We present up to 45 years of cancer incidence data by occupational category for the Nordic populations. The study covers the 15 million people aged 30Á64 years in the 1960, 1970, 1980/1981 and/or 1990 censuses in Denmark, Finland, Iceland, Norway and Sweden, and the 2.8 million incident cancer cases diagnosed in these people in a follow-up until about 2005. The study was undertaken as a cohort study with linkage of individual records based on the personal identity codes used in all the Nordic countries.In the censuses, information on occupation for each person was provided through free text in self-administered questionnaires. The data were centrally coded and computerised in the statistical offices. For the present study, the original occupational codes were reclassified into 53 occupational categories and one group of economically inactive persons.All Nordic countries have a nation-wide registration of incident cancer cases during the entire study period. For the present study the incident cancer cases were classified into 49 primary diagnostic categories. Some categories have been further divided according to sub-site or morphological type. The observed number of cancer cases in each group of persons defined by country, sex, age, period and occupation was compared with the expected number calculated from the stratum specific person years and the incidence rates for the national population. The result was presented as a standardised incidence ratio, SIR, defined as the observed number of cases divided by the expected number. For all cancers combined (excluding non-melanoma skin cancer), the study showed a wide variation among men from an SIR of 0.79 (95% confidence interval 0.66Á0.95) in domestic assistants to 1.48 (1.43Á1.54) in waiters. The occupations with the highest SIRs also included workers producing beverage and tobacco, seamen and chimney sweeps. Among women, the SIRs varied from 0.58 (0.37Á0.87) in seafarers to 1.27 (1.19Á1.35) in tobacco workers. Low SIRs were found for farmers, gardeners and teachers.Our study was able to repeat most of the confirmed associations between occupations and cancers. It is known that almost all mesotheliomas are associated with asbestos exposure. Accordingly, plumbers, seamen and mechanics were the occupations with the highest risk in the present study. Mesothelioma was the cancer type showing the largest relative differences between the occupations. Outdoor workers such as fishermen, gardeners and farmers had the highest risk of lip cancer, while the lowest risk was found among indoor workers such as physicians and artistic workers.Studies of nasal cancer have shown increased risks associated with exposure to wood dust, both for those in furniture making and for those exposed exclusively to soft wood like the majority of Nordic woodworkers. We observed an SIR of 1.84 (1.66Á2.04) in male and 1.88 (0.90Á3.46) in female woodworkers. For nasal adenocarcinoma, the SIR in males was as high as 5.50 (4.60Á6.56).Male waiters and tobacco workers had the highest risk of ...

Objectives-The possibility of an association between exposure to silica and autoimmune diseases has recently come under discussion. In the following casereferent study, a cohort exposed to diatomaceous earth and cristobalite provided an opportunity to evaluate such an exposure with reference to sarcoidosis. Methods-The inhabitants of a district served by a single healthcare centre and a hospital formed the study base. A diatomaceous earth plant is located in this community and the medical institutions are responsible for primary and secondary health care of the population. Cases of sarcoidosis were identified from the hospital records according to certain clinical, radiological, and histological criteria. Referents were selected randomly from the population of the district. Information on exposure to crystalline silica, cristobalite, was obtained by record linkage of the cases and referents with a file which included all present and past workers at the diatomaceous earth plant and those who had worked at loading vessels with the product from the plant. Results-Eight cases of sarcoidosis were found, six of which were in the exposed group. Of the 70 referents, 13 were exposed. The odds ratio (95% confidence interval) was 13.2 (2.0 to 140.9). Conclusion-The odds ratios were high and there were some indications of a dose-response relation which will hopefully encourage further studies. To our knowledge this is the first study to indicate a relation between sarcoidosis and exposure to the crystalline silica, cristobalite. (Occup Environ Med 1998;55:657-660)

Differences in ill health and functional status between various groups of non-employed cancer survivors need to be considered when planning policy measures for improving the labour market participation of this population and preventing their early withdrawal from working life.

More attention should be paid to assisting cancer survivors in work life, particularly those who have chronic diseases or have undergone chemotherapy. Although most factors affecting the work ability of the survivors and reference subjects were the same, survivors' work ability seemed to be particularly sensitive to avoidance behavior. The results suggest that there is a need to improve communication at the workplace and develop supportive leadership practices in order to avoid isolating behavior towards cancer survivors.

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