Lung cancer risk among bakers, pastry cooks and confectionary makers: the SYNERGY study

Behrens, Thomas; Kendzia, Benjamin; Treppmann, Tabea; Olsson, Ann; Jöckel, Karl Heinz; Gustavsson, Per; Pohlabeln, Hermann; Ahrens, Wolfgang; Brüske, Irene; Wichmann, Hans; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Simonato, Lorenzo; Заридзе, Давид; Szeszenia-Da̧browska, Neonila; Rudnai, Péter; Lissowska, Jolanta; Fabiánovà, Eleonóra; Tardón, Adonina; Field, John K.; Dumitru, Rodica Stanescu; Bencko, Vladimír; Foretová, Lenka; Janout, Vladimí­r; Siemiatycki, Jack; Parent, Marie; McLaughlin, John; Demers, Paul A.; Landi, Maria Teresa; Caporaso, Neil E.; Kromhout, Hans; Vermeulen, Roel; Peters, Susan; Benhamou, Simone; Stücker, Isabelle; Guida, Florence; Consonni, Dario; Bueno‐de‐Mesquita, Bas; Mannetje, Andrea ’t; Pearce, Neil; Tse, Lap Ah; Yu, Ignatius Tak Sun; Plato, Nils; Boffetta, Paolo; Straif, Kurt; Schüz, Joachim; Pesch, Beate; Brüning, Thomas

doi:10.1136/oemed-2013-101469

Cited by 12 publications

(5 citation statements)

References 15 publications

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“…We observed an increased risk of lung cancer among female bakers, which aligns with several studies including one from Finland that estimated exposure to flour dust using a job exposure matrix (FINJEM) 19 36 37. However, a recent pooling large study of 16 case–control studies from Europe and Canada did not show any associations 20. One explanation could be that female bakers in rural area of Iran still mostly bake the bread in a traditional way using ovens without chimneys, for example, using wood, which expose them to combustion products.…”

Section: Discussionsupporting

confidence: 88%

“… 19 36 37 However, a recent pooling large study of 16 case–control studies from Europe and Canada did not show any associations. 20 One explanation could be that female bakers in rural area of Iran still mostly bake the bread in a traditional way using ovens without chimneys, for example, using wood, which expose them to combustion products. The Golestan cohort study from northeast Iran showed higher risk of gastrointestinal cancers in those who were exposed to biomass combustions from cooking and heating, without chimneys.…”

Section: Discussionmentioning

confidence: 99%

“…We also selected occupations with a large sample size and adequate power including farmers (field farmers, animal farmers) and drivers (road drivers, heavy vehicle drivers). In addition, we included bakers in our analyses since there is inconclusive results regarding a potential association between being a baker and the risk of lung cancer 19 20. Working conditions of Iranian bakers and the environment of bakeries are different compared with in the western countries.…”

Section: Methodsmentioning

confidence: 99%

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Lung cancer risk in relation to jobs held in a nationwide case–control study in Iran

et al. 2022

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BackgroundGlobally, lung cancer is the most frequent occupational cancer, but the risk associated with the occupations or occupational environment in Iran is not clear. We aimed to assess occupations with the risk of lung cancer.MethodsWe used the IROPICAN nationwide case–control study data including 658 incident lung cancer cases and 3477 controls. We assessed the risk of lung cancer in relation to ever working in major groups of International Standard Classification of Occupations, high-risk occupations for lung cancer and duration of employment and lung cancer subtype among construction workers and farmers while controlling for cigarette smoking and opium consumption. We used unconditional regression logistic models to estimate ORs for the association between increased lung cancer risk and occupations.ResultsWe observed elevated ORs for lung cancer in male construction workers (OR=1.4; 95% CI: 1.0 to 1.8), petroleum industry workers (OR=3.2; 95% CI: 1.1 to 9.8), female farmers (OR=2.6; 95% CI: 1.3 to 5.3) and female bakers (OR=5.5; 95% CI: 1.0 to 29.8). A positive trend by the duration of employment was observed for male construction workers (p< 0.001). Increased risk of squamous cell carcinoma was observed in male construction workers (OR=1.9; 95% CI: 1.2 to 3.0) and female farmers (OR=4.3; 95% CI: 1.1 to 17.2), who also experienced an increased risk of adenocarcinoma (OR=3.8; 95% CI: 1.4 to 9.9).DiscussionAlthough we observed associations between some occupations and lung cancer consistent with the literature, further studies with larger samples focusing on exposures are needed to better understand the occupational lung cancer burden in Iran.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Lung cancer risk in relation to jobs held in a nationwide case–control study in Iran

et al. 2022

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“…[ 42 ] A recent SYNERGY study among bakers, pastry cooks and confectionary makers from 16 countries did not suggest an increase of lung cancer risks in baking-related professions as well. [ 44 ] On the other hand, suggestive evidence was found that exposure to grain dust among millers may increase the risk of laryngeal cancer. [ 42 ] In a French case–control study comprising 207 cases and 409 controls, significant excesses in risk of squamous nasal cell cancer were noted for bakers, pastry cooks and grain millers.…”

Section: Health Effectsmentioning

confidence: 99%

Exposure to flour dust in the occupational environment

Stobnicka-Kupiec

Górny

2015

International Journal of Occupational Safety and Ergonomics

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Exposure to flour dust can be found in the food industry and animal feed production. It may result in various adverse health outcomes from conjunctivitis to baker's asthma. In this paper, flour dust exposure in the above-mentioned occupational environments is characterized and its health effects are discussed. A peer-reviewed literature search was carried out and all available published materials were included if they provided information on the above-mentioned elements. The hitherto conducted studies show that different components of flour dust like enzymes, proteins and baker's additives can cause both non-allergic and allergic reactions among exposed workers. Moreover, the problem of exposure to cereal allergens present in flour dust can also be a concern for bakers’ family members. Appreciating the importance of all these issues, the exposure assessment methods, hygienic standards and preventive measures are also addressed in this paper.

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“…Studies on bakers and baking-related occupations did not suggest any significant association with lung cancer risk. 31 …”

Section: Discussionmentioning

confidence: 99%

Occupational exposure to endotoxins and lung cancer risk: results of the ICARE Study

et al. 2017

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ObjectivesTo investigate the role of occupational exposure to endotoxins in lung cancer in a French population-based case–control study (ICARE (Investigation of occupational and environmental causes of respiratory cancers)).MethodsDetailed information was collected on the occupational history and smoking habits from 2926 patients with histologically confirmed lung cancer and 3555 matched controls. We evaluated each subject’s endotoxin exposure after cross referencing International Standard Classification of Occupations (ISCO) codes (for job tasks) and Nomenclature d'Activités Françaises (NAF) codes (for activity sectors). Endotoxin exposure levels were attributed to each work environment based on literature reports. ORs and 95% CIs were estimated using unconditional logistic regression models and controlled for main confounding factors.ResultsAn inverse association between exposure to endotoxins and lung cancer was found (OR=0.80, 95% CI 0.66 to 0.95). Negative trends were shown with duration and cumulative exposure, and the risk was decreased decades after exposure cessation (all statistically significant). Lung cancer risk was particularly reduced among workers highly exposed (eg, in dairy, cattle, poultry, pig farms), but also in those weakly exposed (eg, in waste treatment). Statistically significant interactions were shown with smoking, and never/light smokers were more sensitive to an endotoxin effect than heavy smokers (eg, OR=0.14, 95% CI 0.06 to 0.32 and OR=0.80, 95% CI 0.45 to 1.40, respectively, for the quartiles with the highest cumulative exposure, compared with those never exposed). Pronounced inverse associations were shown with adenocarcinoma histological subtype (OR=0.37, 95% CI 0.25 to 0.55 in the highly exposed).ConclusionsOur findings suggest that exposure to endotoxins, even at a low level, reduces the risk of lung cancer.

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Lung cancer risk among bakers, pastry cooks and confectionary makers: the SYNERGY study

Cited by 12 publications

References 15 publications

Lung cancer risk in relation to jobs held in a nationwide case–control study in Iran

Lung cancer risk in relation to jobs held in a nationwide case–control study in Iran

Exposure to flour dust in the occupational environment

Occupational exposure to endotoxins and lung cancer risk: results of the ICARE Study

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