Occupational Exposures and Esophageal Cancer: Prog Study

Our plain-English summary of Occupational Exposures and Esophageal Cancer: Prog Study, by A. Gressier, G. Gourier, J.P. Metges, et al (International Journal of Environmental Research and Public Health, 2022).

The study

• Authors: A. Gressier, G. Gourier, J.P. Metges, J.D. Dewitte, B. Loddé, D. Lucas
• Journal: International Journal of Environmental Research and Public Health
• Published: 2022;19(16)
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Esophageal cancer is the sixth most common cause of cancer death worldwide. In France, Brittany is one of the regions most seriously affected. This increased incidence is usually linked to high rates of alcohol overconsumption and smoking, established risk factors for esophageal cancer, but the region has special occupational exposures. We aim to describe the occupational exposures of patients with esophageal cancer. Between June and October 2020, we conducted a monocentric descriptive study in a French Teaching Hospital and identified 37 eligible patients. We gathered data through a systematic individual interview for each participant and by an analysis of their medical file. We were able to include 36 patients; most were men (n = 27, 75.0%) and smokers (n = 25, 69.4%), 21 (58.3%) presented an adenocarcinoma esophageal cancer, 13 (36.1%) a squamous cell cancer, and 2 other types. On occupational exposure, patients declared respectively high exposure by manipulating asbestos materials for 11 (30.6%) patients, regularly in contact with benzene by handling fuel in 7 cases (19.4%), chlorinated solvents in 4 cases (11.1%), pesticides in 4 cases, and ionizing radiation exposure in 3 patients (8.3%). Our findings support the creation of a large-scale study to explore the impact of occupational exposures, particularly exposure to asbestos and hydrocarbons.

In plain English

This pilot study, published as a short communication, described the job histories and workplace exposures of 36 adults with esophageal cancer followed by the medical oncology team at one teaching hospital in Brest, Brittany, France, in 2020. A trained occupational medicine resident interviewed each patient with a questionnaire and reviewed their medical file. Most patients were men (27) and smokers (25). Twenty-one had adenocarcinoma and 13 had squamous cell cancer. Eleven patients (30.6%) reported high exposure from handling asbestos materials without protective equipment, as electricians, mechanics, boilermakers or farmers. Their mean period of exposure was 12.6 years, and the mean time from the end of exposure to diagnosis was estimated as 23.7 years. Twenty (55.6%) reported environmental exposure in workplaces built with asbestos. Seven had regular contact with benzene from handling fuel. The article did not name asbestos fiber types. There was no comparison group, and exposures rested on patients' recall, so the study could not test whether any exposure raised cancer risk. The authors concluded that their findings support a large-scale study of occupational exposures, particularly asbestos and hydrocarbons.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Single-hospital (monocentric) prospective descriptive pilot study based on interviews and medical file review, with no control group and no statistical comparisons
• Who was studied: 36 adults with histologically confirmed esophageal cancer followed by the medical oncology team at a teaching hospital in Brest, Brittany, France, from June to November 2020. Thirty-seven were eligible and one declined. There were 27 men; 25 were smokers. Twenty-one had adenocarcinoma, 13 had squamous cell cancer, and 2 had other types.
• Exposure: Self-reported occupational exposures recorded by questionnaire for jobs lasting at least 6 months: asbestos (high exposure from handling asbestos materials, or environmental exposure in asbestos-built workplaces), hydrocarbons including benzene in fuel, aromatic amines, chlorinated solvents, sulfuric acid, pesticides and ionizing radiation. No asbestos fiber types were named.
• Main results:
  • 11 of 36 patients (30.6%) had been highly exposed to asbestos by handling asbestos materials without personal protective equipment, as electricians, mechanics, boilermakers or farmers
  • Among the 11 highly exposed patients, the mean period of asbestos exposure was 12.6 years, and the mean latency between the end of exposure and diagnosis was estimated as 23.7 years
  • 20 patients (55.6%) declared environmental asbestos exposure, specifically in workplaces built using asbestos. The table lists 5 (13.8%) with no asbestos exposure.
  • 7 patients (19.4%) had regularly come into contact with benzene by handling fuel at work, for example as mechanics and boilermakers
  • 4 patients (11.1%) used chlorinated solvents for cleaning and degreasing
  • 4 patients (11.1%) declared handling pesticides, including two farmers with regular exposure
  • 4 patients (11.1%) had radiation exposure, all in the military nuclear field
  • Of the 36 patients, 27 (75.0%) were men, 25 (69.4%) were smokers, and 16 (44.4%) were regular consumers of alcohol
• The authors' conclusion: The authors concluded that their findings support creating a large-scale study to explore the impact of occupational exposures, particularly asbestos and hydrocarbons
• Limitations the authors state:
  • Selection bias, because the study included a small group of 36 patients over a limited period
  • Recall bias, because results came from interviewing patients, most of them retired, rather than from measurements of exposure
  • No control group
  • Too few participants to make comparative statistical tests
  • The authors stated the findings do not prove that the exposures highlighted are causally associated with esophageal cancer

Topics

The National Library of Medicine indexes this study under subjects our site covers: Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Esophageal Cancer, Adenocarcinoma, Squamous Cell.

Related studies

• Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers — C. Jansson, A.L. Johansson, et al. (2005)
• Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study — N.S. Offermans, R. Vermeulen, et al. (2014)
• Occupational exposures and risk of oesophageal cancer by histological type: a case-control study in eastern Spain — M. Santibañez, J. Vioque, et al. (2008)
• Esophageal carcinoma with asbestos bodies — J.P. Parmar (1992)
• Ingested asbestos in filtered beer, in addition to occupational exposure, as a causative factor in oesophageal adenocarcinoma — R.C. Fitzgerald, J.M. Rhodes (2019)
• Meta-Analysis of the Association between Asbestos Exposure and Esophageal Cancer — C.W. Wu, H.Y. Chuang, et al. (2021)

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