Rad u smjenama i rak - znanstvene spoznaje i praktične posljedice

In 2007, an expert Working Group convened by the IARC Monographs Programme concluded that shift work that involves circadian disruption is probably carcinogenic to humans (Group 2A). We scrutinised the epidemiological basis for this conclusion, with a focus on, but not limited to, breast and prostate cancers. We further considered practical consequences for shift workers in our industry against the background of new findings. We carried out a literature search including the epidemiological studies cited by IARC and newer available literature on shift work and cancer. Since the IARC assessment, eleven new studies have emerged, ten of which have already been published, with inconclusive results. Heterogeneity of exposure metrics and study outcomes and emphasis on positive but non-signifi cant results make it diffi cult to draw general conclusions. Also, several reviews and commentaries, which have been published meanwhile, came to equivocal results. Published evidence is widely seen as suggestive but inconclusive for an adverse association between night work and breast cancer, and limited and inconsistent for cancers at other sites and all cancers combined. At this point in time it can not be ruled out that shift work including night work may increase the risk for some cancers in those who perform it. However, shift schedules can be organised in ways that minimise the associated health risks, and the risks may be further reduced through the implementation of structured and sustained health promotion programs specifi cally tailored to the needs of shift workers.Stručna radna skupina, koju je okupio Program monografija Međunarodne agencije za istraživanje raka (eng. International Agency for Research on Cancer, krat. IARC), 2007. godine zaključila je da je rad u smjenama, koji uključuje prekid cirkadijurnoga ritma, najvjerojatnije kancerogen za ljude (skupina 2A). Procijenili smo epidemiološku osnovu takvoga zaključka i usredotočili se na rak dojke i rak prostate između ostalih malignih bolesti. Nadalje, razmatrali smo praktične posljedice koje rad u smjenama ima na radnike u kemijskoj kompaniji BASF u okvirima novih spoznaja na tom području. Istražili smo literaturu, uključujući i epidemiološka istraživanja studije koje citira IARC kao i noviju literaturu o povezanosti rada u smjenama i raku. Od zaključka IARC-a nastalo je jedanaest novih istraživanja, a deset ih je već objavljeno. Njihovi rezultati ipak ne dovode do konačnoga i jednoznačnoga zaključka. Heterogenost mjerenja izloženosti i ishoda istraživanja i naglasak na pozitivne, ali ne uvijek i značajne rezultate, otežavaju postavljanje općih zaključaka. Jednako tako u nekoliko nedavno objavljenih recenzija i komentara ne iznose se jednoznačni rezultati. Objavljeni znanstveno utemeljeni dokazi samo upućuju, ali ne dovode u očiglednu vezu noćni rad i rak dojke. Nadalje, ograničeni su i nedosljedni za malignome na drugim lokacijama u tijelu, kao i za sve malignome zajedno. U ovom trenutku nije moguće odbaciti hipotezu da smjenski rad (uključujući noćni rad) može povećati rizik nastanka određenih malignih bolesti. Međutim, raspored smjena se može organizirati na način da se opasnosti za zdravlje svedu na najmanju moguću mjeru. Rizici se također mogu dodatno smanjiti provedbom strukturiranih programa promicanja održivoga zdravlja koji bi bili posebno osmišljeni prema potrebama radnika

Mortality from cancer and other causes in commercial airline crews: A joint analysis of cohorts from 10 countries

Background: Commercial airline crew is one of the occupational groups with the highest exposures to ionising radiation. Crew members are also exposed to other physical risk factors and subject to potential disruption of circadian rhythms. Methods: This study analyses mortality in a pooled cohort of 93 771 crew members from 10 countries. The cohort was followed for a mean of 21.7 years (2.0 million person-years), during which 5508 deaths occurred. Results: The overall mortality was strongly reduced in male cockpit (SMR 0.56) and female cabin crews (SMR 0.73). The mortality from radiation-related cancers was also reduced in male cockpit crew (SMR 0.73), but not in female or male cabin crews (SMR 1.01 and 1.00, respectively). The mortality from female breast cancer (SMR 1.06), leukaemia and brain cancer was similar to that of the general population. The mortality from malignant melanoma was elevated, and significantly so in male cockpit crew (SMR 1.57). The mortality from cardiovascular diseases was strongly reduced (SMR 0.46). On the other hand, the mortality from aircraft accidents was exceedingly high (SMR 33.9), as was that from AIDS in male cabin crew (SMR 14.0). Conclusions: This large study with highly complete follow-up shows a reduced overall mortality in male cockpit and female cabin crews, an increased mortality of aircraft accidents and an increased mortality in malignant skin melanoma in cockpit crew. Further analysis after longer follow-up is recommended

David Lichine as The Faune, in L'Apres-Midi d'un Faune, Original Ballet Russe, Australian tour, His Majesty's Theatre, Melbourne, Apr - May 1940 (17) [picture] /

Part of the collection: Hugh P. Hall collection of photographs, 1938-1940.; From: L'Apres-midi d'un faun (Afternoon of a faun) : choreographic poem / music by Claude Debussy.; Inscription: "4Q/33 (44)".; Choreography by Waslaw Nijinsky ; scenery by Prince A. Schervachidze ; costumes by Léon Bakst.; Also available in an electronic version via the Internet at: http://nla.gov.au/nla.pic-vn3995629. One of a collection of photographs taken by Hugh P. Hall of 28 ballet productions performed by the Covent Garden Russian Ballet (toured Australia 1938-1939) and the Original Ballet Russe (toured Australia 1939-1940). These are the second and third of the three Ballets Russes companies which toured Australasia between 1936 and 1940. The photographs were taken from the auditorium during a live performance in His Majesty's Theatre, Melbourne and mounted on cardboard for display purposes. For conservation and storage, the photographs have been demounted. The original arrangement of the photographs has been recorded, and details are available from the Pictures Branch of the National Library