Table 1.
Occupation and Pancreatic Cancer: Selected Publications by Exposure and Publication Year
| Occupational exposure category | Refs. | Study design (location) | Study subjects | Occupational exposures | Results |
|---|---|---|---|---|---|
| Chlorinated hydrocarbon compounds | |||||
| Ojajärvi et al. [3] | Meta analysis, 1969–1998 (Asia, Europe, North America) | 20 populations | Chlorinated hydrocarbon solvents and related compoundsa | MRR = 1.4, 1.0–1.8 | |
| Ojajärvi et al. [5] | Meta analysis of chlorinated hydrocarbon solvent exposures, 1969–1998 (Asia, Europe, North America) | 5 populations | Trichlorothylenea | MRR = 1.24, 0.79–1.97 | |
| 5 populations | Polychlorinated biphenyls (PCB)a | MRR = 1.37, 0.56–3.31 | |||
| 4 populations | Methylene chloridea | MRR = 1.42, 0.80–2.53 | |||
| 4 populations | Vinyl and polyvinal chloridea | MRR = 1.17, 0.71–1.91 | |||
| 2 populations | Carbon tetrachloridea | MRR = 0.9, 0.2–2.6 | |||
| 6 populations | Metal degreasingb | MRR = 2.0, 1.2–3.6 | |||
| 8 populations | Laundry and dry cleaningb | MRR = 1.4, 1.1–2.4 | |||
| Ojajärvi et al. [6] | Meta analysis using hierarchical Bayesian methods, 1969–1998 (Asia, Europe, North America) | 20 populations | Chlorinated hydrocarbon solvents and related compoundsa | MRR = 2.21, 1.31–3.68 | |
| 6 populations | Metal-plating workersb | MRR = 2.11, 1.33–3.35 | |||
| 8 populations | Laundry and dry cleaningb | MRR = 1.4, 1.12–1.75 | |||
| Santibañez et al. [7] | Hospital-based case–control (Eastern Spain) | 161 cases, 455 controls | Chlorinated hydrocarbon solventsa | All pancreatic cancer: OR = 1.99, 0.62–6.42; Ductal adenocarcinoma: OR = 4.1, 1.11–15.23, P-trend = 0.04 | |
| Organochlorines | |||||
| Garabrant et al. [9] | Nested case–control in cohort of chemical manufacturing workers (US) | 28 cases, 112 controls | DDT; DDE; ethylanb | OR = 4.8, 1.3–17.6; OR = 4.3; OR = 5.0 |
|
| Fryzek et al. [11] | Population-based case–control (Southeastern Michigan) | 66 cases, 131 controls | Any organochlorinec; DDTc | OR = 1.5, 0.8–2.9; OR = 1.6, 0.8–3.1 | |
| Porta et al. [13] | Hospital-based case–control (Eastern Spain) | 51 cases (34 with K-ras mutation, 17 wild-type), 26 controls | Serum concentration of DDT and DDEd | DDE cases vs. controls: OR = 5.6, 1.3–24.6, P-trend = 0.025; DDE k-ras cases vs. controls: OR = 10.5, 1.9–59.3, P-trend = 0.007; DDT K-ras vs. wild-type cases: OR = 8.7, 1.6–48.5, P-trend = 0.005; DDE K-ras vs. wild-type cases: OR = 5.3, 1.1–25.2, P-trend = 0.03 | |
| Ojajärvi et al. [3] | Meta analysis, 1969–1998 (Asia, Europe, North America) | 3 populations | Organochlorine insecticidesa | MRR = 1.5, 0.6–3.7 | |
| Hoppin et al. [14] | Population-based case–control (San Francisco) | 108 cases, 82 controls | Serum levels of DDE, PCB, HCB, trans-nonachlord | Median levels of DDE, PCB, and trans-nonachlor were significantly elevated (P < 0.5) in cases compared to controls | |
| Beard et al. [12] | Cohort of outdoor insecticide applicators compared to non-pesticide workers (Australia) | DDT: 394 exposed, 185 unexposed; 8 cases, 2 controls | DDTb | Serum level of DDT five times that of non-exposed; SMR = 1.98, 0.79–4.07 | |
| Cocco et al. [16] | Cohort of antimalarial operation workers (Sardina, Italy) | DDT: 464 exposed, 4088 unexposed; 13 cases, 9 controls | DDTa | SMR = 79, 45–139; mortality RR = 0.8, 0.3–1.9 | |
| Andreotti et al. [17] | Nested case–control of pesticide applicators (Iowa, North Carolina) | 64 cases, 52 000 controls | DDTb | OR = 0.4, 0.2–0.9 based on 6 cases | |
| Bosch deBasea et al. [15] | Cross-sectional analysis of cases from a hospital-based case–control (Eastern Spain) | 135 exocrine pancreatic cancer cases | Serum concentrations of DDT, DDE, PCBs, HCB, HCHd | Median levels of PCBs significantly higher in cases whose last occupation included craftsman, manufacturing, construction, mining compared to cases in other occupations (P ≤ 0.005) | |
| Other pesticides | |||||
| Forastiere et al. [18] | Population-based case–control (central Italy) | 37 cases, 29 controls | Farmingb | Licensed farmers for >10 yr: OR = 3.78, 1.24–11.0 compared to non-farmers | |
| Kauppinen et al. [19] | Population-based case–control (Finland) | 595 cases, 1622 controls | Pesticidesa | OR = 1.7, 0.8–3.4 | |
| Cantor and Silberman [20] | Nested case–control in cohort of aerial pesticide applicators and flight instructors (US) | 9961 aerial pesticide applicators; 9969 flight instructors; 22 cases, 8 controls | Pesticide applicationb | Mortality RR = 2.71, 1.4–5.3 | |
| Alguacil et al. [21] | Hospital-based case–control (Eastern Spain) | 185 cases, 264 controls | Pesticide usea | Arsenical pesticides: OR = 3.4, 0.9–12; Other pesticides: OR = 3.17, 1.1–9.2 | |
| Ji et al. [23] | Population-based case–control (US) | 484 cases, 2095 controls | Pesticide usea | P-trend for increasing level of exposure = 0.01 | |
| Lo et al. [22] | Hospital-based case–control (East Nile Delta region of Egypt) | 129 cases, 194 controls | Pesticide and natural fertilizer exposurec | Pesticide: OR = 2.6, 0.97–7.2; natural fertilizer: OR = 0.1, 0.1–0.4 | |
| Andreotti et al. [17] | Nested case–control in cohort of pesticide applicators (Iowa, North Carolina) | 64 cases, 52 000 controls | Ever use of 24 pesticidesc | Pendimethalin: OR = 3.0, 1.3–7.2; EPTC: OR = 2.56, 1.1–5.4 | |
| Polycyclic aromatic hydrocarbons (PAHs) | |||||
| Ojajärvi et al. [3] | Meta analysis, 1969–1998 (Asia, Europe, North America) | 4 populations | Polycyclic aromatic hydrocarbonsa | MRR = 1.5, 0.9–2.5 | |
| Kauppinen et al. [28] | Cohort of road paving workers (Finland) | 9643 workers | Bitumen work (6 cases)a construction work (9 cases)b | SMR = 2.39, 0.88–5.21; SIR 1.52, 0.56–3.31 SMR = 2.35, 1.08– 4.47 |
|
| Ojajärvi et al. [3] | Meta analysis using hierarchical Bayesian methods, 1969–1998 (Asia, Europe, North America) | 20 populations | Polycyclic aromatic hydrocarbonsa | MRR = 1.14, 0.89–1.45 | |
| Aluminum production | |||||
| Rønneberg et al. [29] | Cohort of aluminum smelter workers (Norway) | 2647 short-term workers, 10 cases; 2888 production workers, 12 cases; 373 maintenance workers, 1 case | PAH from aluminum workb | P-trend for cumulative PAH exposure = 0.13 | |
| Romundstad et al. [30] | Cohort of aluminum plant workers (Norway) | 11 103 workers; 46 cases | PAH from aluminum workb | SIR = 0.9, 0.7–1.2; P-trend for cumulative PAH exposure = 0.08 | |
| Romundstad et al. [31] | Cohort of aluminum reduction workers (Norway) | 5627 workers; 13 cases | PAH from aluminum workb | SIR = 1.13, 0.6–1.94 for more than 3 yr employment | |
| Carta et al. [32] | Cohort of prebake aluminum smelter workers (Sardina, Italy) | 1152 workers; 6 cases | PAH from aluminum workb | SMR = 2.4, 1.1–5.2; SMR for anodes workers = 5.0, 2.1–12.1 (4 deaths) | |
| Gibbs and Sevigny [33] | Cohort of aluminum smelter workers (Quebec, Canada) | 1421 workers; 11 cases | Aluminum reductionb | SIR = 259, 129–463 | |
| Diesel exhaust | |||||
| Ojajärvi et al. [3] | Meta analysis, 1969–1998 (Asia, Europe, North America) | 7 populations | Diesel engine exhausta | MRR = 1.0, 0.9–1.2 | |
| Boffetta et al. [35] | Cohort of Swedish population using Swedish Cancer Environment Register (Sweden) | 1859 male cases, 47 female cases | Diesel exhausta | SIRmen = 1.05, 1.00–1.10; SIR women: 1.09, 0.90–1.45 | |
| Santibañez et al. [7] | Hospital-based case–control (Eastern Spain) | 161 cases, 455 controls | Diesel engine exhausta | All pancreatic cancer: OR = 1.88, 0.72–4.90; Ductal adenocarcinoma of pancreas: OR = 2.08, 0.58–7.38 | |
| Metal | |||||
| Ojajärvi et al. [3] | Meta analysis, 1969–1998 (Asia, Europe, North America) | 4 populations | Nickel and related compoundsa | MRR = 1.9, 1.2–3.2 | |
| 9 populations | Chromium and related compoundsa | MRR = 1.9, 0.9–2.3 | |||
| Alguacil et al. [39] | Hospital-based case–control (Eastern Spain) | 164 cases, 238 controls | Metal-related jobsb | OR = 3.3, 0.5–2.1 | |
| Eisen et al. [38] | Cohort of automobile manufacturing workers (Michigan) | 46 399 workers; 66 cases | Metalworking fluidsb | SMR = 1.44, 1.11–1.83 | |
| Alguacil et al. [40] | Nested case–control in cohort of Swedish workers (Sweden) | 4420 male cases, 2143 female cases | Metal processing workb | RR = 1.94, 1.12–3.34 based on 13 cases | |
| Weiderpass et al. [42] | Cohort of female workers based on Population Census of Finland (Finland) | 413 877 workers, 1302 cases | Chromiuma | RR = 1.8, 1.04–3.12; P trend = 0.01 | |
| Kriegel et al. [46] | Hospital-based case–control (East Nile Delta region of Egypt) | 31 cases, 52 controls | Serum levels of cadmiumd; Farminga | OR = 1.12, 1.04–1.23, P trend = 0.0089; OR = 3.25, 1.03–11.64 | |
| Nitrosamines | |||||
| Li and Yu [53] | Nested case–control in rubber industry workers (China) | 9 cases, 36 controls | Rubber tire curingb | OR = 9.28, 1.00–86.1 | |
| Ionizing radiation | |||||
| Kauppinen et al. [19] | Population-based case–control (Finland) | 595 cases, 1622 controls | Ionizing radiationa | OR = 4.3, 1.6–11.4 | |
| Zielinski et al. [56] | Cohort of nuclear, industrial, medical and dental workers using National Dose Registry of Canada (Canada) | 200 000 workers | Measured ionizing radiationb | Excess RR per 1 Sv = 9.2, 0.1–36.8 | |
| Santibañez et al. [7] | Hospital-based case–control (Eastern Spain) | 161 cases, 455 controls | Ionizing radiationa | OR = 4.73, 0.72–30.88 | |
| Airborne particles | |||||
| Ojajärvi et al. [3] | Meta analysis, 1969–1998 (Asia, Europe, North Americao | 3 populations | Silica dusta | MRR = 1.4, 0.9–2.0 | |
| 4 populations | Wood dusta | MRR = 1.1, 0.8–1.5 | |||
| 1 population | Flour dusta | MRR = 1.1, 0.3–3.2 | |||
| 5 populations | Man-made vitreous fibersa | MRR = 1.0, 0.6–1.6 | |||
| 24 populations | Asbestosa | MRR = 1.1, 0.9–1.5 | |||
| Li et al. [58] | Nested case–control in cohort of female textile industry workers (Shanghai, China) | 267 400 workers; 180 cases, 3183 controls | Cotton dusta | HR for 20 yr lag between exposure and diagnosis = 0.6, 0.3–0.9, P-trend = 0.006 | |
| Birk et al. [57] | Cohort of porcelain and fine ceramic manufacturing workers (Germany) | 17 644 workers, 33 cases | Silicaa | SMR = 1.71, 1.18–2.41 | |
| Sedentary occupations | |||||
| Bao and Michaud [59] | Meta-analysis | 3 studies: Isaksson 2002, Stolzenber-Solomon 2002, Berrington 2006 | Occupational physical activityc | RR = 0.75, 0.58–0.96 | |
| O’Rorke et al. [60] | Meta-analysis | 4 studies: Paffenbarger 1987, Isaksson 2002, Stolzenber-Solomon 2002, Berrington 2006 | Occupational physical activity | Crude RR = 0.75, 0.59–0.95; BMI adjusted RR = 0.98, 0.71–1.35; smoking adjusted RR = 0.75, 0.59–0.96 |
RR, risk ratio; OR, odds ratio; MRR, meta-risk ratio; SMR, standardized mortality ratio; SIR, standardized incidence ratio; HR, Hazard ratio; BMI, body mass index.
a
Exposure agent based on job exposure matrix (JEM-based).
b
Based on job or job title.
c
Self-reported exposure.
d
Measured in biological sample.