Investigation of occupational and environmental causes of respiratory cancers (ICARE): a multicenter, population-based case-control study in France

<p>Abstract</p> <p>Background</p> <p>Occupational causes of respiratory cancers need to be further investigated: the role of occupational exposures in the aetiology of head and neck cancers remains largely unknown, and there are still substantial uncertainties for a number of suspected lung carcinogens. The main objective of the study is to examine occupational risk factors for lung and head and neck cancers.</p> <p>Methods/design</p> <p>ICARE is a multi-center, population-based case-control study, which included a group of 2926 lung cancer cases, a group of 2415 head and neck cancer cases, and a common control group of 3555 subjects. Incident cases were identified in collaboration with cancer registries, in 10 geographical areas. The control group was a random sample of the population of these areas, with a distribution by sex and age comparable to that of the cases, and a distribution by socioeconomic status comparable to that of the population. Subjects were interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumption, residential history and a detailed description of occupational history. Biological samples were also collected from study subjects. The main occupational exposures of interest are asbestos, man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes more than 60 substances. Occupational exposure assessment will use several complementary methods: case-by-case evaluation of exposure by experts; development and use of algorithms to assess exposure from the questionnaires; application of job-exposure matrices.</p> <p>Discussion</p> <p>The large number of subjects should allow to uncover exposures associated with moderate increase in risks, and to evaluate risks associated with infrequent or widely dispersed exposures. It will be possible to study joint effects of exposure to different occupational risk factors, to examine the interactions between occupational exposures, tobacco smoking, alcohol drinking, and genetic risk factors, and to estimate the proportion of respiratory cancers attributable to occupational exposures in France. In addition, information on many non-occupational risk factors is available, and the study will provide an excellent framework for numerous studies in various fields.</p

Analisi di un campione di popolazione generale affetta da asma bronchiale e relazione con l’attività lavorativa

. To find the impact of occupational exposure to irritants or sensitizers on the occurrence, recurrence and worsening of asthma and to identify unrecognized cases of occupational asthma in a general asthma clinic population sample, we studied 768 subjects (age: 16-46 yrs) with a diagnosis of asthma and a current or previous occupational activity. A trained survey worker administered a computer assisted interview in order to collect data on their demographic characteristics, smoking history, asthma severity, treatment, work history and current work status. Current or previous work did not appear to affect the severity of asthma, though more activtiy limitations were observed among subjects with current work (p=0.02). Overall, subjects who reported symptoms from Work Related Asthma (WRA), when compared to subjects without WRA, more frequently (p&lt;0.05) reported having more severe symptoms, assuming antiasthmatic therapy, and having changed their job because of their asthma. With regard to their occupational history, subjects with WRA were more likely to work, or having worked in the past, in jobs at higher risk of exposure to occupational risk factors (sector, p=0.05; job title, p=0.001, respectively). Our findings suggest that additional studies are needed to detect factors that may hinder the recognition of WR