Women's occupation and cancer: preliminary analysis of cancer registrations in England and Wales, 1971-1990

Our plain-English summary of Women's occupation and cancer: preliminary analysis of cancer registrations in England and Wales, 1971-1990, by J. Simpson, E. Roman, G. Law, et al (American Journal of Industrial Medicine, 1999).

The study

• Authors: J. Simpson, E. Roman, G. Law, B. Pannett
• Journal: American Journal of Industrial Medicine
• Published: 1999;36(1):172-85
• Cited by: 28 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: In recent years increasing attention has been paid to examining the relation between women's health and their own occupation. The findings presented here relate to an analysis of 381,915 cancers in women registered in England and Wales over the 20-year period 1971-1990.

Methods: To explore the value of the data for epidemiological research, five sites (pleura, bladder, stomach, lung, and breast) and two occupations (agriculture and textile) were selected. Associations between cancer and occupation were evaluated using age and social class adjusted proportional registration ratios (PRRs) and 95% confidence intervals (CI).

Results: Pleural cancer risk was increased in a range of occupations with a potential for asbestos exposure (e.g., PRR 608, 95% CI 381-921 for craft and other production process workers), and the well-established link between bladder cancer and employment in the rubber industry was confirmed (PRR 303, 95% CI 188-464). Associations between "dusty" occupations and stomach cancer were noted (e.g., PRR 198, 95% CI 126-298 for ceramic decorators and finishers), and possible links with lung cancer and smoke in the work environment were highlighted (e.g., PRR 167, 95% CI 147-189 for publicans). As a group, agricultural workers were found to be at increased risk of non-Hodgkin's lymphoma (PRR 164, 95% CI 126-211), and textile workers at increased risk of pleural cancer (PRR 145, 95% CI 111-185). No evidence for an occupational aetiology for breast cancer was found within these data.

Conclusions: Occupational information collected at cancer registration in the United Kingdom can be reliably used to identify groups that may be at increased risk of disease.

In plain English

This study analysed national cancer registration records for women aged 20–74 in England and Wales from 1971 to 1990. Of 1,582,795 women registered with cancer, 381,915 (24.1%) who had a valid occupation recorded were included. Housewives and full-time students were excluded. The authors calculated proportional registration ratios (PRRs), adjusted for age and social class, for five cancer sites and two occupational groups. Pleural cancer accounted for 475 registrations. For craft and other production workers (not elsewhere classified), the pleural cancer PRR was 608 (95% CI 381–921; 22 cases). For laborers and unskilled workers it was 209 (95% CI 138–305; 27 cases). Tailoring had a PRR of 330 (95% CI 195–521), and textile cutting and seaming workers as a group had 145 (95% CI 111–185). The study had no data on specific exposures. The authors noted that many of these job groups contain workers who could have been exposed to asbestos, and concluded it seemed highly probable that many pleural cancers had an occupational cause. Limitations they stated included missing denominator data, the exclusion of a large share of registrations, and chance findings among many comparisons.

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: Analysis of routine national cancer registration data using proportional registration ratios (PRRs), adjusted for age and social class
• Who was studied: 381,915 women aged 20–74 registered with cancer in England and Wales, 1971–1990, who had a valid occupation recorded, out of 1,582,795 registered. Full-time students and housewives were excluded.
• Exposure: Occupation as recorded at cancer registration (job groups). No specific exposures or fiber types were measured. The authors noted that many job groups with raised pleural cancer contained workers who could have been exposed to asbestos.
• Main results:
  • Pleural cancer made up 0.1% (475) of all registrations in the study.
  • Pleural cancer PRR for craft and other production workers (not elsewhere classified) was 608 (95% CI 381–921), based on 22 registrations.
  • Pleural cancer PRR for laborers and unskilled workers (not elsewhere classified) was 209 (95% CI 138–305), based on 27 registrations.
  • Pleural cancer PRRs were also significantly raised for carpenters and joiners (824, 95% CI 166–2,410; 3 registrations) and furnace and chemical process workers (412, 95% CI 165–848; 7 registrations).
  • Women in the textile cutting and seaming group (Nordic classification) had a pleural cancer PRR of 145 (95% CI 111–185), based on 63 registrations.
  • Within the textile group, the only individual job group with a statistically significant pleural cancer PRR was tailoring (330, 95% CI 195–521; 18 registrations). Other point estimates were raised, and the authors said it was not clear the excess was confined to one group.
  • Bladder cancer PRR for workers in rubber was 303 (95% CI 188–464).
  • Lung cancer PRR for publicans and innkeepers was 167 (95% CI 147–189). The authors considered this likely to be smoking related.
  • Agricultural workers (Nordic classification) had a non-Hodgkin's lymphoma PRR of 164 (95% CI 126–211), based on 61 registrations.
  • For breast cancer, only modest increases were seen. The authors judged confounding or chance the most likely explanation for most of them.
• The authors' conclusion: The authors concluded that it seemed highly probable that many of the pleural cancers had an occupational cause. They also concluded that occupational information collected at cancer registration in the UK can be used to identify groups that may be at increased risk of disease.
• Limitations the authors state:
  • Lack of appropriate denominator data
  • Exclusion of a large percentage of individuals with inadequately described occupations
  • Reliance on job titles recorded at the time of cancer registration
  • Limited information on confounding factors and no data on specific occupational exposures
  • With many associations examined, some results may be significant by chance alone
  • Women's occupation is poorly recorded at cancer registration, so the cancer pattern among included women may differ from that of all women

Topics

Medical terms in this study, explained in our Lexicon: Pleura, confidence interval, Asbestos Exposure, Stomach Cancer, Lung Cancer.

Related studies

• Breast cancer and occupational exposures in women in Finland — E. Weiderpass, E. Pukkala, et al. (1999)
• Cancer mortality among women in the Russian printing industry — M.A. Bulbulyan, S.A. Ilychova, et al. (1999)
• Cancer in electrical workers: an analysis of cancer registrations in England, 1981-87 — N.T. Fear, E. Roman, et al. (1996)
• Occupational risk factors for lung cancer in women: results of a case-control study in Germany — I. Jahn, W. Ahrens, et al. (1999)
• Work-related mortality in England and Wales, 1979-2000 — D. Coggon, E.C. Harris, et al. (2010)
• Trends in mortality from occupational hazards among men in England and Wales during 1979-2010 — E.C. Harris, K.T. Palmer, et al. (2016)

Browse more research in American Journal of Industrial Medicine, or return to medical research.