Cancer incidence in Danish health care workers

Abstract

Health care workers are exposed to various occupational hazards. In a register linkage study we investigated cancer incidence in health care personnel in Denmark. The overall cancer incidence was elevated in female general and dental practitioners. Male doctors had a risk of brain cancer twice as high as expected. Male dental practitioners, female hospital doctors and nurses had significantly high risks of melanomas of the skin. The breast cancer risk was elevated among female salaried dentists, hospital doctors, and nurses. Female cleaners had a significantly elevated risk of leukemia (31 cases, SIR 1.54). The lung cancer risk was low in several occupational groups. This indicates a change in risk behaviour related to tobacco smoking. A high risk of skin melanomas may indicate that behaviour related to sunlight exposure has not changed.

Keywords

health personnel neoplasms lung neoplasms breast neoplasms brain neoplasms melanoma leukemia

Get full access to this article

View all access options for this article.

References

Gestal J. Occupational hazards in hospitals: accidents, radiation, exposure to noxious chemicals, drug addiction and psychic problems, and assault . Br J Ind Med 1987; 44: 510–20.

Gestal J. Occupational hazards in hospitals: risk of infection . Br J Ind Med 1987; 44: 435–42.

Kinlen L. Infections and immune impairment. In: Vessey MP , Gray M , eds. Cancer risks and prevention. Oxford: Oxford University Press, 1985.

Vainio H. Occupational cancer prevention. In: Heller T et al, eds. Preventing cancers. Milton Keynes: Open University Press, 1992.

IARC monographs on the evaluation of carcinogenic risks to humans. Overall evaluations of carcinogenicity: an updating of IARC monographs volumes 1 to 42. Lyon: International Agency for Research on Cancer, 1987.

Hoover R , Fraumeni JF. Drug induced cancer . Cancer 1981; 47: 1071–80.

McDevitt J , Lees PSJ , McDiarmid MA. Exposure of hospital pharmacists and nurses to antineoplastic agents . J Occup Med 1993; 35: 57–60.

Skov T , Lynge E , Maarup B , Olsen J , Rorth M , Winthereik H. Risks for physicians handling antineoplastic drugs . Lancet 1990; 336: 1446 .

Skov T , Maarup B , Olsen J , Rorth M , Winthereik H , Lynge E. Leukaemia and reproductive outcome among nurses handling antineoplastic drugs . Br J Ind Med 1992; 49: 855–61.

10.

Lynge E , Thygesen L. Occupational cancer in Denmark. Cancer incidence in the 1970 census population . Scand J Work Environ Health 1990; 16: Suppl 2.

11.

Breslow N , Day NE. Statistical methods in cancer research. Vol. II. Lyon: International Agency for Research on Cancer, 1987.

12.

Malker H , Weiner J. The cancer and work environment register. Arbete och Hälsa 9. Solna: Arbetarskyddsverket, 1984.

13.

Sankila R , Karjalainen, Läärä E , Pukkala E. Cancer risk among health care personnel in Finland, 1971-1980 . Scand J Work Environ Health 1990; 16: 252–7.

14.

Nurminen M , Rimpala A , Pukkala E. Exceptionally low cancer incidence in doctors . Lancet 1988; I: 190 .

15.

Office of Population Censuses and Surveys. Occupational mortality: The Registrar General's decennial supplement for Great Britain: 1970-72. London: Her Majesty's Stationery Office, 1978.

16.

Bulbulyan M , Zahm SH , Zaridze DG. Occupational cancer mortality among urban women in the former USSR . Cancer Causes Control 1992; 3: 299–307.

17.

Milham S. Occupational mortality in Washington State 1950-1979. Cincinnati, OH: US Department of Health and Human Services, 1983.

18.

The Danish Association of Junior Hospital Doctors. Junior hospital doctors' work and living conditions. Copenhagen: The Danish Association of Junior Hospital Doctors, 1990.

19.

Hansen H , Rasmussen NK , Poulsen J. Life style and health habits in Denmark (in Danish). Copenhagen: Ministry of Health, 1994.

20.

Williams R , Stegens NL , Goldsmith JR. Associations of cancer site and type with occupation and industry from the third national cancer interview . J Natl Cancer Inst 1977; 59: 1147–85.

21.

Burns P , Swanson GM. The occupational cancer incidence surveillance study (OCISS): Risk of lung cancer by usual occupation and industry in the Detroit metropolitan area . Am J Ind Med 1991; 19: 655–71.

22.

Doll R , Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors . BMJ 1976; 2: 1525–36.

23.

Doll R , Peto R , Wheatley K , Gray R , Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors . BMJ 1994; 309: 901–11.

24.

Carstensen J , Pershagen G , Eklund G. Smoking-adjusted incidence of lung cancer among Swedish men in different occupations . Int J Epidemiol 1988; 17: 753–8.

25.

Doll R , Peto R. Mortality among doctors in different occupations . BMJ 1977; 1: 1433–6.

26.

Roman E , Beral V , Inskip H. Occupational mortality among women in England and Wales . BMJ 1985; 291: 194–6.

27.

Adami H , Adams G , Boyle P, et al. Breast-cancer etiology . Int J Cancer 1990; Suppl 5: 22–39.

28.

Kelsey J. Breast cancer epidemiology: Summary and future directions . Epidemiol Rev 1993; 15: 256–63.

29.

Bertelsen O. The falling birth rate (in Danish). Publ. 104. Copenhagen: The Danish National Institute of Social Research, 1981.

30.

Knudsen LB : Fertility trends in Denmark in the 1980s. Copenhagen: Danmarks Statistik, 1993.

31.

Katsouyanni K , Trichopoulou A , Stuver S, et al. Ethanol and breast cancer: an association that may be both confounded and causal . Int J Cancer 1994; 58: 356–61.

32.

Schatzkin A , Longnecker MP.

Alcohol and breast cancer. Where are we now and where do we go from here?

Cancer 1994; 74: 1101–10.

33.

Habel L , Stanford JL , Vaughan TL, et al. Occupation and breast cancer in middle-aged women . J Occup Environ Med 1995; 37: 349–55.

34.

Gunnarsdóttir H , Rafnsson V. Cancer incidence among Icelandic nurses . J Occup Environ Med 1995; 37: 307–12.

35.

Savitz D , Pearce N , Poole C. Update on methodological issues in the epidemiology of electromagnetic fields and cancer . Epidemiol Rev 1993; 15: 558–65.

36.

Thomas T , Waxweiler RJ. Brain tumors and occupational risk factors. A review . Scand J Work Environ Health 1986; 12: 1–15.

37.

Stroup N , Blair A , Erikson GE. Brain Cancer and other causes of death in anatomists . J Natl Cancer Inst 1986; 77: 1217–24.

38.

McLaughlin J , Malker HSR , Blot WJ et al. Occupational risks for intracranial gliomas in Sweden . J Natl Cancer Inst 1987; 78: 253–7.

39.

Brownson R , Reif JS , Chang JC , Davis JR. An analysis of occupational risks for brain cancer . Am J Public Health 1990; 80: 169–72.

40.

Ahlbom A , Norell S , Rodvall Y. Dentists, dental nurses and brain tumours . BMJ 1986; 292: 662 .

41.

Cohen E , Brown BW , Wu ML et al. Occupational disease in dentistry and chronic exposure to trace anesthetic gases . J Am Dent Assoc 1980; 101: 21–31.

42.

IARC monographs on the evaluation of carcinogenic risks to humans . Beryllium, cadmium, mercury and exposures in the glass manufacturing industry. Lyon: International Agency for Research on Cancer, 1993.

43.

Vågerö D , Swerdlow AJ , Beral V. Occupation and malignant melanoma: a study based on cancer registration data in England and Wales and Sweden . Br J Ind Med 1990; 47: 317–24.

44.

Office of Population Censuses and Surveys. Occupational mortality: The Registrar General's decennial supplement for Great Britain: 1979-80, 1982-83. London: Her Majesty's Stationery Office, 1986.

45.

Østerlind A. Epidemiology on malignant melanoma in Europe . Reviews in Oncology. 1992; 5: 903–8.

46.

Morton W , Marjanovic D. Leukemia incidence by occupation in the Portland-Vancouver metropolitan area . Am J Ind Med 1984; 6: 185–205.