Prostate cancer risk by occupation in the Occupational Disease Surveillance System (ODSS) in Ontario, Canada

• DOI: 10.24095/hpcdp.39.5.02
• Publication Date: 2019-05-15T15:58:31Z
• Authors: Jeavana Sritharan; Jill S. MacLeod; Christopher B. Mc...; Alice Peter; Paul A. Demers
• Keywords: Adult; Male; Medicine (General); Transportation; 03 medical and health sciences; R5-920; Law Enforcement; 0302 clinical medicine; Risk Factors; Humans; Industry; Occupations; occupation, prostate cancer, surveillance, Ontario, cohort, compensation claims; Occupational Health; Proportional Hazards Models; Ontario; Teaching; Construction Industry; Administrative Personnel; Prostatic Neoplasms; Agriculture; Middle Aged; 3. Good health; Occupational Diseases; Firefighters; 8. Economic growth; Administrative Claims, Healthcare

Introduction Previous Canadian epidemiologic studies have identified associations between occupations and prostate cancer risk, though evidence is limited. However, there are no well-established preventable risk factors for prostate cancer, which warrants the need for further investigation into occupational factors to strengthen existing evidence. This study uses occupation and prostate cancer information from a large surveillance cohort in Ontario that linked workers’ compensation claim data to administrative health databases.

Methods Occupations were examined using the Occupational Disease Surveillance System (ODSS). ODSS included 1 231 177 male workers for the 1983 to 2015 period, whose records were linked to the Ontario Cancer Registry (OCR) in order to identify and follow up on prostate cancer diagnoses. Cox proportional hazard models were used to calculate age-adjusted hazard ratios and 95% CI to estimate the risk of prostate cancer by occupation group.

Results A total of 34 997 prostate cancer cases were diagnosed among workers in ODSS. Overall, elevated prostate cancer risk was observed for men employed in man¬agement/administration (HR 2.17, 95% CI = 1.98–2.38), teaching (HR 1.99, 95% CI = 1.79–2.21), transportation (HR 1.20, 95% CI = 1.16–1.24), construction (HR 1.09, 95% CI = 1.06–1.12), firefighting (HR 1.62, 95% CI = 1.47–1.78), and police work (HR 1.20, 95% CI = 1.10–1.32). Inconsistent findings were observed for clerical and farm¬ing occupations.

Conclusion Associations observed in white collar, construction, transportation, and protective services occupations were consistent with previous Canadian studies. Findings emphasize the need to assess job-specific exposures, sedentary behaviour, psy¬chological stress, and shift work. Understanding specific occupational risk factors can lead to better understanding of prostate cancer etiology and improve prevention strategies.