Abstract
Background
Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations.
Methods
The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis.
Results
During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01–1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04–1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01–1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77–0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men.
Conclusion
The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.
Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations.
Methods
The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis.
Results
During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01–1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04–1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01–1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77–0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men.
Conclusion
The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.
| Original language | English |
|---|---|
| Article number | 106825 |
| Journal | Environment International |
| Volume | 157 |
| DOIs | |
| Publication status | Published - 27 Aug 2021 |
Bibliographical note
Funding Information:We thank Ms. Sooyoung Cho for preparation of aggregated cancer incidence data for KMCC cohort. We also thank Prof Vivi Schl?nssen who was part of the preparatory work for the data from Danish cohort. The creation of the AGRICOH consortium was supported in part by the International Agency for Research on Cancer and the Intramural Research Program of the National Cancer Institute, National Institutes of Health. The AGRICAN cohort was supported by the Ligue Contre le Cancer, the Mutualit? Sociale Agricole, the Agence Nationale de S?curit? Sanitaire de l'Alimentation, de l'Environnement et du Travail (ANSES), the Office national de l'eau et des milieux aquatiques, the Office Fran?ais pour la Biodiversit?, the Institut National de M?decine Agricole, the Centre Fran?ois Baclesse, the Minist?re de l'Enseignement Sup?rieur et de la Recherche. The Agricultural Health Study is funded by the Intramural Research Program of the National Institutes of Health, National Cancer Institute (Z01 CP 010119). The Australian cohorts were supported by the Australian National Health and Medical Research Council (34093) and the Cancer Council Victoria (V-52). The Korean Multi-Center Cancer (KMCC) cohort was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C1127). The MESA cohort was supported in part by the Clinical and Translational Science Award (CTSA) program through the U.S. National Center for Advancing Translational Sciences (NCATS), grant UL1TR002373. The SUS cohort was supported by the Danish Agency for Science Technology and Innovation, the Danish Medical Research Council, The Danish Agricultural Research Council, Helsefonden, the P.C. Petersen Foundation, the Danish Working Environment Research Fund, the Danish Research Council Aarhus University and the Danish Lung Association. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the institutions with which they are affiliated.
Funding Information:
The creation of the AGRICOH consortium was supported in part by the International Agency for Research on Cancer and the Intramural Research Program of the National Cancer Institute, National Institutes of Health .
Funding Information:
The AGRICAN cohort was supported by the Ligue Contre le Cancer , the Mutualité Sociale Agricole , the Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail (ANSES), the Office national de l’eau et des milieux aquatiques , the Office Français pour la Biodiversité , the Institut National de Médecine Agricole , the Centre François Baclesse , the Ministère de l’Enseignement Supérieur et de la Recherche . The Agricultural Health Study is funded by the Intramural Research Program of the National Institutes of Health, National Cancer Institute ( Z01 CP 010119 ). The Australian cohorts were supported by the Australian National Health and Medical Research Council ( 34093 ) and the Cancer Council Victoria (V-52). The Korean Multi-Center Cancer (KMCC) cohort was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C1127 ). The MESA cohort was supported in part by the Clinical and Translational Science Award (CTSA) program through the U.S. National Center for Advancing Translational Sciences ( NCATS ), grant UL1TR002373 . The SUS cohort was supported by the Danish Agency for Science Technology and Innovation , the Danish Medical Research Council , The Danish Agricultural Research Council , Helsefonden , the P.C. Petersen Foundation , the Danish Working Environment Research Fund , the Danish Research Council Aarhus University and the Danish Lung Association .
Publisher Copyright:
© 2021 World Health Organization
Keywords
- Farmers
- Agriculture
- Occupational health
- Cohort
- Consortium
- Cancer incidence
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