Andrea 't Mannetje

Publications of Andrea 't Mannetje

• Welding and Lung Cancer in Central and Eastern Europe and the United Kingdom.

  Authors: Andrea 't Mannetje, Paul Brennan, David Zaridze, Neonila Szeszenia-Dabrowska, Peter Rudnai, Jolanta Lissowska, Eleonóra Fabiánová, Adrian Cassidy, Dana Mates, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Joelle Fevotte, Tony Fletcher, Paolo Boffetta

  American journal of epidemiology. 02/2012;

  Occupation as a welder has been associated with a 25%-40% increase in lung cancer risk. This study aims to elucidate to what extent confounding by smoking and asbestos drives this association and toOccupation as a welder has been associated with a 25%-40% increase in lung cancer risk. This study aims to elucidate to what extent confounding by smoking and asbestos drives this association and to evaluate the role of welding-related exposures such as chromium. The study included 2,197 male incident lung cancer cases and 2,295 controls from Romania, Hungary, Poland, Russia, Slovakia, the Czech Republic, and the United Kingdom from 1998 to 2001. Information on risk factors was collected through face-to-face interviews. Experts assessed exposure to 70 agents, and risk estimates were adjusted for smoking and occupational exposures. Occupation as a welder/flame cutter (prevalence controls: 3.7%) was associated with an odds ratio of 1.36 (95% confidence interval (CI): 1.00, 1.86) after adjustment for smoking and occupational exposures including asbestos. An odds ratio of 1.18 (95% CI: 1.01, 1.38) was found for welding fumes (prevalence controls: 22.8%), increasing to 1.38 for more than 25 exposure years (95% CI: 1.09, 1.75). A duration-response association was also observed for mild steel welding without chromium exposure. In this population, occupational exposure to welding fumes accounted for approximately 4% of lung cancer cases, to which both stainless and mild steel welding contributed equally. Given that welding remains a common task for many workers, exposure to welding fumes represents an important risk factor for lung cancer.

• Prevalence and work-related risk factors for reduced activities and absenteeism due to low back symptoms.

  Authors: Baiduri Widanarko, Stephen Legg, Mark Stevenson, Jason Devereux, Amanda Eng, Andrea 't Mannetje, Soo Cheng, Neil Pearce

  Applied ergonomics. 11/2011;

  Although quite a lot is known about the risk factors for low back symptoms (LBS), less is known about the risk factors for the consequences of LBS. A sample of 3003 men and women randomly selectedAlthough quite a lot is known about the risk factors for low back symptoms (LBS), less is known about the risk factors for the consequences of LBS. A sample of 3003 men and women randomly selected from the New Zealand Electoral Roll, were interviewed by telephone about self reported physical, psychosocial, organizational, environmental factors and the consequences of LBS (i.e. self-reported reduced activities and absenteeism). The 12-month period prevalence of reduced activities and absenteeism were 18% and 9%, respectively. Lifting (OR 1.79 95% CI 1.16-2.77) increased the risk of reduced activities. Working in awkward/tiring positions (OR 2.11 95% CI 1.20-3.70) and in a cold/damp environment (OR 2.18 95% CI 1.11-4.28) increased the risk of absenteeism. Among those with LBS, reduced activities increased with working in a hot/warm environment (OR 2.14 95% CI 1.22-3.76) and absenteeism was increased with work in awkward/tiring positions (OR 2.06 95% CI 1.13-3.77), tight deadlines (OR 1.89 95% CI 1.02-3.50), and a hot/warm environment (OR 3.35 95% CI 1.68-6.68). Interventions to reduce the consequences of LBS should aim to reduce awkward/tiring positions, lifting and work in a cold/damp environment. For individuals with LBS, additional focus should be to reduce tight deadlines, and work in hot/warm environments.

• Lung cancer risk attributable to occupational exposures in a multicenter case-control study in Central and Eastern Europe.

  Authors: Ann C Olsson, Per Gustavsson, David Zaridze, Anush Mukeriya, Neonila Szeszenia-Dabrowska, Peter Rudnai, Jolanta Lissowska, Eleonora Fabianova, Dana Mates, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Joelle Fevotte, Andrea 't Mannetje, Tony Fletcher, Paul Brennan, Paolo Boffetta

  Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. 11/2011; 53(11):1262-7.

  To estimate the lung cancer risk attributable to occupational lung carcinogens. Information was collected through interviews from 2624 newly diagnosed lung cancer cases and 2690 frequency-matchedTo estimate the lung cancer risk attributable to occupational lung carcinogens. Information was collected through interviews from 2624 newly diagnosed lung cancer cases and 2690 frequency-matched controls in Central and Eastern Europe. Industrial hygiene experts evaluated exposure to 70 occupational agents. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression and attributable fractions (AF) by Miettinen's formula. Exposure to at least one occupational lung carcinogen resulted in an AF of 7.9% in men and 1.4% in women. Metals and silica contributed the most to the AF. The AF was highest for squamous cell carcinoma among men (11.4%) and for small cell carcinoma among women (7.1%); the effect of occupational lung carcinogens was stronger overall among current smokers. This estimation of the AF of occupational lung carcinogens is comparable to that estimated in other European studies, and cannot alone explain the high lung cancer rates in Central and Eastern Europe.

• Occupational exposure to metal compounds and lung cancer. Results from a multi-center case-control study in Central/Eastern Europe and UK.

  Authors: Andrea 't Mannetje, Vladimir Bencko, Paul Brennan, David Zaridze, Neonila Szeszenia-Dabrowska, Peter Rudnai, Jolanta Lissowska, Eleonóra Fabiánová, Adrian Cassidy, Dana Mates, Lenka Foretova, Vladimir Janout, Joelle Fevotte, Tony Fletcher, Paolo Boffetta

  Cancer causes & control : CCC. 09/2011; 22(12):1669-80.

  To study the association between occupational exposure to metals including chromium, cadmium, nickel, and arsenic compounds, within a population-based study design, while adjusting for confoundingTo study the association between occupational exposure to metals including chromium, cadmium, nickel, and arsenic compounds, within a population-based study design, while adjusting for confounding factors. A population-based lung cancer case-control study in Central/Eastern Europe and UK was conducted in 1998-2003, including 2,853 cases and 3,104 controls. Exposure to 70 occupational agents was assessed by local expert-teams for all subjects. Odds ratios (OR) for exposure to dust and fumes/mist of chromium, nickel, cadmium, arsenic, as well as inorganic pigment dust and inorganic acid mist, were adjusting for smoking, age, center, sex, and exposure to other occupational agents including the metals under study. Exposure to arsenic (prevalence = 1.4%) was associated with an increased lung cancer risk ((OR) 1.65, 95% confidence interval (95% CI):1.05-2.58). For chromium dust (prevalence = 4.8%, OR: 1.25, 95% CI: 0.95-1.65), a linear upward trend for duration and cumulative exposure was observed. A weak association was observed for exposure to cadmium fumes (prevalence = 1.8%, OR: 1.19, 95% CI: 0.77-1.82), which was strongest for the highest category of cumulative exposure (OR: 2.04, 95% CI: 1.07-3.90). No increased risk was observed for inorganic acid mist, inorganic pigment dust, or nickel, after adjustment for other metals. An independent effect of nickel cannot be excluded, due to its collinearity with chromium exposure. Occupational exposure to metals is an important risk factor for lung cancer. Although the strongest risk was observed for arsenic, exposure to chromium dust was most important in terms of attributable risk due to its high prevalence.

• Work-related stress and asthma: results from a workforce survey in New Zealand.

  Authors: Amanda Eng, Andrea 't Mannetje, Neil Pearce, Jeroen Douwes

  The Journal of asthma : official journal of the Association for the Care of Asthma. 08/2011; 48(8):783-9.

  We assessed the association between work-related stress and asthma in a cross-sectional workforce survey in New Zealand. Men and women randomly selected from the Electoral Roll were invited to takeWe assessed the association between work-related stress and asthma in a cross-sectional workforce survey in New Zealand. Men and women randomly selected from the Electoral Roll were invited to take part in a telephonic interview, which collected information on current workplace exposures and respiratory symptoms. Participants rated how stressful they found their current job on a five-point scale. We conducted unconditional logistic regression to calculate prevalence odds ratios (OR) and 95% confidence intervals (CI) for job stress and both current and adult-onset asthma, adjusting for age, sex, smoking, and deprivation. Analyses were also stratified by sex, smoking status, body mass index, and age group. Results were based on 2903 interviews. Participants with very or extremely stressful jobs were twice as likely to have current asthma (OR = 1.98; 95% CI = 1.52-2.58) and 50% more likely to have adult-onset asthma (OR = 1.50; 95% CI = 1.05-2.15) compared to those with not at all or mildly stressful jobs. This association was evident for both sexes and was not explained by either occupation, age, body mass index, or smoking, although the results did differ by smoking status. Our study adds to the sparse evidence on the relationship between work-related stress and asthma in adult working populations.

• Farming, growing up on a farm, and haematological cancer mortality.

  Authors: Andrea 't Mannetje, Amanda Eng, Neil Pearce

  Occupational and environmental medicine. 07/2011; 69(2):126-32.

  Occupation as a farmer has been associated with increased risks of haematological cancers in adults. This study aimed to examine whether farm exposures in childhood contribute to these risks, byOccupation as a farmer has been associated with increased risks of haematological cancers in adults. This study aimed to examine whether farm exposures in childhood contribute to these risks, by using parental occupation in farming as a proxy for growing up on a farm. New Zealand death records (1998-2003) of persons aged 35-85 were extracted (n=114 289). For 82.3% usual occupation and the occupation of at least one of the parents could be coded (n=94 054). Unconditional logistic regression analyses included 3119 haematological cancer deaths (cases) and 90 935 deaths from other causes (controls). ORs for farming and growing up on a farm were adjusted for each other, year of birth, age at death, socio-economic status, Māori ethnicity, immigration status and sex. Growing up on a livestock farm was positively associated with haematological cancer (OR 1.22, 95% CI 1.05 to 1.41), particularly for poultry farms (OR 2.99, 95% CI 1.44 to 6.21), while growing up on a crop farm was not (OR 0.81, 95% CI 0.64 to 1.03). Crop farming in adulthood was associated with an increased haematological cancer risk (OR 1.49, 95% CI 1.13 to 1.96), while livestock farming was not (OR 0.80, 95% CI 0.63 to 1.00), except for beef cattle farming (OR 2.99, 95% CI 1.28 to 7.00). These results did not change appreciably when different control groups with different causes of death were used. These results could suggest a role for early life biological exposures in the development of haematological cancers.

• Determinants of non-response in an occupational exposure and health survey in New Zealand.

  Authors: Andrea 't Mannetje, Amanda Eng, Jeroen Douwes, Lis Ellison-Loschmann, David McLean, Neil Pearce

  Australian and New Zealand journal of public health. 06/2011; 35(3):256-63.

  Study the determinants of non-response and the potential for non-response bias in a New Zealand survey of occupational exposures and health. A random sample of 10,000 New Zealanders aged 20-64 yearsStudy the determinants of non-response and the potential for non-response bias in a New Zealand survey of occupational exposures and health. A random sample of 10,000 New Zealanders aged 20-64 years were invited by mail to take part in a telephone survey. Multiple logistic regression was used to study the determinants of non-response. Whether occupational exposure, lifestyle and health indicators were associated with non-response was studied by standardising their prevalence towards the demographic distribution of the source population, and comparing early with late responders. The response rate was 37%. Younger age, Māori descent, highest and lowest deprivation groups and being a student, unemployed, or retired were determinants of non-contact. Refusal was associated with older age and being a housewife. Prevalence of key survey variables were unchanged after standardising to the demographic distribution of the source population. Following up the non-responders to the mailed invitations with telephone calls more than doubled the response rate and improved the representativeness of the sample. Although the response rate was low, we found no evidence of major non-response bias. Judgement regarding the validity of a survey should not be based on its response rate.

• Gender differences in occupational exposure patterns.

  Authors: Amanda Eng, Andrea 't Mannetje, Dave McLean, Lis Ellison-Loschmann, Soo Cheng, Neil Pearce

  Occupational and environmental medicine. 04/2011; 68(12):888-94.

  The authors conducted a population-based survey to examine gender differences in occupational exposure patterns and to investigate whether any observed differences are due to: (a) gender differencesThe authors conducted a population-based survey to examine gender differences in occupational exposure patterns and to investigate whether any observed differences are due to: (a) gender differences in occupational distribution; and/or (b) gender differences in tasks within occupations. Men and women aged 20-64 years were randomly selected from the Electoral Roll and invited to take part in a telephone interview, which collected information on self-reported occupational exposure to specific dusts and chemicals, physical exposures and organisational factors. The authors used logistic regression to calculate prevalence ORs and 95% CIs comparing the exposure prevalence of males (n=1431) and females (n=1572), adjusting for age. To investigate whether men and women in the same occupation were equally exposed, the authors also matched males to females on current occupation using the five-digit code (n=1208) and conducted conditional logistic regression adjusting for age. Overall, male workers were two to four times more likely to report exposure to dust and chemical substances, loud noise, irregular hours, night shifts and vibrating tools. Women were 30% more likely to report repetitive tasks and working at high speed, and more likely to report exposure to disinfectants, hair dyes and textile dust. When men were compared with women with the same occupation, gender differences were attenuated. However, males remained significantly more likely to report exposure to welding fumes, herbicides, wood dust, solvents, tools that vibrate, irregular hours and night-shift work. Women remained more likely to report repetitive tasks and working at high speed, and in addition were more likely to report awkward or tiring positions compared with men with the same occupation. This population-based study showed substantial differences in occupational exposure patterns between men and women, even within the same occupation. Thus, the influence of gender should not be overlooked in occupational health research.

• Ethnic differences in patterns of occupational exposure in New Zealand.

  Authors: Amanda Eng, Andrea 't Mannetje, Lis Ellison-Loschmann, Dave McLean, Soo Cheng, Neil Pearce

  American journal of industrial medicine. 02/2011; 54(5):410-8.

  To investigate the differences in occupational exposure between Māori (New Zealand's indigenous people) and non-Māori. Participants were randomly selected from the Electoral Roll. Exposure toTo investigate the differences in occupational exposure between Māori (New Zealand's indigenous people) and non-Māori. Participants were randomly selected from the Electoral Roll. Exposure to occupational risk factors was assessed through telephone interviews and exposure prevalences of Māori (n = 273) and non-Māori (n = 2,724) were compared. Subsequently, Māori were matched with non-Māori on current occupation (n = 482) to assess whether ethnic differences also exist within occupations. Māori were more likely to report exposure to physical strain (e.g., lifting, standing). Part of these differences remained when Māori were compared with non-Māori in the same job. In addition, Māori women were twice as likely to categorize their job as very or extremely stressful than non-Māori women in the same job, while Māori men were twice as likely to report exposure to dust. Marked ethnic differences exist in risk factors for occupational ill-health, due to both occupational distribution and the distribution of tasks within occupations.

• Comparison of exposure assessment methods for occupational carcinogens in a multi-centre lung cancer case-control study.

  Authors: Susan Peters, Roel Vermeulen, Adrian Cassidy, Andrea 't Mannetje, Martie van Tongeren, Paolo Boffetta, Kurt Straif, Hans Kromhout

  Occupational and environmental medicine. 02/2011; 68(2):148-53.

  Retrospective exposure assessment remains a problematic aspect of population-based case-control studies. Different methods have been developed, including case-by-case expert assessment andRetrospective exposure assessment remains a problematic aspect of population-based case-control studies. Different methods have been developed, including case-by-case expert assessment and job-exposure matrices (JEM). The present analyses compare exposure prevalence and risk estimates derived by different exposure assessment methods. In the context of a case-control study conducted in seven European countries, exposure was estimated for asbestos, diesel motor emissions (DME) and crystalline silica, using three different assessment methods. First, experts assigned exposures to all reported jobs on a case-by-case basis. Second, a population-specific JEM (PSJEM) was developed using the expert assessments of controls only, and re-applied to all study subjects. Third, an independent general population JEM (GPJEM) was created by occupational exposure experts not involved in the original study, and applied to study subjects. Results from these methods were compared. There was poor to fair agreement in assigned exposure between expert assessment and the GPJEM (kappas: asbestos 0.17; DME 0.48; silica 0.38). Exposure prevalence was significantly heterogeneous (p<0.01) between countries for all three agents and assessment methods. For asbestos and DME, significant country heterogeneity in risk estimates was observed when using expert assessment. When applying the GPJEM, the heterogeneity in risk estimates for asbestos and, to some extent, silica diminished. It has been previously advocated that the expert assessment approach to assign exposures based on detailed questionnaire responses provides more accurate exposure estimates than JEM-based results. However, current results demonstrated little, if any, advantage of case-by-case assessment when compared to a JEM approach.

• Occupational mortality studies: still relevant in the 21st century.

  Authors: Andrea 't Mannetje, Neil Pearce

  Occupational and environmental medicine. 10/2010; 67(12):802-3.

• Lung cancer and occupation: A New Zealand cancer registry-based case-control study.

  Authors: Marine Corbin, David McLean, Andrea 't Mannetje, Evan Dryson, Chris Walls, Fiona McKenzie, Milena Maule, Soo Cheng, Chris Cunningham, Hans Kromhout, Aaron Blair, Neil Pearce

  American journal of industrial medicine. 10/2010; 54(2):89-101.

  There are many proven and suspected occupational causes of lung cancer, which will become relatively more important over time, as smoking prevalence decreases. We interviewed 457 cases aged 20-75There are many proven and suspected occupational causes of lung cancer, which will become relatively more important over time, as smoking prevalence decreases. We interviewed 457 cases aged 20-75 years notified to the New Zealand Cancer Registry during 2007-2008, and 792 population controls. We collected information on demographic details, potential confounders, and employment history. Associations were estimated using logistic regression adjusted for gender, age, ethnicity, smoking, and socio-economic status. Among occupations of a priori interest, elevated odds ratios (ORs) were observed for sawmill, wood panel and related wood-processing plant operators (OR 4.63; 95% CI 1.05-20.29), butchers (OR 8.77, 95% CI 1.06-72.55), rubber and plastics products machine operators (4.27; 1.16-15.66), heavy truck drivers (2.24; 1.19-4.21) and workers in petroleum, coal, chemical and associated product manufacturing (1.80; 1.11-2.90); non-significantly elevated risks were also observed for loggers (4.67; 0.81-27.03), welders and flame-cutters (2.50; 0.86-7.25), pressers (5.74; 0.96-34.42), and electric and electronic equipment assemblers (3.61; 0.96-13.57). Several occupations and industries not of a priori interest also showed increased risks, including nursing associate professionals (5.45; 2.29-12.99), enrolled nurses (7.95; 3.10-20.42), care givers (3.47; 1.40-8.59), plant and machine operators and assemblers (1.61; 1.20-2.16), stationary machine operators and assemblers (1.67; 1.22-2.28), food and related products processing machine operators (1.98; 1.23-3.19), laborers and related elementary service workers (1.45; 1.05-2.00), manufacturing (1.34; 1.02-1.77), car retailing (3.08; 1.36-6.94), and road freight transport (3.02; 1.45-6.27). Certain occupations and industries have increased lung cancer risks in New Zealand, including wood workers, metal workers, meat workers, textile workers and drivers. Am. J. Ind. Med. 54:89-101, 2011. © 2010 Wiley-Liss, Inc.

• The New Zealand workforce survey II: occupational risk factors for asthma.

  Authors: Amanda Eng, Andrea 'T Mannetje, Jeroen Douwes, Soo Cheng, Dave McLean, Lis Ellison-Loschmann, Neil Pearce

  The Annals of occupational hygiene. 03/2010; 54(2):154-64.

  We conducted a cross-sectional population-based survey in New Zealand that collected information on work history, current workplace exposures, and selected health outcomes. We report here theWe conducted a cross-sectional population-based survey in New Zealand that collected information on work history, current workplace exposures, and selected health outcomes. We report here the findings on occupational risk factors for asthma symptoms. A random sample of men and women aged 20-64 years were selected from the New Zealand Electoral Roll and invited to take part in a telephone survey. Current asthma was defined as: (i) woken up by shortness of breath in the past 12 months; or (ii) an attack of asthma in the past 12 months; or (iii) currently taking asthma medication. Adult-onset asthma was defined as first attack of asthma at age 18 or over. Prevalence odds ratios (ORs) for all occupations were calculated using logistic regression adjusting for sex, age, smoking, and deprivation. Totally, 2903 participants were included in the analyses. The prevalence of current asthma was 17% and the prevalence of adult-onset asthma was 9%. Prevalence ORs for current asthma were elevated for ever working as a printer [OR = 2.26; 95% confidence interval (CI) = 1.09-4.66], baker (OR = 1.98; 95% CI = 1.02-3.85), sawmill labourer (OR = 3.26; 95% CI = 1.05-10.16), metal processing plant operator (OR = 2.48; 95% CI = 1.22-5.05), and cleaner (OR = 1.60; 95% CI = 1.09-2.35). Excess risks of adult-onset asthma were also found for ever working as a printer, baker, and sawmill labourer as well as ever-working as a market-oriented animal producer (OR = 1.66; 95% CI = 1.14-2.41), and other agricultural worker (OR = 2.08; 95% CI = 1.03-4.20). A number of occupations not previously considered at high risk for asthma were also identified, including teachers and certain sales professionals. This population-based study has confirmed findings of previous international studies showing elevated risks in a number of high-risk occupations. The strongest risks were consistently observed for printers, bakers, and sawmill labourers. Several occupations were also identified that have not been previously associated with asthma, suggesting that the risk of occupational asthma may be more widely spread across the workforce than previously assumed.

• The New Zealand workforce survey I: self-reported occupational exposures.

  Authors: Amanda Eng, Andrea 'T Mannetje, Soo Cheng, Jeroen Douwes, Lis Ellison-Loschmann, Dave McLean, Philippa Gander, Ian Laird, Stephen Legg, Neil Pearce

  The Annals of occupational hygiene. 03/2010; 54(2):144-53.

  This study examines the prevalence of a range of occupational risk factors reported by a random sample of the New Zealand working population. Men and women aged 20-64 were selected from the NewThis study examines the prevalence of a range of occupational risk factors reported by a random sample of the New Zealand working population. Men and women aged 20-64 were selected from the New Zealand Electoral Roll and invited to take part in a telephone interview, which collected information on lifetime work history, current workplace exposures and organizational factors, and various health conditions. The prevalences of occupational risk factors in each occupational and industry group are reported. Three thousand and three interviews were completed (37% of the eligible sample and 55% of those that could be contacted). Trades workers reported the highest prevalences of exposure to dust (75%) and oils and solvents (59%). Agriculture and fishery workers reported the highest prevalences of exposure to pesticides (63%) and acids or alkalis (25%). Plant and machine operators and assemblers reported the highest prevalences of exposure to smoke/fume/gas (43%), working night shift in the previous 4 weeks (18%), and working irregular hours (33%). In the high exposure occupational and industry groups, males reported a higher prevalence of exposure than females. Lifting, exposure to loud noise, and the use of personal protective equipment were reported by >50% of the manual occupational groups. This study indicates that occupational exposure to risk factors for work-related disease and injury remains common in the New Zealand working population. While these occupational exposures are disproportionately experienced by workers in certain industries, they also occur in occupational groups not traditionally associated with hazardous exposures or occupational disease.

• Occupational Exposure to Polycyclic Aromatic Hydrocarbons and Lung Cancer Risk: a Multicenter Study in Europe.

  Authors: Ann C Olsson, Joelle Fevotte, Tony Fletcher, Adrian Cassidy, Andrea 't Mannetje, David Zaridze, Neonila Szeszenia-Dabrowska, Peter Rudnai, Jolanta Lissowska, Eleonora Fabianova, Dana Mates, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Paul Brennan, Paolo Boffetta

  Occupational and environmental medicine. 09/2009;

  BACKGROUND: Lung cancer incidence in Central and Eastern Europe (CEE) is among the highest in the world, and the role of occupational exposures has not been adequately studied in these countries.BACKGROUND: Lung cancer incidence in Central and Eastern Europe (CEE) is among the highest in the world, and the role of occupational exposures has not been adequately studied in these countries. OBJECTIVES: To investigate the contribution of occupational exposure to polycyclic aromatic hydrocarbons (PAH) to lung cancer in CEE. METHODS: A case-control study was conducted in Czech Republic, Hungary, Poland, Romania, Russia, and Slovakia, as well as the United Kingdom (UK) between 1998 and 2002. Occupational and socio-demographic information was collected through interviews from 2861 newly diagnosed lung cancer cases and 2936 population or hospital controls. Industrial hygiene experts in each country evaluated exposure to 70 occupational agents, whereof 15 mixtures containing PAH. Odds ratios (OR) of lung cancer were calculated after adjusting for other occupational exposures and tobacco smoking. RESULTS: The OR for ever-exposure to PAH in the CEE countries was 0.93 (95% CI 0.77-1.14). The OR for the highest category of cumulative exposure, duration of exposure and intensity of exposure were 1.13 (95% CI 0.80-1.58), 1.02 (95% CI 0.66-1.57) and 1.11 (95% CI 0.60-2.05), respectively. The OR for ever PAH exposure in the UK was 1.97 (95% CI 1.16-3.35). CONCLUSION: Occupational PAH exposure does not appear to substantially contribute to the burden of lung cancer in CEE. The apparently stronger effect observed in the UK may be due to high exposure levels and a joint effect with asbestos.

• Serum dioxin levels in former New Zealand sawmill workers twenty years after exposure to pentachlorophenol (PCP) ceased.

  Authors: David McLean, Amanda Eng, Chris Walls, Evan Dryson, Joe Harawira, Soo Cheng, Khoon Ching Wong, Andrea 't Mannetje, Michelle Gray, Phil Shoemack, Allan Smith, Neil Pearce

  Chemosphere. 12/2008;

  From the 1950s to the late 1980s pentachlorophenol (PCP) based anti-sapstain fungicides were widely used in the New Zealand timber industry. Workers involved in treatment, or those handling freshlyFrom the 1950s to the late 1980s pentachlorophenol (PCP) based anti-sapstain fungicides were widely used in the New Zealand timber industry. Workers involved in treatment, or those handling freshly treated timber, experienced significant PCP exposure. Commercial grade PCP contained contaminants including 2,3,7,8-substituted polychlorinated dibenzo-p-dioxin (PCDD) and dibenzofuran (PCDF) congeners. To determine whether PCP exposure had resulted in elevated serum dioxin levels twenty years after its use had ceased we tested 94 former sawmill workers randomly selected from surviving members of a cohort enumerated for a mortality and cancer incidence study. After interviewing these individuals to collect demographic data and a comprehensive work history, they were divided into 71 PCP-exposed and 23 non-exposed individuals on the basis of job title and work tasks performed. We compared age-adjusted dioxin levels in the exposed and non-exposed groups, examined the effect of PCP exposure duration and intensity, and compared congener profiles with those found in the commercial grade PCP used at the time. Mean levels in exposed workers were elevated when compared with the non-exposed, with levels of 1,2,3,6,7,8-HxCDD, 1,2,3,4,6,7,8-HpCDD and OCDD being two to three times higher. The congener profiles in serum were consistent with those in PCP solutions, and dioxin levels increased with both employment duration and estimated exposure intensity. Serum dioxin levels in former New Zealand sawmill workers remain elevated twenty years after exposure to PCP ceased, and reflect the pattern of past PCP exposure.

• Leukaemia and occupation: a New Zealand Cancer Registry-based case-control Study.

  Authors: David McLean, Andrea 't Mannetje, Evan Dryson, Chris Walls, Fiona McKenzie, Milena Maule, Soo Cheng, Chris Cunningham, Hans Kromhout, Paolo Boffetta, Aaron Blair, Neil Pearce

  International journal of epidemiology. 11/2008;

  BACKGROUND: To examine the association between occupation and leukaemia. METHODS: We interviewed 225 cases (aged 20-75 years) notified to the New Zealand Cancer Registry during 2003-04, and 471BACKGROUND: To examine the association between occupation and leukaemia. METHODS: We interviewed 225 cases (aged 20-75 years) notified to the New Zealand Cancer Registry during 2003-04, and 471 controls randomly selected from the Electoral Roll collecting demographic details, information on potential confounders and a comprehensive employment history. Associations between occupation and leukaemia were analysed using logistic regression adjusted for gender, age, ethnicity and smoking. RESULTS: Elevated odds ratios (ORs) were observed in agricultural sectors including horticulture/fruit growing (OR: 2.62, 95% confidence interval (CI): 1.51, 4.55), plant nurseries (OR: 7.51, 95% CI: 1.85, 30.38) and vegetable growing (OR: 3.14, 95% CI: 1.18, 8.40); and appeared greater in women (ORs: 4.71, 7.75 and 7.98, respectively). Elevated ORs were also observed in market farmers/crop growers (OR: 1.84, 95% CI: 1.12, 3.02), field crop/vegetable growers (OR: 3.98, 95% CI: 1.46, 10.85), market gardeners (OR: 5.50, 95% CI: 1.59, 19.02), and nursery growers/workers (OR: 4.23, 95% CI: 1.34, 13.35); also greater in women (ORs: 3.48, 7.62, 15.74 and 11.70, respectively). These elevated ORs were predominantly for chronic lymphocytic leukaemia (CLL). Several associations persisted after semi-Bayes adjustment. Elevated ORs were observed in rubber/plastics products machine operators (OR: 3.76, 95% CI: 1.08, 13.08), predominantly in plastic product manufacturing. CLL was also elevated in tailors and dressmakers (OR: 7.01, 95% CI: 1.78, 27.68), cleaners (OR: 2.04, 95% CI: 1.00, 4.14) and builder's labourers (OR: 4.03, 95% CI: 1.30, 12.53). CONCLUSIONS: These findings suggest increased leukaemia risks associated with certain agricultural, manufacturing, construction and service occupations in New Zealand.

• Prognostic factors in women with breast cancer: inequalities by ethnicity and socioeconomic position in New Zealand.

  Authors: Fiona McKenzie, Mona Jeffreys, Andrea 't Mannetje, Neil Pearce

  Cancer causes & control : CCC. 06/2008; 19(4):403-11.

  OBJECTIVE: To investigate differences in breast cancer prognostic factors between ethnic and socioeconomic groups in New Zealand. METHODS: We analyzed all 21,586 breast cancer cases on the NewOBJECTIVE: To investigate differences in breast cancer prognostic factors between ethnic and socioeconomic groups in New Zealand. METHODS: We analyzed all 21,586 breast cancer cases on the New Zealand Cancer Registry (July 1994-June 2004). Māori, Pacific, and non-Māori/non-Pacific women were categorized according to ethnicity on the Registry. Deprivation was analyzed as quintiles of the New Zealand Deprivation Index 2001, an area-based measure of socioeconomic position. Logistic regression was used to estimate age-adjusted odds ratios (OR) (95% confidence intervals (CI)). RESULTS: Māori and Pacific women were more likely to have non-local stage, less well differentiated cancer, larger tumors and positive human epidermal growth factor receptor-type 2 (HER-2) status than non-Māori/non-Pacific women. Māori were less likely and Pacific women more likely than non-Māori/non-Pacific women to have negative oestrogen (ER) and progesterone receptor (PR) status. Adjusting for deprivation did not materially alter the results. Women living in more deprived areas had a higher risk of non-local stage and larger tumors. These associations were only partially explained by ethnicity. There was no relationship between tumor grade, ER, PR or HER-2 status and deprivation. CONCLUSIONS: Our results confirm that Māori, Pacific and low socioeconomic women present with poor prognosis breast tumors.

• Exposure to ultraviolet radiation and risk of malignant lymphoma and multiple myeloma--a multicentre European case-control study.

  Authors: Paolo Boffetta, Olga van der Hel, Anne Kricker, Alexandra Nieters, Silvia de Sanjosé, Marc Maynadié, Pier Luigi Cocco, Anthony Staines, Nikolaus Becker, Rebecca Font, Andrea 't Mannetje, Chris Goumas, Paul Brennan

  International journal of epidemiology. 06/2008;

  BACKGROUND: Three recent studies have reported a decreased risk of non-Hodgkin lymphoma (NHL) for high ultraviolet (UV) radiation exposure. METHODS: We conducted a multicentre case-control studyBACKGROUND: Three recent studies have reported a decreased risk of non-Hodgkin lymphoma (NHL) for high ultraviolet (UV) radiation exposure. METHODS: We conducted a multicentre case-control study during 1998-2004 in France, Germany, Ireland, Italy and Spain, comprising 1518 cases of NHL, 268 cases of Hodgkin lymphoma, 242 cases of multiple myeloma and 2124 population or hospital controls. We collected information on sensitivity to sun and personal exposure to UV radiation in childhood and adulthood via interview, and assessed occupational exposure to UV radiation from the occupational history. RESULTS: The risk of Hodgkin and NHL was increased for increasing skin sensitivity to the sun [odds ratio (OR) for no suntan vs very brown 2.35, 95% CI 0.94-5.87 and 1.39, 95% CI 1.03-1.87, respectively]. The risk of diffuse large B-cell lymphoma was reduced for increasing adult personal (OR for highest vs lowest quartile of exposure in free days 0.62, 95% CI 0.44-0.87) and for occupational exposure to UV radiation (OR for highest vs lowest exposure tertile 0.63, 95% CI 0.37-1.04). The risk of multiple myeloma was increased for personal exposure to UV radiation during adulthood (OR for highest vs lowest quartile of exposure in free days 1.49, 95% CI 0.88-2.50). A protective effect was observed for use of sun lamps for diffuse large B-cell lymphoma (OR for 25+ times vs never 0.63, 95% CI 0.38-1.03). CONCLUSIONS: The hypothesis of a protective effect of UV radiation on lymphoma is supported by our results. The underlying mechanisms might differ from those operating in skin carcinogenesis. The increased risk of multiple myeloma is worth replication.

• Case-control study of high risk occupations for bladder cancer in New Zealand.

  Authors: Evan Dryson, Andrea 't Mannetje, Chris Walls, Dave McLean, Fiona McKenzie, Milena Maule, Soo Cheng, Chris Cunningham, Hans Kromhout, Paolo Boffetta, Aaron Blair, Neil Pearce

  International journal of cancer. Journal international du cancer. 04/2008; 122(6):1340-6.

  We conducted a nationwide case-control study of bladder cancer in adult New Zealanders to identify occupations that may contribute to the risk of bladder cancer in the New Zealand population. A totalWe conducted a nationwide case-control study of bladder cancer in adult New Zealanders to identify occupations that may contribute to the risk of bladder cancer in the New Zealand population. A total of 213 incident cases of bladder cancer (age 25-70 years) notified to the New Zealand Cancer Registry during 2003 and 2004, and 471 population controls, were interviewed face-to-face. The questionnaire collected demographic information and a full occupational history. The relative risks for bladder cancer associated with ever being employed in particular occupations and industries were calculated by unconditional logistic regression adjusting for age, sex, smoking and socio-economic status. Estimates were subsequently semi-Bayes adjusted to account for the large number of occupations and industries being considered. An elevated bladder cancer risk was observed for hairdressers (odds ratio (OR) 9.15 95% Confidence Interval (95%CI) 1.60-62.22), and sewing machinists (OR 3.07 95%CI 1.35-6.96). Significantly increased risks were not observed for several other occupations that have been reported in previous studies, including sales assistants (OR 1.03 95%CI 0.64-1.67), painters and paperhangers (OR 1.42 95%CI 0.56-3.60), sheet metal workers (OR 0.39, 95%CI 0.15-1.00), printing trades workers (OR 1.11 95%CI 0.41-3.05) and truck drivers (OR 1.36 95%CI 0.60-3.09), although the elevated odds ratios for painters, printers and truck drivers are consistent with excesses observed in other studies. Nonsignificantly increased risks were observed for tailors and dressmakers (OR 2.84 95%CI 0.62-13.05), rubber and plastics products machine operators (OR 2.82 95%CI 0.75-10.67), building workers (OR 2.15, 95%CI 0.68-6.73), and female market farmers and crop growers (OR 2.05 95%CI 0.72-5.83). In conclusion, this study has confirmed that hairdressers and sewing machinists are high risk occupations for bladder cancer in New Zealand, and has identified several other occupations and industries of high bladder cancer risk that merit further study.