Lin Fritschi

• PhD, MBBS, FAFPHM
• Professor at Curtin University

Background Breast cancer is multifactorial. Focusing on limited risk factors may miss high-risk individuals. Methods We assessed the performance and overlap of various risk factors in identifying high-risk individuals for invasive breast cancer (BrCa) and ductal carcinoma in situ (DCIS) in 161,849 European-ancestry and 18,549 Asian-ancestry women....

The One Health concept is increasingly employed to combat zoonotic diseases. This study assessed the knowledge, attitudes, and practices regarding One Health and zoonotic diseases among key sector professionals to identify gaps and opportunities for enhancing One Health strategies in Bhutan. A cross-sectional, facility-based study was used to condu...

Background The 313-variant polygenic risk score (PRS313) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS313 across different European populations which could influence risk estimation has not been performed. Methods We explored the distribution of PRS313 across European populations using genotyp...

In March, 2024, an Advisory Group of 28 independent scientists from 22 countries met in Lyon, France to recommend priorities for carcinogenicity evaluations by the International Agency for Research on Cancer (IARC) Monographs programme during 2025–29. IARC periodically convenes such advisory groups to ensure that the agents evaluated in the Monogra...

Background Artificial ultraviolet radiation (UVR) is produced during welding and can cause damage to both the eyes (ocular) and the skin (dermal). We aimed to investigate the protection used by welders to reduce their exposure to ocular and dermal UVR. Methods We conducted a cross-sectional online survey in Australia that asked welders about their...

Objectives To summarise the rationale, workflow and recommendations for the conduct of exposure assessment critiques in key human studies evaluated for International Agency for Research on Cancer (IARC) Monographs on the Identification of Carcinogenic Hazards. Methods Approaches to evaluating exposure assessment quality in human cancer and mechani...

Introduction Occupational carcinogens may be induced by physical, chemical, biological and organizational workplace hazards. In the United Arab Emirates (UAE), migrant workers account for 80% of labor. Being sometimes employed as unskilled workers and more willing to work in demanding jobs, their vulnerability to harmful exposures may be increased....

Introduction Noise at work is a significant problem, with 15% of the Australian working population exposed above the occupational limit (LAeq8h > 85dB) on any single working day. However the approach to occupational noise control relies on workers themselves wearing correct hearing protection. The management of environmental noise control is a bett...

Context Workplace noise regulations and guidance follow the hierarchy of control model that prioritizes eliminating or reducing noise at its source. Objectives To determine the main sources of workplace noise exposure in the Australian working population and estimate the reduction of workers exposed over the noise limit (LAeq,8h > 85 dB) if noise...

In March, 2024, an Advisory Group of 28 independent scientists from 22 countries met in Lyon, France to recommend priorities for carcinogenicity evaluations by the International Agency for Research on Cancer (IARC) Monographs programme during 2025–29. IARC periodically convenes such advisory groups to ensure that the agents evaluated in the Monogra...

The 313-variant polygenic risk score (PRS313) provides a promising tool for breast cancer risk prediction. However, evaluation of the PRS313 across different European populations which could influence risk estimation has not been performed. Here, we explored the distribution of PRS313 across European populations using genotype data from 94,072 fema...

The international authorities, such as the Food and Agriculture Organization of the United Nations, World Health Organization, World Organization for Animal Health, United Nations Environment Programme, and World Bank, have endorsed the One Health concept as an effective approach to optimize the health of people, animals, and the environment. The O...

Background Exposure to welding fume is associated with adverse effects on worker health. The use of various control measures can reduce levels of exposure and the resulting health effects. However, little is known about the factors that may influence workers' use of control measures in the workplace and their perceived intervention needs. This stud...

Background Polygenic risk score (PRS), calculated based on genome-wide association studies (GWASs), can improve breast cancer (BC) risk assessment. To date, most BC GWASs have been performed in individuals of European (EUR) ancestry, and the generalisation of EUR-based PRS to other populations is a major challenge. In this study, we examined the pe...

Objective: To investigate the occupational risk factors associated with tinnitus in the Australian working population. Design: The research was conducted using data collected from the Australian Workplace Exposure Survey-Hearing, a national cross-sectional study of 4970 workers conducted in 2016 to 2017. Workers were asked if they experienced ti...

Purpose: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality. Breast arterial calcification (BAC) on mammograms is not associated with breast cancer risk. However, there is increasing evidence supporting its association with cardiovascular disease (CVD). This study examines the association between BAC and ASC...

Background Assessment of occupational exposures is an integral component of population-based studies investigating the epidemiology of occupational diseases. However, all the available methods for exposure assessment have been developed, tested and used in high-income countries. Except for a few studies examining pesticide exposures, there is limit...

Per- and poly-fluoroalkyl substances (PFAS) are a group of manmade compounds produced since the 1950s and used in a range of industrial processes and consumer products. In Australia, PFAS serum concentrations have been measured in the general population since 2002. However, few studies have retrospectively measured PFAS concentrations in serum samp...

Occupational illnesses, such as cancer, cause more deaths each year than occupational accidents. Occupational carcinogens include physical, chemical, biological and organizational hazards. In the United Arab Emirates (UAE), migrant workers account for 80% of labor. Being sometimes employed as unskilled workers and more willing to work in demanding...

Objectives Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using ge...

Background Reproductive factors have been shown to be differentially associated with risk of estrogen receptor (ER) positive and ER-negative breast cancer. However, their associations with intrinsic-like subtypes are less clear. Methods Analyses included up to 23,353 cases, and 71,072 controls pooled from 31 population-based case-control or cohort...

Germline copy number variants (CNVs) are pervasive in the human genome but potential disease associations with rare CNVs have not been comprehensively assessed in large datasets. We analysed rare CNVs in genes and non-coding regions for 86,788 breast cancer cases and 76,122 controls of European ancestry with genome-wide array data. Gene burden test...

Objectives To estimate the prevalence of tinnitus in Australian working people; to identify occupational and demographic factors associated with tinnitus. Design Cross-sectional national telephone survey of self-reported frequency and duration of tinnitus. Setting, participants Australian Workplace Exposure Survey (AWES) ‒ Hearing; 4970 currently...

Background Many cancers are caused by exposure to lifestyle, environmental, and occupational factors. Earlier studies have estimated the number of cancers occurring in a single year which are attributable to past exposures to these factors. However, there is now increasing appreciation that estimates of the future burden of cancer may be more usefu...

Background Despite a modest association between tobacco smoking and breast cancer risk reported by recent epidemiological studies, it is still equivocal whether smoking is causally related to breast cancer risk. Methods We applied Mendelian randomisation (MR) to evaluate a potential causal effect of cigarette smoking on breast cancer risk. Both ind...

Background Diesel engine exhaust (DEE) is classified as a potential carcinogen for bladder cancer in humans by the International Agency for Research on Cancer. We aimed to compare bladder cancer incidence in Western Australian miners against the general population and determine if there was an association with DEE, measured as Elemental Carbon. Me...

Background Myeloproliferative neoplasms (MPNs) are a relatively new group of blood cancers arising from genetic mutations in haematopoietic stem cells. Diagnostic delay is associated with thromboses, strokes and heart attacks. We investigated geographic variation in diagnosis and survival for classic MPNs. Methods Data for classic MPNs were obtain...

Myeloproliferative neoplasms (MPNs) are an uncommon group of blood cancers that, if untreated, result in an increased risk of haemorrhagic event or thrombosis. Unlike other cancer types, diagnosis of MPNs requires a combination of microscopic, clinical and genetic evidence, which provide unique challenges given the typical notification processes of...

Abstract Background Given the high heterogeneity among breast tumors, associations between common germline genetic variants and survival that may exist within specific subgroups could go undetected in an unstratified set of breast cancer patients. Methods We performed genome-wide association analyses within 15 subgroups of breast cancer patients ba...

BACKGROUND: Given the high heterogeneity among breast tumors, associations between common germline genetic variants and survival that may exist within specific subgroups could go undetected in an unstratified set of breast cancer patients. METHODS: We performed genome-wide association analyses within 15 subgroups of breast cancer patients based on...

Background Coal mine dust lung disease comprises a group of occupational lung diseases including coal workers pneumoconiosis. In many countries, there is a lack of robust prevalence estimates for these diseases. Our objective was to perform a systematic review and meta-analysis of published contemporary estimates on prevalence, mortality, and survi...

Background: Despite a modest association between tobacco smoking and breast cancer risk reported by recent epidemiological studies, it is still equivocal whether smoking is causally related to breast cancer risk. Methods: We applied Mendelian randomisation (MR) to evaluate a potential causal effect of cigarette smoking on breast cancer risk. Bot...

Evidence for the human health effects of pesticides is needed to inform risk assessment. We studied the relationship between occupational insecticide use and risk of non‐Hodgkin lymphoma (NHL) by pooling data from nine case‐control studies participating in the InterLymph Consortium, including 7909 cases and 8644 controls from North America, the Eur...

Background Copy number variants (CNVs) are pervasive in the human genome but potential disease associations with rare CNVs have not been comprehensively assessed in large datasets. We analysed rare CNVs in genes and non-coding regions for 86,788 breast cancer cases and 76,122 controls of European ancestry with genome-wide array data. Results Gene b...

Background Copy number variants (CNVs) are pervasive in the human genome but potential disease associations with rare CNVs have not been comprehensively assessed in large datasets. We analysed rare CNVs in genes and non-coding regions for 86,788 breast cancer cases and 76,122 controls of European ancestry with genome-wide array data. Results Gene...

Objective To estimate the prevalence of hand-arm vibration (HAV) in Australian workplaces. Methods The Australian Workplace Exposure Survey (AWES)—Hearing was a cross-sectional telephone survey of Australian workers conducted in 2016–2017. Respondents were asked about the time spent using tools or performing tasks known to be associated with HAV d...

Introduction: The SARS-CoV-2/Covid-19 pandemic is a challenge for public health and occupational medicine and developing prevention and protection strategies needs expertise from many disciplines. To make prevention successful, individuals have to be motivated to participate and, in turn, motivation depends on understanding how and why prevention...

Disparities in exposure to workplace hazards exist between Māori and non-Māori workers in New Zealand, with Māori workers generally incurring poorer conditions. This study aimed to determine if these ethnic disparities are similar after migration to Australia. A national cross-sectional telephone survey asked participants what tasks they undertook...

A common chemical exposure in alumina refining is caustic mist. Although recognized as a strong airways irritant, little is known of the chronic respiratory effects of caustic mist in alumina refining. A suitable metric for caustic mist exposure assessment in alumina refining for epidemiological purposes has not been identified. Peak exposure is li...

Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of th...

Breast cancer (BC) risk for BRCA1 and BRCA2 mutation carriers varies by genetic and familial factors. About 50 common variants have been shown to modify BC risk for mutation carriers. All but three, were identified in general population studies. Other mutation carrier-specific susceptibility variants may exist but studies of mutation carriers have...

Background; The etiology of follicular lymphoma (FL), a common non-Hodgkin lymphoma subtype, is largely unknown. Objective We performed a systematic review and meta-analysis of observational studies examining the relationship between occupational exposures and FL risk. Methods We searched Ovid MEDLINE, Ovid EMBASE, and Web of Science for eligible...

Background Occupational exposures to hazardous chemicals among healthcare workers can result in long‐term adverse health outcomes. Research on such exposures from low‐ and middle‐income countries is limited. The aim of this study was to estimate the prevalence of exposures to a range of chemicals used in healthcare settings among Bhutanese healthca...

Background: Information is scarce about the occupational health effects of exposure to alumina dust. This study examines the respiratory effects of inspirable alumina dust exposure in alumina refineries. Methods: An inception cohort study at three alumina refineries in Western Australia recruited 416 participants (351 males, 65 females) between...

Background: Collection of reliable and valid occupational history data is of utmost importance to assess work-related exposures and their health effects. Few standardized questionnaires are available for the collection of occupational history data in low-and-middle income countries. Objective: To adapt and test a validated questionnaire developed...

Background: Occupational noise-induced hearing loss (ONIHL) is one of the most common yet preventable occupational diseases. The aim of this study was to estimate the economic burden of ONIHL in the Australian working population by quantifying and monetising ONIHL—related loss of Quality Adjusted Life Years (QALY) and Productivity Adjusted Life Yea...

In breast cancer, high levels of homeobox protein Hox-B13 (HOXB13) have been associated with disease progression of ER-positive breast cancer patients and resistance to tamoxifen treatment. Since HOXB13 p.G84E is a prostate cancer risk allele, we evaluated the association between HOXB13 germline mutations and breast cancer risk in a previous study...

Background Disparities in exposure to occupational hazards may be linked to social position as well as the type of job a person holds. This study aimed to describe the prevalence of exposure to workplace hazards among three migrant worker groups and to assess whether social disparities in exposure for these groups remain after adjusting for occupat...

Background Increased mammographic density is one of the strongest risk factors for breast cancer. Night shiftwork and its related factors, which include light at night, phase shift and sleep disruption, are believed to increase breast cancer risk however, their effects on mammographic density have barely been studied. Methods This study included 1...

We evaluated the joint associations between a new 313-variant PRS (PRS313) and questionnaire-based breast cancer risk factors for women of European ancestry, using 72,284 cases and 80,354 controls from the Breast Cancer Association Consortium. Interactions were evaluated using standard logistic regression, and a newly developed case-only method, fo...

Objective To assess the predictive value of bronchial hyper-responsiveness (BHR) for the subsequent development of respiratory symptoms, airflow limitation and decline in lung function among aluminium smelter workers. Methods An inception cohort study of new employees at two Australian aluminium smelters was conducted. Participants completed a mod...

Experimental evidence suggests that perinatal light imprinting of circadian clocks and systems may affect downstream physiology and cancer risk in later life. For humans, the predominant circadian stimulus is the daily light-dark cycle. Herein, we explore associations between perinatal photoperiod characteristics (photoperiod: duration of daylight...

Most epidemiological studies of disease aetiology do not consider potential risk factors at work. This may be because work is a complex exposure: people usually have a series of different jobs over their working lifetime; within each job there may be a range of different tasks; and there may be a variety of exposures in each job. Because of this co...

Background Healthcare workers are occupationally exposed to various hazardous chemicals and agents that can potentially result in long‐term adverse health effects. These exposures have not been comprehensively examined at a population level. The aim of this study was to examine occupational exposures to a wide range of asthmagens, carcinogens, and...

Previous transcriptome‐wide association studies (TWAS) have identified breast cancer risk genes by integrating data from expression quantitative loci and genome‐wide association studies (GWAS), but analyses of breast cancer subtype‐specific associations have been limited. In this study, we conducted a TWAS using gene expression data from GTEx and s...

Despite the identification of acquired genetic mutations associated with Myeloproliferative Neoplasms (MPNs) there is a paucity of information relating to modifiable risk factors that may lead to these mutations. The MOSAICC Study was an exploratory case-control study of polycythemia vera (PV), essential thrombocythemia (ET), and Myelofibrosis (MF)...

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. Thi...

Asbestos-containing materials (ACMs) were used extensively throughout much of the 20th century and can still be found in many Australian homes. Therefore, we developed a mobile application (“app”), called ACM Check, which guides users through a home inspection to identify and assess certain types of in situ ACM. A cross-sectional study was conducte...

Background Previous gene-environment interaction studies of breast cancer risk have provided sparse evidence of interactions. Using the largest available dataset to date, we performed a comprehensive assessment of potential effect modification of 205 common susceptibility variants by 13 established breast cancer risk factors, including replication...

Background: The palm oil industry is the largest contributor to global production of oils and fats. Indonesia and Malaysia are the largest producers of palm oil. More than a million workers are employed in this industry, yet there is a lack of information on their occupational health and safety. Objective: To identify and summarize occupational...

The Advisory Group to Recommend an Update to the Preamble to the IARC Monographs was convened at a time when significant shifts are occurring in the scientific evidence that contributes to the understanding of carcinogenicity, as well as in approaches to information gathering and evidence assessment and integration. Historically, for many agents, t...

Fanconi anemia (FA) is a genetically heterogeneous disorder with 22 disease-causing genes reported to date. In some FA genes, monoallelic mutations have been found to be associated with breast cancer risk, while the risk associations of others remain unknown. The gene for FA type C, FANCC, has been proposed as a breast cancer susceptibility gene ba...

Purpose Research on the association between physical activity and the risk of prostate cancer is inconsistent. The aim of this study was to investigate whether the timing, intensity, and type of recreational physical activity influence prostate cancer risk. Methods A population-based case–control study was conducted in Western Australia in 2001–20...

Background In addition to the established association between general obesity and breast cancer risk, central obesity and circulating fasting insulin and glucose have been linked to the development of this common malignancy. Findings from previous studies, however, have been inconsistent, and the nature of the associations is unclear. Methods We co...

Objectives Mining is associated with exposures to various lung carcinogens such as diesel engine exhaust (DEE) and respirable crystalline silica (RCS). We aimed to determine if lung cancer incidence was higher in Western Australian (WA) miners than the general population and if risk varied within the cohort according to exposures and work or job ty...

For the benefits of autonomous vehicles (AVs) to be optimized, the fleet conversion process needs to be efficient and timely. This study explored public attitudes to AVs to inform strategies to increase receptivity to the wide-scale use of AVs. A national online survey was administered to a sample of 1,624 Australians aged 16+ years. The survey fea...

Stratification of women according to their risk of breast cancer based on polygenic risk scores (PRSs) could improve screening and prevention strategies. Our aim was to develop PRSs, optimized for prediction of estrogen receptor (ER)-specific disease, from the largest available genome-wide association dataset and to empirically validate the PRSs in...

p>Exposure to diesel engine exhaust contributes appreciably to the burden of occupational cancer. This study aims to estimate the potential impact of a range of interventions on the future burden of cancer from occupational exposure to diesel engine exhaust in Australia. The future excess fraction method, a novel method based on the lifetime risk a...

Objectives: To estimate the inter-rater agreement between exposure assessment to asthmagens in current jobs by algorithms based on task-based questionnaires (OccIDEAS) and by experts. Methods: Participants in a cross-sectional national survey of exposure to asthmagens (AWES-Asthma) were randomly split into two subcohorts of equal size. Subcohort...

Assessing individual chronotypes can become relevant for epidemiological studies, for instance when investigating the impact of night-shift work on human’s health. The objective of this study was to explore and compare three different approaches (Self-rating, Munich Chronotype Questionnaire (MCTQ), Perfect Day (PD)) of assessing the chronotype in a...

Background: High body mass index (BMI > 25 kg/m ² ) has been found to be associated with an increased risk of many cancers, including cancers of the colon and rectum, liver, and pancreas. Aim: This study aimed to estimate the future burden of cancer resulting from current levels of overweight and obesity in Australia. Methods: The future excess fra...

The advent of autonomous vehicles is forecast to bring enormous changes to the workplace as positions primarily involving driving become progressively redundant. Little is known about public awareness of these impending changes and the potential impacts on society and individuals. This study involved a national survey of Australians and interviews...

Background Limited information is available on exposure to high molecular weight (HMW) asthmagens derived from plants and on the main occupations and tasks that result in such exposure among workers. Methods Data were collected as part of the Australian Work Exposures Study—Asthma. We estimated adjusted prevalence ratios (aPR) using modified Poiss...

Endometrial cancer is the most commonly diagnosed cancer of the female reproductive tract in developed countries. Through genome-wide association studies (GWAS), we have previously identified eight risk loci for endometrial cancer. Here, we present an expanded meta-analysis of 12,906 endometrial cancer cases and 108,979 controls (including new geno...

Endometrial cancer is the most commonly diagnosed cancer of the female reproductive tract in developed countries. Through genome-wide association studies (GWAS), we have previously identified eight risk loci for endometrial cancer. Here, we present an expanded meta-analysis of 12,906 endometrial cancer cases and 108,979 controls (including new geno...

Introduction: Farmers experience a range of carcinogenic exposures, including some pesticides, fuels, engine exhausts, metals, some organic solvents, silica, wood dusts and solar radiation. However many studies investigating the risk of cancer in farmers focus on pesticide exposure alone. The aim of this study was to determine which carcinogens Au...

Context: Construction industry workers are at high risk of occupational noise exposure. Although regulations and guidelines for this industry specify the use of noise controls, workers continue to be exposed to hazardous noise levels. Objectives: The objectives of this study were (i) to collate and describe full-shift noise exposure experienced...

The breast cancer risk variants identified in genome-wide association studies explain only a small fraction of the familial relative risk, and the genes responsible for these associations remain largely unknown. To identify novel risk loci and likely causal genes, we performed a transcriptome-wide association study evaluating associations of geneti...

In humans and most other species, changes in the intensity and duration of light provide a critical set of signals for the synchronisation of the circadian system to the astronomical day. The timing of activity within the 24 h day defines an individual’s chronotype, i.e. morning, intermediate or evening type. The aim of this study was to investigat...

Breast cancer risk variants identified in genome-wide association studies explain only a small fraction of familial relative risk, and genes responsible for these associations remain largely unknown. To identify novel risk loci and likely causal genes, we performed a transcriptome-wide association study evaluating associations of genetically predic...

In situ asbestos in the built environment is a remaining source of exposure in countries that have prohibited the manufacture and use of asbestos. However, it is difficult to identify in situ asbestos-containing material in residential settings. The objective of this study was to evaluate the accuracy of the mobile phone application (“app”), ACM Ch...