Case-control study of occupational exposures and male breast cancer

OBJECTIVE: To investigate whether risk of male breast cancer is associated with workplace exposures. METHODS: A case-control study of 178 cases of male breast cancer and 1041 controls was carried out with data from the United States national mortality follow-back survey, which collected questionnaire information from proxy respondents of a 1% sample of all 1986 United States deaths among subjects aged 25-74 years. Occupational exposure to electromagnetic fields, high temperatures, polycyclic aromatic hydrocarbons (PAHs), herbicides, other pesticides, and organic solvents was assessed by applying job-exposure matrices, based on the 1980 United States census occupation and industry codes, to the longest job held by study subjects as reported by the informants. A socioeconomic status index was created by combining information on annual family income, education, assets, and occupation to assess the association of socioeconomic status with male breast cancer. Relative risks were derived from logistic regression modelling, which included age, socioeconomic status, marital status, and body mass index, as well as occupational exposures. RESULTS: Risk for male breast cancer increased significantly with increasing socioeconomic status index (test for trend: p < 0.01), but the risks associated with individual socioeconomic status variables were smaller and the trends were not significant. A significant increase in risk of male breast cancer was associated with employment in blast furnaces, steel works, and rolling mills (odds ratio (OR) 3.4; 95% confidence interval (95% CI) 1.1 to 10.1, based on six cases), and motor vehicle manufacturing (OR 3.1; 95% CI 1.2 to 8.2, based on seven cases). However, exposures to electromagnetic fields, high temperature, PAHs, herbicides, other pesticides, and organic solvents were not associated with risk of male breast cancer. CONCLUSIONS: The role of workplace exposures in increasing risk of breast cancer among men employed in motor vehicle manufacturing and in blast furnaces, steel works, and rolling mills deserves further investigation. The finding on socioeconomic status suggests that, as well as reproductive factors, other lifestyle factors such as diet that may be related to high socioeconomic status in men should be investigated further

Case-control study of occupational exposures and male breast cancer

OBJECTIVE: To investigate whether risk of male breast cancer is associated with workplace exposures. METHODS: A case-control study of 178 cases of male breast cancer and 1041 controls was carried out with data from the United States national mortality follow-back survey, which collected questionnaire information from proxy respondents of a 1% sample of all 1986 United States deaths among subjects aged 25-74 years. Occupational exposure to electromagnetic fields, high temperatures, polycyclic aromatic hydrocarbons (PAHs), herbicides, other pesticides, and organic solvents was assessed by applying job-exposure matrices, based on the 1980 United States census occupation and industry codes, to the longest job held by study subjects as reported by the informants. A socioeconomic status index was created by combining information on annual family income, education, assets, and occupation to assess the association of socioeconomic status with male breast cancer. Relative risks were derived from logistic regression modelling, which included age, socioeconomic status, marital status, and body mass index, as well as occupational exposures. RESULTS: Risk for male breast cancer increased significantly with increasing socioeconomic status index (test for trend: p < 0.01), but the risks associated with individual socioeconomic status variables were smaller and the trends were not significant. A significant increase in risk of male breast cancer was associated with employment in blast furnaces, steel works, and rolling mills (odds ratio (OR) 3.4; 95% confidence interval (95% CI) 1.1 to 10.1, based on six cases), and motor vehicle manufacturing (OR 3.1; 95% CI 1.2 to 8.2, based on seven cases). However, exposures to electromagnetic fields, high temperature, PAHs, herbicides, other pesticides, and organic solvents were not associated with risk of male breast cancer. CONCLUSIONS: The role of workplace exposures in increasing risk of breast cancer among men employed in motor vehicle manufacturing and in blast furnaces, steel works, and rolling mills deserves further investigation. The finding on socioeconomic status suggests that, as well as reproductive factors, other lifestyle factors such as diet that may be related to high socioeconomic status in men should be investigated further

Predictors of 2,4-dichlorophenoxyacetic acid exposure among herbicide applicators.

To determine the major factors affecting the urinary levels of 2,4-dichlorophenoxyacetic acid (2,4-D) among county noxious weed applicators in Kansas, we used a regression technique that accounted for multiple days of exposure. We collected 136 12-h urine samples from 31 applicators during the course of two spraying seasons (April to August of 1994 and 1995). Using mixed-effects models, we constructed exposure models that related urinary 2,4-D measurements to weighted self-reported work activities from daily diaries collected over 5 to 7 days before the collection of the urine sample. Our primary weights were based on an earlier pharmacokinetic analysis of turf applicators; however, we examined a series of alternative weighting schemes to assess the impact of the specific weights and the number of days before urine sample collection that were considered. The derived models accounting for multiple days of exposure related to a single urine measurement seemed robust with regard to the exact weights, but less to the number of days considered; albeit the determinants from the primary model could be fitted with marginal losses of fit to the data from the other weighting schemes that considered a different numbers of days. In the primary model, the total time of all activities (spraying, mixing, other activities), spraying method, month of observation, application concentration, and wet gloves were significant determinants of urinary 2,4-D concentration and explained 16% of the between-worker variance and 23% of the within-worker variance of urinary 2,4-D levels. As a large proportion of the variance remained unexplained, further studies should be conducted to try to systematically assess other exposure determinants

Student Voices: A Call for Equity in Representations of Gender in Occupational Science and Occupational Therapy Literature

Aims/Intent: The intent of this forum is to critically examine representations of gender expression within occupational science (OS) and occupational therapy (OT) literature, frequently used within OT curricula, in response to students\u27 call for social inclusion in learning about occupation. Our aim is to promote an understanding of gender expression among researchers, educators, students, and practitioners in order to better support clients with diverse gender expressions. First, we will share approaches for inclusive pedagogy and the importance of creating a learning environment of social inclusion.1 Next, we will present findings from a review of OS and OT literature examining representations of gender and how inequity in portrayal of gender prevents client-centeredness. Then, we will discuss disparities in the health and occupations of individuals with gender expressions outside the binary norm. Through these areas of discussion and by posing key questions, we aim to facilitate critical discourse about representations of gender expression within OS and OT. Rationale: Current feminist and social psychology theorists view gender as socially constructed and performed along a spectrum of expression.2, 3 This expression influences occupational opportunities and choices.4 Client-centered thinking values affirming identity; therefore, it is essential that practitioners give voice to client gender expression. Unfortunately, much of the available literature in OS and OT has treated gender at best as categorical and at worst as a determinant of behavior. Gender minorities experience disparities in everyday living due to the stressors of performing gender and the lack of societal acceptance of diverse gender expressions. Gender minorities are at higher risk of experiencing refusal of care, harassment, violence, and lack of practitioner knowledge when seeking health care, a reality that contributes to higher instances of avoidance of care and subsequent physical and mental health disparities. Similarly, lack of knowledge of the occupational needs and experiences of gender minorities contributes to occupational marginalization, deprivation, and alienation.5 Learning about the importance of gender inclusivity, and applying that knowledge to education, practice and research, is one way to help lessen these disparities. Potential Outcomes: OS can inform understanding of gender disparities and critical discussion can influence theory and research about occupation that may lead to a shift in understanding of diverse gender expressions. Outcomes of this forum include furthering collaborations among OS and other disciplines to move forward research and practice that reflects the evolving understanding of gender expression in contemporary society. Questions/Objectives for Discussion: What is the current state of representing gender expression in occupational science and occupational therapy literature? What factors (theory, research methods) may limit inclusion of diverse gender representations? What opportunities exist for research and literature within occupational science to inform gender inclusivity in society, and particularly among health care providers? What knowledge, skills, and values are needed to foster true social inclusion in client-centered practice? How does the current level of societal understanding of diverse gender expressions influence occupational performance for this population? What opportunities exist for occupational science to contribute to intentional, inclusive pedagogy in occupational therapy education? What pedagogical approaches and learning activities are well suited for fostering social inclusion in education and practice? How can students play a role in advocating for inclusion of diverse gender expressions in occupational therapy education? Key words: gender expression, occupation, pedagog