Occupational exposures and risk of pancreatic cancer

Miguel Santibañez (1, 2) , Jesús Vioque (2, 3) , Juan Alguacil (3, 4) , Manuela García Hera (3, 2) , Eduardo Moreno-Osset (5) , Alfredo Carrato (6) , Miquel Porta (3, 7, 8) , Timo Kauppinen (9)

1 Research Support Unit
2 Departamento de Salud Pública
3 CIBER de Epidemiología y Salud Pública (CIBERESP)
4 Departamento de Biología Ambiental y Salud Pública
5 Servicio de Medicina Digestiva, Hospital Universitario Dr. Peset
6 Servicio de Oncología Médica
7 IMIM-Hospital del Mar
8 UAB - Universitat Autònoma de Barcelona = Autonomous University of Barcelona = Universidad Autónoma de Barcelona
9 Finnish Institute of Occupational Health

The objective was to analyze the relationship between occupation (and specific occupational exposures) and risk of exocrine pancreatic cancer (EPC). We conducted a multicenter hospital-based case-control study in Eastern Spain. We included 161 incident cases of EPC (59.6% men, 94 with histological confirmation, of whom 80% had ductal adenocarcinoma). Cases were frequency-matched with 455 controls by sex, age and province of residence. Information was elicited using structured questionnaires. Occupations were coded according to the Spanish version of the International Standard Classification of Occupations 1988. Occupational exposure to a selection of carcinogenic substances was assessed with the Finnish Job-Exposure Matrix (FINJEM). Odds ratios (OR) and 95% confidence intervals (CI) were estimated by multiple logistic regression, adjusting for sex, age, province, education, alcohol and smoking. A higher risk of EPC was associated with having worked as 'Miners, shotfirers, stone cutters and carvers', 'Machinery mechanics and fitters', 'Building trades workers' and 'Motor vehicle drivers' in men, 'Office Clerks' in women, and 'Waiters' in both sexes. Cases with ductal adenocarcinomas were more likely to have been exposed to chlorinated hydrocarbon solvents (OR = 4.1, 95% CI: 1.1-15.2, -trend = 0.04). We also observed significant associations with exposure to 'synthetic polymer dust exposure' and 'ionizing radiation'. Suggestive increases in risk were observed for 'pesticides', 'diesel and gasoline engine exhaust', and 'hydrocarbon solvents'. Results support the hypothesis that occupational exposure to chlorinated hydrocarbon solvents is associated with exocrine pancreatic cancer.

Mots clés: Chlorinated hydrocarbons; Occupation; Occupational exposures; Pancreatic neoplasms

Miguel Santibañez, Jesús Vioque, Juan Alguacil, Manuela García Hera, Eduardo Moreno-Osset, et al.. Occupational exposures and risk of pancreatic cancer. European Journal of Epidemiology, 2010, 25 (10), pp.721-730. ⟨10.1007/s10654-010-9490-0⟩. ⟨hal-00608998⟩