 Motor Vehicle Repair Shops 48 0.96 0.806 0.69 1.33 13 0.72 0.273 0.40 1.30
6351 Motor Vehicle Repair Garages (General Repairs) 42 0.97 0.860 0.69 1.36 8 0.50 0.064 0.24 1.04
64 General Retail Merchandising 43 0.83 0.266 0.60 1.15 16 0.90 0.704 0.52 1.55
641 General Merchandise Stores 43 0.83 0.266 0.60 1.15 16 0.90 0.704 0.52 1.55
6411 Department Stores 36 0.91 0.612 0.63 1.31 14 1.02 0.948 0.56 1.85
65 Other Retail Stores 36 0.93 0.703 0.64 1.35 9 0.64 0.202 0.32 1.27
70 Deposit Accepting Intermediaries 19 0.72 0.183 0.44 1.17 11 0.98 0.953 0.50 1.91
702 Chartered Banks, Other Banking-Type Intermediaries 14 0.64 0.118 0.37 1.12 8 0.92 0.828 0.43 1.95
7021 Chartered Banks 13 0.66 0.172 0.36 1.20 7 0.87 0.737 0.39 1.96
73 Insurance Underwriters 27 1.63 0.032 1.04 2.55 9 1.12 0.759 0.54 2.31
733 Property and Casualty Insurers 14 1.46 0.219 0.80 2.67 7 1.51 0.342 0.65 3.53
7339 Other Property and Casualty Insurers 13 1.38 0.309 0.74 2.57 6 1.25 0.633 0.50 3.12
76 Insurance and Real Estate Agencies 54 1.26 0.146 0.92 1.72 26 1.67 0.024 1.07 2.60
77 Business Services 79 1.09 0.508 0.85 1.41 30 1.03 0.888 0.68 1.55
773 Accounting and Bookkeeping Services 10 0.82 0.572 0.41 1.63 5 0.98 0.968 0.37 2.62
775 Architectural, Engineering and Other Services 37 1.17 0.402 0.81 1.69 14 0.97 0.920 0.54 1.75
7752 Offices of Engineers 20 1.20 0.473 0.73 1.98 6 0.75 0.519 0.31 1.80
7759 Other Scientific and Technical Services 16 1.14 0.639 0.66 1.97 6 1.21 0.684 0.48 3.03
81 Federal Government Services 348 1.12 0.131 0.97 1.30 86 1.24 0.099 0.97 1.58
811 Defence Services 316 1.11 0.168 0.96 1.29 66 1.41 0.018 1.06 1.88
815 General Administrative Service 17 1.00 0.971 0.59 1.74 6 0.70 0.417 0.30 1.66
817 Economic Service Administration 9 0.58 0.132 0.29 1.18 6 0.83 0.675 0.35 1.98
82 Provincial and Territorial Government Services 45 1.11 0.538 0.80 1.55 20 1.24 0.406 0.75 2.06
822 Protective Services 15 1.09 0.764 0.62 1.91 6 1.12 0.803 0.46 2.73
826 Human Resource Administration 10 2.34 0.024 1.11 4.89 7 4.72 0.002 1.79 12.46
83 Local Government Services 33 0.84 0.345 0.59 1.20 18 0.96 0.878 0.57 1.62
8323 Police Services 8 1.17 0.692 0.54 2.54 6 1.85 0.193 0.73 4.67
8324 Firefighting Services 9 1.50 0.289 0.71 2.17 7 1.83 0.168 0.78 4.32
85 Educational Services 88 1.05 0.704 0.82 1.35 48 1.01 0.952 0.73 1.40
851 Elementary and Secondary Education 63 1.08 0.597 0.81 1.44 33 1.02 0.919 0.70 1.50
853 University Education 21 1.17 0.524 0.72 1.90 11 1.07 0.843 0.55 2.09
86 Health and Social Services 55 0.98 0.896 0.72 1.33 28 0.98 0.925 0.65 1.49
861 Hospitals 24 0.75 0.196 0.49 1.16 9 0.64 0.224 0.31 1.31
8611 General Hospitals 18 0.68 0.124 0.42 1.11 6 0.47 0.082 0.20 1.10
865 Offices: Physicians, Surgeons and Dentists, Private 15 1.31 0.368 0.73 2.36 13 1.27 0.455 0.68 2.38
8651 Offices: Physicians, General Practice 7 1.48 0.371 0.63 3.49 6 1.57 0.341 0.62 3.98
91 Accommodation Services 48 0.91 0.554 0.67 1.24 15 1.39 0.259 0.78 2.46
911 Hotels, Motels and Tourist Courts 46 0.95 0.749 0.69 1.30 13 1.26 0.464 0.68 2.34
9111 Hotels and Motor Hotels 35 0.88 0.488 0.61 1.26 9 1.09 0.812 0.54 2.22
96 Amusement and Recreational Services 27 0.97 0.888 0.64 1.48 6 0.97 0.946 0.40 2.36
97 Personal and Household Services 19 0.85 0.522 0.52 1.40 9 0.93 0.843 0.46 1.90
98 Membership Organizations 39 1.57 0.017 1.08 2.28 16 1.78 0.058 0.98 3.23
981 Religious Organizations 15 1.17 0.595 0.66 2.09 8 1.20 0.658 0.54 2.69
99 Other Services 27 0.65 0.040 0.43 0.98 8 0.69 0.327 0.33 1.45

3.1. Usual Occupation (Table 4)

In the usual occupation category, significant excess risk in the major occupation groups (two-digit codes) was only observed at P = 0.10 for occupations in social sciences and related (SOC 23). Excess risks for minor groups (three-digit codes) were significant at P = 0.05 for occupations in fabricating, assembling and repairing wood products (SOC 854) and at P = 0.10 for occupations in other managers and administrators (SOC 113/114), bookkeeping and account-recording (SOC 413), and lodging and other accommodation services (SOC 613). Several unit occupations (four-digit codes) had significantly increased ORs at P = 0.05 for: insurance sales jobs (SOC 5171), rail transport equipment mechanics and repairers (SOC 8583), brick and stone masons-tile setters (SOC 8782), ship engineering officers (SOC 9153), and at P = 0.10 for: administrators in teaching and related fields (SOC 1133), financial management (SOC 1135), livestock farm workers (SOC 7183), sawmill sawyers and related (SOC 8231), cabinet and wood furniture makers (SOC 8541), and taxi drivers and chauffeurs (SOC 9173); the ORs were significantly low at P = 0.10 for sales clerks and salespersons in commodities, not else classified (SOC 5135) and welding and flame cutting (SOC 8335).

3.2. Usual Industry (Table 5)

In the usual industry category, a significant excess risk in the major industry group was noted at P = 0.05 for motor vehicle, parts and accessories, wholesale (SIC 55) and insurance and real estate agencies (SIC 76) and at P = 0.10 for beverage (SIC 11), federal government services (SIC 81) and membership organizations (SIC 98); ORs for printing, publishing and allied (SIC 28) industry was low at P = 0.10. Excess risks were significant at P = 0.05 for the following minor industry groups (three-digit codes): brewery products (SIC 113), defense services (SIC 811), and human resource administration (SIC 826) and at P = 0.10 for livestock farms (except animal specialties) (SIC 011), and dairy products (SIC 104). Odds ratio was significantly low at P = 0.10 for interior and finishing work (SIC 427). Several industry classes (four-digit codes) had significantly increased ORs at P = 0.05 for poultry and egg farms (SIC 0114), construction, mining machinery, materials handling (SIC 3192), exterior close-in: masonry work (SIC 4231), used goods moving and storage (SIC 4562), and specialty food stores (SIC 6012). ORs were significantly low at P = 0.10 for general freight trucking (SIC 4561), motor vehicle repair garages (general repairs) (SIC 6351) and general hospitals (SIC 8611).

In the validation study of the questionnaire, company job records of 81 individuals who reported having been employed in one of two large companies in BC were compared with information from their questionnaire; and the interclass correlation was 0.996 for starting year of employment and 0.971 for duration of employment.

4. Discussion

Significant associations between colon cancer and a number of occupations and industries were observed in our study. Several sedentary occupations in management, administration, bookkeeping and recording, financial management, insurance and real estate, and lodging and accommodation showed significantly increased risk of colon cancer either at P = 0.05 or at P = 0.10, which are consistent with findings from the previous studies [2529].

In this study, we found some occupations and industries with significantly elevated risks of colon cancer in both ever and usual employment categories: workers working in occupations or industries with low physical activity, including insurance sales, human resource administration and membership organizations; rail transport equipment mechanics and repairers who were exposed to asbestos that has been reported to be associated with a higher risk of colon cancer; taxi drivers/chauffeurs who were exposed to engine exhaust and diesel engine emissions, a known carcinogen for colon cancer [21]; workers working in brewery products with exposure to chemicals such as ammonia refrigerant. Ammonia, potentially toxic to cells, shortens cell life span and alters DNA synthesis in various tissues including the ileum and colon [39] and is also thought to promote colon carcinogenesis in rats [40].

Elevated colon risks were also found in usual employment categories for occupations in wood products fabricating, assembling and repairing with exposure to wood dusts, a controversial agent without sufficient evidence of the association by the International Agency of Research on Cancer by far; industries of poultry and egg farms with exposure to gaseous agents such as ammonia from litter, carbon monoxide from poorly ventilated gas-fired heaters and hydrogen sulphide from liquid manure. Also, particles of organic or agricultural dust are aerosolized from poultry house litter; livestock farms (except animal specialties) and dairy products and relevant occupations with exposure to noxious gases such as hydrogen sulfide, and ammonia and methane in the ambient barn air; sawmill sawyers and workers working in motor vehicle parts and accessory wholesale and truck transportation on used goods, with exposure to engine exhaust and diesel engine emissions [21]; workers in construction, mining machinery material handling, brick and stone masons-tile setters as well as exterior close-in masonry work, with exposure to asbestos, which was widely used prior to 1978 in many building projects to increase the strength of concrete; ship engineering officers who were exposed to exhaust gases, engine emissions and asbestos; and workers in beverage industry with exposure to chemicals in gases and vapors typically involving chemical-handling activities related to cleaning operations, disinfection of process areas and use of preservatives in long-term food storage, in addition to thermal oils in the maintenance of heating and ammonia in cooling systems.

The strengths of this study are several folds. It is population-based with ascertainment of pathology confirmed cancer incident cases and includes lifetime occupational history with the ability to control for potential confounding factors and effect modifiers. Our study has revealed a number of occupational risk factors for colon cancer. Interpretation of those findings is limited by the lack of information on occupational exposures and the possibility that statistically significant results may have occurred by chance because of multiple comparisons; also, especially for many usual occupations and industries, numbers are few. In addition, other cancer cases used as controls may not be representative of the general population. Particularly, other cancers may also have some occupational risks that are common to those of colon cancer cases; in such situation, the corresponding estimated OR’s noted in this study would underestimate the true risks. A missing value category was used in the analysis to avoid reducing the study sample size and that may yield biased results. However, since the proportion of missing data is small and it is unlikely that missing information on education and smoking is correlated with job classification, the biases if any should be relatively small. Some of the confounding factors such as measures of body-mass index and physical activities were not collected for this study. Nevertheless, our validation study demonstrates that self-reported employment history bear little recall errors in out study.

Some of the risks observed may not apply to current workers because of a potential decrease in industrial exposures. However, the results of our study are in line such as elevated colon cancer risk by exposure to asbestos and to engine exhaust and diesel engine emissions from the literature and further suggest that exposure to wood dusts and to ammonia may carry an increased risk of colon cancer. More specific studies using population controls are needed to investigate associations between occupation and exposures to chemical substances, taking into account changes in concentration levels over time.

Acknowledgements

The research was partially supported by grants from the Workers’ Compensation of British Columbia and the National Health Research and Development Program, Health Canada. We gratefully acknowledge the invaluable contribution of the research assistants, Ms. Donna Kan and Ms. Barbara Jamieson. Finally, the authors would like to thank two anonymous reviewers and a guest editor who provided thoughtful and insightful comments that helped to improve this article.

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