Pancreatic cancer and occupational exposures

Our plain-English summary of Pancreatic cancer and occupational exposures, by T. Kauppinen, T. Partanen, R. Degerth, et al (Epidemiology, 1995).

The study

• Authors: T. Kauppinen, T. Partanen, R. Degerth, A. Ojajärvi
• Journal: Epidemiology
• Published: 1995;6(5):498-502
• Cited by: 59 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We conducted a nationwide case-control study in Finland to identify occupational risk factors for pancreatic cancer. We constructed the occupational exposure histories for 595 incident cases of primary exocrinic cancer of the pancreas and of 1,622 cancer controls, using three different methods. We found elevated odds ratios (OR) for ionizing radiation [OR = 4.3; 95% confidence interval (CI) = 1.6-11.4], nonchlorinated solvents (OR = 1.6-1.8), and pesticides (OR = 1.7; 95% CI = 0.8-3.4). Asbestos, chromates, cleaning agents, waxes, polishes, and most other exposures were not meaningfully associated with pancreatic cancer. Inorganic dust containing crystalline silica (OR = 2.0; 95% CI = 1.2-3.5), heat stress (OR = 2.2; 95% CI = 0.8-6.6), and rubber chemicals including acrylonitrile (OR = 2.1; 95% CI = 0.9-4.7) emerged as previously unsuspected risk factors. Occupational exposure probably has a small role in the etiology of pancreatic cancer in the present-day industrialized or postindustrial work environment.

In plain English

This Finnish case-control study looked for workplace exposures linked to pancreatic cancer. The authors studied people diagnosed in 1984 to 1987 at ages 40 to 74 who later died. They compared 595 exocrine pancreatic cancer cases with 1,622 stomach, colon or rectal cancer controls. Relatives answered postal questionnaires on each person's lifelong work history; 47% of case relatives responded. Exposures were assessed three ways, including a 50-agent job-exposure matrix and a detailed reassessment of cumulative exposure. The authors reported asbestos, chromates, cleaning agents, waxes, polishes and most other exposures were not meaningfully associated with the disease. Higher odds ratios were found for ionizing radiation (OR 4.3; 95% CI 1.6 to 11), inorganic dust containing crystalline silica (OR 2.0; 95% CI 1.2 to 3.5), aliphatic (OR 1.6; 95% CI 1.0 to 2.6) and aromatic hydrocarbon solvents (OR 1.8; 95% CI 1.1 to 2.8). Chlorinated solvents showed no raised odds ratios. Relatives' work histories were often inaccurate, the authors noted. Writing in 1995, they concluded that occupational exposure probably has a small role in pancreatic cancer in the present-day industrialized or postindustrial work environment.

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: Community-based case-control study using three exposure-assessment methods: industrial hygiene survey, job-exposure matrix, and industrial hygiene reassessment of cumulative exposure
• Who was studied: Deceased people in Finland diagnosed in 1984-1987 at ages 40-74, identified from the Finnish Cancer Register. After exclusions: 595 cases of primary exocrine pancreatic cancer and 1,622 cancer controls (936 stomach, 395 colon, 291 rectal cancers). Work histories came from next-of-kin postal questionnaires; the response rate was 47% for cases.
• Exposure: Occupational chemical and physical agents, assessed in three ways: an industrial hygiene survey of 17 selected agents, a job-exposure matrix covering 50 agents, and an industrial hygiene reassessment of cumulative exposure (none, light, moderate, heavy) for agents with elevated odds ratios. Asbestos was among the agents assessed.
• Main results:
  • Asbestos, chromates, cleaning agents, waxes, polishes, and most other exposures were not meaningfully associated with pancreatic cancer.
  • Ionizing radiation, examined only with the job-exposure matrix: OR = 4.3; 95% CI = 1.6-11.
  • Inorganic dust containing crystalline silica: OR = 2.0; 95% CI = 1.2-3.5.
  • Silica-containing dust in the reassessment: moderate exposure OR = 2.6 (95% CI = 1.2-5.5); people under 56 years OR = 6.4 (95% CI = 1.2-35).
  • Aliphatic hydrocarbon solvents, all exposed categories combined: OR = 1.6 (95% CI = 1.0-2.6).
  • Aromatic hydrocarbon solvents, all exposed categories combined: OR = 1.8 (95% CI = 1.1-2.8).
  • Chlorinated hydrocarbon solvents showed no elevated odds ratios.
  • Pesticides: OR = 1.7; 95% CI = 0.8-3.4.
• The authors' conclusion: The authors concluded that occupational exposure probably has a small role in the cause of pancreatic cancer in the present-day (1995) industrialized or postindustrial work environment.
• Limitations the authors state:
  • Occupational histories from next-of-kin were often inaccurate and did not allow quantitative calculation of cumulative exposure.
  • Misclassification between the ordinal exposure classes (light, moderate, heavy) is likely.
  • Restricting the study to deceased subjects may introduce bias if the exposures are associated with survival.
  • The response rate was low and information came from next-of-kin, although the authors judged these not to be serious flaws.
  • The silica association has not been seen in large studies of heavily exposed workers and silicotic patients.
  • Workplaces with heat exposure involve possibly confounding exposures.

Topics

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Case-Control Study, Odds Ratio, confidence interval, Crystalline, Etiology.

Related studies

• Occupational exposures and pancreatic cancer: a meta-analysis — I.A. Ojajärvi, T.J. Partanen, et al. (2000)
• Environmental risk factors for pancreatic cancer: an update — E. Barone, A. Corrado, et al. (2016)
• Occupational exposure to dyes, metals, polycyclic aromatic hydrocarbons and other agents and K-ras activation in human exocrine pancreatic cancer — J. Alguacil, M. Porta, et al. (2003)
• Exposure to environmental chemicals and heavy metals, and risk of pancreatic cancer — S.O. Antwi, E.C. Eckert, et al. (2015)
• Association of diabetes susceptibility gene calpain-10 with pancreatic cancer among smokers — P.Y. Fong, M.D. Fesinmeyer, et al. (2010)
• Breast cancer and occupational exposures in women in Finland — E. Weiderpass, E. Pukkala, et al. (1999)

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