DERMATITIS

Background

 

What is dermatitis?

 

 

Key Findings

 

Here are some key findings…

 

Relative Incidence by Industry and Occupation

 

 

FIG1. Incidence of dermatitis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

 

FIG2. Incidence of dermatitis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

 

 

Table1. Surveillance of Dermatitis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture 214 7,686 0.76 (0.67, 0.87)
2/3 Forestry, Fishing and
Trapping
33 1,333 0.72 (0.51, 1.02)
4 Mines, Quarries and
Oil Wells
80 2,938 0.81 (0.65, 1.01)
5 Manufacturing 4,254 106,619 1.11 (1.07, 1.14)
6 Construction 1,315 49,098 0.78 (0.74, 0.83)
7 Transportation, Communication
and Other Utilities
1,621 46,208 0.96 (0.92, 1.01)
8 Trade 3,878 105,536 0.95 (0.92, 0.99)
9 Finance, Insurance and
Real Estate
188 5,194 0.91 (0.79, 1.05)
10 Community, Business and
Personal Service
7,311 170,758 1.02 (0.99, 1.05)
11 Public Administration and
Defense
1,821 45,567 1.00 (0.96, 1.05)
* SIC: Standard Industrial Classification (1970)
† Hazard rate in each group relative to all others

Table2. Surveillance of Dermatitis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
498 11,973 0.98 (0.89, 1.07)
21 Natural sciences, engineering
and mathematics
283 7,203 1.06 (0.94, 1.19)
23 Social sciences and
related fields
532 10,389 1.13 (1.04, 1.23)
25 Religion <5 43
27 Teaching and related 888 17,718 1.09 (1.02, 1.17)
31 Medicine and health 1,731 40,325 0.90 (0.85, 0.94)
33 Artistic, literary,
recreational and related
241 5,215 1.17 (1.03, 1.33)
41 Clerical and related 1,999 45,733 1.04 (0.99, 1.09)
51 Sales 1,862 46,968 0.96 (0.92, 1.01)
61 Service 3,852 91,788 1.03 (1.00, 1.07)
71 Farming, horticultural
and animal husbandry
350 11,817 0.81 (0.73, 0.91)
73 Fishing, hunting,
trapping and related
10 168 1.03 (0.46, 2.29)
75 Forestry and logging 33 1,110 0.87 (0.61, 1.22)
77 Mining and quarrying,
including oil and gas field
50 1,818 0.82 (0.62, 1.09)
81 Processing
(mineral, metal, chemical)
514 13,255 1.05 (0.96, 1.14)
82 Processing
(food, wood, textile)
831 19,613 1.09 (1.02, 1.17)
83 Machining and related 1,143 29,146 1.14 (1.07, 1.21)
85 Product fabricating,
assembling and repairing
2,075 53,765 1.08 (1.03, 1.13)
87 Construction trades 1,318 47,847 0.81 (0.77, 0.86)
91 Transport equipment
operating
1,286 38,990 0.94 (0.89, 1.00)
93 Materials handling and related,
not elsewhere classified
890 24,050 1.04 (0.97, 1.11)
95 Other crafts and
equipment operating
154 3,481 1.20 (1.03, 1.41)
99 Other occupations not elsewhere classified 1,263 34,642 1.01 (0.95, 1.07)
* CCDO: Canadian Classification Dictionary of Occupations (1971)
† Hazard rate in each group relative to all others

 

ASTHMA

Background

What is Asthma?

Asthma is an inflammatory disease of the respiratory system. It is the most common chronic respiratory condition in Canada, affecting roughly 6% of the general population. Asthma is also the most common work-related respiratory condition with an estimated 15% of cases of adult asthma arising due to workplace exposures. There are numerous occupational risk factors for this condition and workers across many occupations and industries are at risk.

Risk Factors

      • Isocyanates
      • Flour dust
      • Latex
      • Wood dust
      • Metal dust
      • Animal dust
      • Chemical irritants
      • Indoor cleaning products
      • Others
Key Findings

Product Fabricating, Assembling, and Repairing

ODSS detected that painters and decorators are at an elevated risk of asthma, which includes workers in the automobile industry. The well-established risk in automotive painters is attributable to isocyanates, the most common cause of occupational asthma in many industrialized countries. In contrast, ODSS results indicate that other groups of painters such as those in construction industries are at a decreased risk of asthma. Construction worker painters typically work with water-based paints that lack isocyanates. Also within this sector are cabinet and wood furniture makers who are at an increased risk of asthma. These workers likely experience exposure to wood dust, which is an established risk factor for asthma.

      • Painters and decorators (not in construction): 1.6x increased risk
      • Painters and paperhangers (within construction): 0.8x decreased risk
      • Cabinet and wood furniture makers: 1.3x increased risk

Food and Beverage

Within the food and beverage industry are a varied array of occupations including service staff and cooks. ODSS results indicate that bakers and confectionary makers are a subgroup of the food and beverage industry that are an increased risk of asthma.

      • Bakers and confectionary makers: 1.6x increased risk

Construction Sector

Within the construction sector, ODSS detected that concrete finishers are at an increased risk of asthma. Concrete finishers are workers with possible exposure to inorganic dusts, such as silica, which may be respiratory irritants and induce asthma.

      • Concrete finishers and related workers: 1.9x increased risk
Relative Incidence by Industry and Occupation

 

 

 

FIG1. Incidence of asthma diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

 

FIG2. Incidence of asthma diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

 

 

Table1. Surveillance of Asthma: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture 91 7,334 0.74 (0.60, 0.91)
2/3 Forestry, Fishing and
Trapping
12 1,295 0.62 (0.35, 1.09)
4 Mines, Quarries and
Oil Wells
35 2,843 0.86 (0.62, 1.20)
5 Manufacturing 1,726 105,201 0.99 (0.94, 1.04)
6 Construction 596 46,501 0.87 (0.80, 0.95)
7 Transportation, Communication
and Other Utilities
742 44,310 1.04 (0.96, 1.12)
8 Trade 1,770 101,827 0.97 (0.92, 1.02)
9 Finance, Insurance and
Real Estate
87 4,976 0.95 (0.77, 1.18)
10 Community, Business and
Personal Service
3,410 163,064 1.02 (0.98, 1.07)
11 Public Administration and
Defense
792 43,588 0.97 (0.90, 1.04)
* SIC: Standard Industrial Classification (1970)
† Hazard rate in each group relative to all others

Table2. Surveillance of Asthma: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
230 11,286 1.04 (0.91, 1.19)
21 Natural sciences, engineering
and mathematics
109 7,012 0.95 (0.79, 1.15)
23 Social sciences and
related fields
235 9,842 1.09 (0.96, 1.24)
25 Religion <5 37
27 Teaching and related 390 16,336 1.08 (0.97, 1.19)
31 Medicine and health 811 38,351 0.91 (0.84, 0.98)
33 Artistic, literary,
recreational and related
115 4,921 1.27 (1.05, 1.52)
41 Clerical and related 962 44,187 1.13 (1.06, 1.21)
51 Sales 827 45,289 0.95 (0.88, 1.02)
61 Service 1,693 88,268 1.01 (0.96, 1.07)
71 Farming, horticultural
and animal husbandry
145 11,255 0.79 (0.67, 0.93)
73 Fishing, hunting,
trapping and related
<5 100
75 Forestry and logging 6 1,103 0.37 (0.17, 0.83)
77 Mining and quarrying,
including oil and gas field
22 1,755 0.91 (0.60, 1.39)
81 Processing
(mineral, metal, chemical)
205 13,002 0.97 (0.85, 1.12)
82 Processing
(food, wood, textile)
370 19,362 1.09 (0.99, 1.21)
83 Machining and related 410 28,820 0.97 (0.87, 1.07)
85 Product fabricating,
assembling and repairing
817 52,735 1.00 (0.93, 1.07)
87 Construction trades 549 45,567 0.86 (0.79, 0.94)
91 Transport equipment
operating
539 37,171 0.99 (0.91, 1.08)
93 Materials handling and related,
not elsewhere classified
391 23,400 1.09 (0.98, 1.20)
95 Other crafts and
equipment operating
52 3,403 0.96 (0.73, 1.26)
99 Other occupations not elsewhere classified 535 33,715 1.00 (0.91, 1.09)
* CCDO: Canadian Classification Dictionary of Occupations (1971)
† Hazard rate in each group relative to all others

 

IPF

Background

 

Idiopathic Pulmonary Fibrosis (IPF)

What is IPF?

Idiopathic Pulmonary Fibrosis (IPF) is a fibrotic respiratory disease that scars interstitial lung tissue and reduces respiratory function. The term idiopathic is used to describe conditions of an unknown cause, but there are some established and possible risk factors for IPF. This disease is the most common fibrotic lung disease and shares a similar disease pathology as other fibrotic conditions, including silicosis and asbestosis. IPF is characterized by poor five-year survival and treatment options are limited.

Risk Factors

  • Family history of disease
  • Smoking
  • Metal dust
  • Wood dust
  • Animal dust from livestock farming

There is not yet a comprehensive understanding of the causes of IPF and more research is being directed to this lack of evidence. Metal and wood dust are possible important occupational risk factors for IPF. The ODSS project sought to understand what occupations and industries were at an increased risk of this fatal and debilitating respiratory condition.

Key Findings

Mining Sector

The mining sector is at a 2-fold increased risk of IPF relative to other industries. Nested within the mining sector are specific occupations and types of mining that demonstrated increased risk of IPF. Gold quartz and uranium mining are at increased risks of IPF, as are drilling and blasting occupations and cutting and loading occupations. These occupations and industries would likely have significant metal dust exposure, as well as other exposures, including diesel exhaust and silica dust.

  • Gold quartz mining: 3x increased risk
  • Uranium mining: 3x increased risk
  • Drilling and blasting: 2x increased risk

Forestry and Papermaking

Within the forestry sector, workers within the logging and pulp and papermaking industries are at increased risks of IPF. These workers are likely exposed to high levels of wood dust, which is a possible risk factor for IPF.

  • Logging: 1.5x increased risk
  • Occupations in elemental work, pulp and papermaking: 3x increased risk

Transportation

While the overall transportation sector did not show an increased risk of IPF, the ODSS detected that bus drivers are at an increased risk. Bus drivers are regularly exposed to exhaust fumes, however, this is not a recognized or possible risk factor for this disease. It is unclear why bus drivers are at an increased risk of IPF given the current understanding of this condition.

  • Bus drivers: 1.5x increased risk

Food and Beverage

The food and beverage industry houses a number of service occupations including bartenders, waiters/waitresses, and cooks and chefs. Cooks and chefs work in kitchen environments that may expose workers to organic dusts and cooking fumes. Within the ODSS cohort, cooks and chefs were at a 1.5-fold increased risk of IPF, relative to other occupations. Organic dusts, such as flour and confectionary materials are known risk factors for other respiratory conditions, but it is not known whether they pose a risk for IPF.

Chefs/cooks: 1.5x increased risk

Relative Incidence by Industry and Occupation

FIG1. Incidence of interstitial pulmonary fibrosis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 2006-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

 

FIG2. Incidence of interstitial pulmonary fibrosis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 2006-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

Table1. Surveillance of Interstitial Pulmonary Fibrosis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture 27 26,863 0.89 (0.61, 1.30)
2/3 Forestry, Fishing and
Trapping
22 7,367 1.59 (1.05, 2.43)
4 Mines, Quarries and
Oil Wells
76 16,712 1.91 (1.52, 2.4)
5 Manufacturing 986 539,988 1.03 (0.95, 1.11)
6 Construction 270 168,536 1.05 (0.92, 1.19)
7 Transportation, Communication
and Other Utilities
268 158,987 1.03 (0.91, 1.17)
8 Trade 404 346,116 0.92 (0.83, 1.03)
9 Finance, Insurance and
Real Estate
35 18,349 1.06 (0.76, 1.48)
10 Community, Business and
Personal Service
572 467,639 0.92 (0.83, 1.01)
11 Public Administration and
Defense
286 151,044 1.09 (0.96, 1.23)
* SIC: Standard Industrial Classification (1970)
† Hazard rate in each group relative to all others


Table2. Surveillance of Interstitial Pulmonary Fibrosis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
30 26,042 0.76 (0.53, 1.08)
21 Natural sciences, engineering
and mathematics
26 22,086 0.77 (0.53, 1.14)
23 Social sciences and
related fields
30 24,474 1.28 (0.89, 1.84)
25 Religion 0 105
27 Teaching and related 46 40,862 0.74 (0.55, 0.99)
31 Medicine and health 146 105,955 1.03 (0.86, 1.22)
33 Artistic, literary,
recreational and related
11 12,410 0.94 (0.52, 1.71)
41 Clerical and related 210 156,416 0.94 (0.81, 1.08)
51 Sales 134 120,077 1.02 (0.86, 1.22)
61 Service 420 286,423 1.02 (0.92, 1.14)
71 Farming, horticultural
and animal husbandry
38 39,527 0.87 (0.63, 1.19)
73 Fishing, hunting,
trapping and related
<5 443
75 Forestry and logging 15 7,263 1.20 (0.72, 2.00)
77 Mining and quarrying,
including oil and gas field
44 9,268 2.07 (1.53, 2.78)
81 Processing
(mineral, metal, chemical)
125 64,553 1.27 (1.06, 1.52)
82 Processing
(food, wood, textile)
121 78,550 1.06 (0.88, 1.27)
83 Machining and related 295 154,998 1.07 (0.95, 1.21)
85 Product fabricating,
assembling and repairing
437 265,589 0.89 (0.80, 0.98)
87 Construction trades 313 173,264 1.04 (0.92, 1.17)
91 Transport equipment
operating
252 137,515 1.04 (0.92, 1.19)
93 Materials handling and related,
not elsewhere classified
211 123,252 1.20 (1.04, 1.38)
95 Other crafts and
equipment operating
52 22,246 1.24 (0.94, 1.63)
99 Other occupations not elsewhere classified 264 173,286 1.09 (0.96, 1.24)
* CCDO: Canadian Classification Dictionary of Occupations (1971)
† Hazard rate in each group relative to all others

 

LUNG CANCER

 

  Lung Cancer

Background

In Canada, lung cancer is the leading cause of cancer mortality in men and women [1]. Lung cancer is primarily caused by smoking, and prevention efforts have largely focused on tobacco control. However, the Burden of Occupational Cancer Project found that approximately 15% of lung cancers are caused by workplace exposures [2]. Workers in many occupations are exposed to known lung carcinogens. Asbestos, crystalline silica, diesel engine exhaust, and welding fumes are the four most important lung occupational carcinogens in Canada [2].

 

Known occupational risk factors
    • Dusts and fibres (e.g. asbestos, crystalline silica) [3]
    • Combustion products (e.g. diesel engine exhaust, secondhand smoke, soot) [3-5]
    • Metals and their compounds (e.g. arsenic, beryllium, cadmium, chromium VI, nickel, welding fumes) [3,6]
    • Ionizing radiation (e.g. radon, x-radiation, gamma-radiation) [7]
    • Occupational exposures in painting, iron and steel founding, coke production, rubber manufacturing, and aluminum production [8]
Possible occupational risk factors
    • Acid mist [8]
    • Benzene [9]
    • Bitumen [10]
    • Polycyclic aromatic hydrocarbons (PAHs) [11]
Key Findings

The greatest risks of lung cancer are observed among workers employed in mining, construction, and transportation occupations. Occupational variation in smoking may also explain some differences in observed lung cancer risk.

 

Mining

Workers in mining and quarrying are exposed to a number of lung carcinogens including crystalline silica, radon, asbestos, and diesel engine exhaust. Workers in most mine types and jobs appeared to have increased risk of lung cancer.

    • Mines, quarries and oil wells: 1.36 times the risk
      • Quarries and sand pits: 1.77 times the risk
      • Metal mines: 1.34 times the risk
        • Uranium mines: 1.88 times the risk
        • Gold quartz mines: 1.45 times the risk
      • Non-metal mines: 1.09 times the risk
        • Asbestos mines: 3.96 times the risk
    • Mining and quarrying occupations: 1.39 times the risk
      • Rock and soil-drilling: 1.62 times the risk
      • Cutting, handling and loading occupations: 1.50 times the risk

 

Construction

Construction workers are involved in a wide variety of jobs and work settings with potential exposure to a wide range of lung carcinogens including diesel engine exhaust, crystalline silica dust, and asbestos-containing materials including insulation. In addition, painters, who may be exposed to chemicals in paints, solvents and adhesives are at increased risk [8].

    • Construction trades occupations: 1.10 times the risk
      • Excavating, grading, paving & related: 1.38 times the risk
      • Other construction trades: 1.11 times the risk
        • Painters and paperhangers: 1.35 times the risk
        • Insulators: 2.01 times the risk
        • Structural metal erectors: 1.35 times the risk
        • Glaziers: 1.30 times the risk
        • Roofing, waterproofing and related occupations: 1.43 times the risk
        • Plasterers and related occupations: 1.23 times the risk
 
Primary metal industries and metal manufacturing

Workers in these industries are exposed to aluminum, arsenic, beryllium, cadmium, chromium, nickel compounds, silica dust, and PAHs. IARC has also classified iron and steel founding as having an increased risk of lung cancer. Boilermakers may be exposed to asbestos and moulding, coremaking and metal casting may involve exposure to crystalline silica.

    • Primary Metal Industries: 1.17 times the risk
      • Iron foundries: 1.49 times the risk
      • Aluminum rolling, casting and extruding: 1.40 times the risk
      • Smelting and refining: 1.25 times the risk
    • Metal processing occupations: 1.26 times the risk
      • Metal heat treating occupations: 1.59 times the risk
      • Metal processing and related occupations (foremen): 1.58 times the risk
      • Moulding, coremaking and metal casting occupations: 1.40 times the risk
    • Metal shaping occupations: 1.19 times the risk
      • Forging occupations: 1.40 times the risk
      • Boilermakers, platers and structural metal workers: 1.39 times the risk
      • Metalworking-machine operators: 1.21 times the risk

 

Transportation sector

Workers employed in the transportation sector may be exposed to elevated levels of diesel engine exhaust through work in or around diesel-powered equipment.

    • Transportation industry: 1.23 times the risk
      • Taxicab operations: 1.53 times the risk
      • Truck transport: 1.49 times the risk

 

Logging and wood processing

Workers in these occupations may be exposed to exhaust from diesel-powered equipment, as well as wood dusts, arsenic-containing insecticides, and other wood preservatives.

    • Logging industry: 1.25 times the risk
      • Log hoisting, sorting, moving and related occupations: 1.46 times the risk
      • Timber cutting and related occupations: 1.23 times the risk
    • Wood manufacturing industries: 1.10 times the risk
      • Sawmills, planning mills and shingle mills: 1.31 times the risk
      • Labouring and other elemental work in wood processing: 1.44 times the risk
 
Bartending and food service

Workers in these occupations were exposed to high levels of second-hand tobacco smoke in the workplace until smoking was banned in bars and restaurants in Ontario in 2006 and patios in 2015 [2,12]. Differences in occupational rates of smoking may also contribute to the excess risks observed for these groups.

    • Bartenders: 1.71 times the risk
    • Waiters, hostesses and stewards, food and beverage: 1.10 times the risk
Sex Differences in Lung Cancer Risk

Historically, lung cancer rates have been higher in men than women. However, this gap has decreased over time as smoking rates have declined faster among men than women, contributing to a faster decline in lung cancer incidence rates among men than women [13-15]. Although occupational exposure is a significant contributor to lung cancer burden, little research has focused on gender or sex differences in occupational lung cancer [16,17]. Here we highlight elevated risks of lung cancer among female workers in select occupations.

 

Machining and related occupations

Female workers in machining and related occupations showed a greater increase in lung cancer risk than male workers. While those employed in this area may include workers who shape various types of materials, those performing metal machining or related metal work may be exposed to dusts and fumes containing metals and their compounds [17,18]. Some examples of carcinogenic exposures among these workers include welding fumes, nickel compounds, cadmium, and chromium VI [3,6,8].

Occupational Group Females Males
Machining and related 1.44 x the risk 1.10 x the risk
  • Metal machining
1.55 x the risk 0.98 x the risk
  • Metal shaping and forming, except machining
1.46 x the risk 1.16 x the risk

 

Construction

Although both male and female workers in construction trades occupations overall are at an increased risk of lung cancer compared to workers in other occupations, this is more pronounced among female workers in certain construction trades. Construction workers have the potential to be exposed to a variety of lung carcinogens such as silica, asbestos, and diesel engine exhaust [3,5].

Occupational Group Females Males
  • Excavating, grading, paving and related
2.25 x the risk 1.36 x the risk
  • Other construction trades
1.54 x the risk 1.11 x the risk
    • Carpenters and related
2.21 x the risk 0.93 x the risk
    • Glaziers
4.75 x the risk 1.24 x the risk
    • Labouring and other elemental work in construction
1.69 x the risk 1.11 x the risk

 

Mining

Although an increased risk of lung cancer is well documented among mining workers, previous studies have often included only limited information on female mining workers [16]. Based on ODSS results, female workers in mining occupations face a disproportionately elevated risk of lung cancer. Workers in mining occupations are exposed to numerous lung carcinogens including crystalline silica, radon, asbestos, and diesel engine exhaust [3,5].

Occupational Group Females Males
  • Mining and quarrying
3.05 x the risk 1.36 x the risk

 

Motor transport operating occupations

Female workers were at an increased risk for lung cancer in transportation-related occupations, where exposure to diesel engine exhaust is common [5].

Occupational Group Females Males
  • Motor transport operating
1.70 x the risk 1.42 x the risk
    • Bus drivers
1.48 x the risk 1.08 x the risk
    • Taxi drivers and chauffeurs
2.75 x the risk 1.00 x the risk
    • Truck drivers
1.85 x the risk 1.46 x the risk

 

Service occupations

Lung cancer risks were elevated in female service workers but reduced in male workers across many service jobs. Other studies have found mixed results for risk of lung cancer in these workers due to the diversity of tasks in the service industry [19]. Some service workers in restaurant settings may have been exposed to second-hand smoke, especially prior to bans on smoking in restaurants and patios [20]. Some research indicates that polycyclic aromatic hydrocarbons (PAHs, found in cooking fumes) may increase lung cancer risk [8,11]. There may also be other exposures unaccounted for in these workers.

Occupational Group Females Males
  • Food and beverage preparation and related service occupations
1.19 x the risk 0.79 x the risk
    • Chefs and cooks
1.30 x the risk 0.79 x the risk
    • Bartenders
2.27 x the risk 1.21 x the risk
    • Waiters, hostesses and stewards, food and beverage
1.18 x the risk 0.75 x the risk

 

Potential contributors to sex differences in lung cancer risk

There are several of factors that could cause female workers to experience different hazards or different levels of exposure than male workers. For example, gender roles may influence the specific tasks male and female workers perform within a given occupation, leading to differences in exposure [21-23]. Personal protective equipment is often not designed with female-specific fit in mind, and may not have the same effectiveness on female bodies as male bodies [16,24]. Female workers may also find it more physically demanding to use protective equipment [16]. Part-time workers, who are more likely to be women, may receive less training on how to properly use protective equipment [16]. Further research is also needed to understand how sex-related factors such as height, reach and strength might impact exposure and the effectiveness of control strategies other than personal protective equipment [16,22].

Biological factors, such as hormonal and metabolic differences between male and female workers, may impact the effect of occupational exposures. Based on some studies of sex differences in smoking-related lung cancer risk, it is possible that female workers may be more susceptible to the carcinogenic effects of some occupational exposures than male workers [25,26].

Cancer risk may also be affected by behavioural differences. Smoking is more common among workers in manual and industrial occupations compared to other workers and this difference may be greater among females than males [27,28]. It is possible that other behavioural differences such as physical activity and dietary patterns may also contribute to observed sex differences in lung cancer risk.

Relative Risk by Industry and Occupation

Figure 1. Risk of lung cancer diagnosis among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2020

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater risk of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Figure 2. Risk of lung cancer diagnosis among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2020 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater risk of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

Table 1. Surveillance of Lung Cancer: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture 370 35,010 0.91 (0.82-1.01)
2/3 Forestry, Fishing and
Trapping
249 10,696 1.25 (1.10-1.42)
4 Mines, Quarries and
Oil Wells
780 23,173 1.40 (1.31-1.51)
5 Manufacturing 12,453 693,490 1.04 (1.02-1.07)
6 Construction 3,568 210,957 1.13 (1.09-1.17)
7 Transportation, Communication
and Other Utilities
3,483 197,194 1.13 (1.09-1.17)
8 Trade 5,306 429,234 1.03 (1.00-1.06)
9 Finance, Insurance and
Real Estate
466 23,989 1.05 (0.96-1.15)
10 Community, Business and
Personal Service
7,160 599,548 0.91 (0.89-0.94)
11 Public Administration and
Defense
3,259 190,864 0.99 (0.95-1.03)
         
         
* SIC: Standard Industrial Classification (1970)    
† Hazard rate in each group relative to all others    

 

Table 2. Surveillance of Lung Cancer: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
344 30,994 0.81 (0.73-0.90)
21 Natural sciences, engineering
and mathematics
278 26,342 0.75 (0.67-0.84)
23 Social sciences and
related fields
250 30,713 0.95 (0.84-1.08)
25 Religion 0 128
27 Teaching and related 328 48,476 0.51 (0.46-0.57)
31 Medicine and health 1,441 135,341 0.83 (0.79-0.88)
33 Artistic, literary,
recreational and related
130 14,992 0.98 (0.83-1.17)
41 Clerical and related 2,777 197,315 1.04 (1.00-1.09)
51 Sales 1,499 148,113 0.97 (0.93-1.03)
61 Service 5,289 370,848 0.99 (0.96-1.02)
71 Farming, horticultural
and animal husbandry
546 50,146 0.95 (0.87-1.03)
73 Fishing, hunting,
trapping and related
11 558 1.03 (0.57-1.86)
75 Forestry and logging 215 10,680 1.15 (1.01-1.32)
77 Mining and quarrying,
including oil and gas field
432 13,028 1.43 (1.30-1.58)
81 Processing
(mineral, metal, chemical)
1,406 79,219 1.22 (1.15-1.28)
82 Processing
(food, wood, textile)
1,404 99,236 0.99 (0.94-1.04)
83 Machining and related 3,569 189,401 1.12 (1.09-1.16)
85 Product fabricating,
assembling and repairing
5,714 328,270 1.02 (0.99-1.05)
87 Construction trades 3,980 215,564 1.08 (1.05-1.12)
91 Transport equipment
operating
3,632 168,082 1.38 (1.33-1.42)
93 Materials handling and related,
not elsewhere classified
2,488 153,025 1.16 (1.11-1.21)
95 Other crafts and
equipment operating
556 28,299 1.10 (1.01-1.19)
99 Other occupations not elsewhere classified 3,364 215,227 1.12 (1.08-1.16)
         
         
* CCDO: Canadian Classification Dictionary of Occupations (1971)  
† Hazard rate in each group relative to all others    

Please note that ODSS results shown here may differ from those previously published or presented. This may occur due to changes in case definitions, methodological approaches, and the ongoing nature of the surveillance cohort.

 

References
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PROSTATE CANCER

Background

 

 

What is prostate cancer?

 

Key Findings

 

Here are some key findings…

 

Relative Incidence by Industry and Occupation

 

 

 

FIG1. Incidence of prostate cancer diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

 

 

FIG2. Incidence of prostate cancer diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

 

 

Table1. Surveillance of Prostate Cancer: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture 361 26,402 0.60 (0.54, 0.67)
2/3 Forestry, Fishing and
Trapping
213 10,223 0.79 (0.69, 0.90)
4 Mines, Quarries and
Oil Wells
738 22,707 1.27 (1.18, 1.37)
5 Manufacturing 14,064 528,890 1.01 (0.99, 1.04)
6 Construction 4,077 202,142 0.86 (0.83, 0.89)
7 Transportation, Communication
and Other Utilities
4,309 164,173 1.20 (1.16, 1.24)
8 Trade 5,200 291,020 0.74 (0.72, 0.76)
9 Finance, Insurance and
Real Estate
429 15,220 1.31 (1.19, 1.44)
10 Community, Business and
Personal Service
4,660 249,204 0.89 (0.87, 0.92)
11 Public Administration and
Defense
4,026 121,480 1.49 (1.44, 1.54)
* SIC: Standard Industrial Classification (1970)
† Hazard rate in each group relative to all others

Table2. Surveillance of Prostate Cancer: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
464 14,228 2.17 (1.98, 2.38)
21 Natural sciences, engineering
and mathematics
538 20,814 1.30 (1.20, 1.42)
23 Social sciences and
related fields
128 6,834 1.10 (0.92, 1.31)
25 Religion <5 79
27 Teaching and related 353 10,018 1.99 (1.79, 2.21)
31 Medicine and health 362 17,068 1.14 (1.03, 1.27)
33 Artistic, literary,
recreational and related
156 8,400 1.11 (0.95, 1.30)
41 Clerical and related 2,133 96,316 1.00 (0.96, 1.04)
51 Sales 1,163 71,727 0.88 (0.83, 0.94)
61 Service 4,221 187,123 1.07 (1.04, 1.11)
71 Farming, horticultural
and animal husbandry
586 39,236 0.68 (0.63, 0.74)
73 Fishing, hunting,
trapping and related
8 518 0.66 (0.33, 1.33)
75 Forestry and logging 183 10,109 0.67 (0.58, 0.77)
77 Mining and quarrying,
including oil and gas field
422 12,870 1.31 (1.19, 1.44)
81 Processing
(mineral, metal, chemical)
1,403 62,878 0.93 (0.88, 0.98)
82 Processing
(food, wood, textile)
1,372 67,325 0.87 (0.82, 0.91)
83 Machining and related 4,428 168,127 1.07 (1.04, 1.11)
85 Product fabricating,
assembling and repairing
7,156 261,187 1.12 (1.09, 1.14)
87 Construction trades 5,284 211,378 1.09 (1.06, 1.12)
91 Transport equipment
operating
3,998 153,882 1.20 (1.16, 1.24)
93 Materials handling and related,
not elsewhere classified
2,392 121,957 0.80 (0.76, 0.83)
95 Other crafts and
equipment operating
619 21,541 1.15 (1.06, 1.24)
99 Other occupations not elsewhere classified 3,554 174,651 0.85 (0.82, 0.88)
* CCDO: Canadian Classification Dictionary of Occupations (1971)
† Hazard rate in each group relative to all others

 

SILICOSIS

Background

What is Silicosis?

Silicosis is a non-malignant fibrotic lung disease that is caused by inhalation of silica dust. It is a rare pulmonary condition that presents either chronically or acutely. In extremely rare cases, silicosis can present at an accelerated rate, which mimics the pathology of chronic silicosis, but presents much faster. Silicosis is characterized by scarring and thickening of lung tissue and can manifest in poor respiratory capacity and a chronic cough.

Risk Factors

  • Crystalline silica dust (silica dioxide)

Silicosis is exclusively caused by inhalation of crystalline silica dust. Workers in the construction industry, mining industry, and manufacturing industry are at an increased risk for developing silicosis due to workplace exposures to silica dust. Drilling, sandblasting, and stonecutting are among some of the occupations that experience high exposure to silica dust.

Key Findings

Mining Sector

The mining, quarrying, and oil well industry is at a significantly increased risk of silicosis relative to other industries. Nested within the mining sector are several occupations and industries where the risk of silicosis is high. Gold quartz and uranium mining industries are at high risks of silicosis, as are drilling and blasting occupations. The highest risk of silicosis is observed among mining foremen, who are longstanding workers within the mining industry who have likely incurred significant exposure to dusts. Historically, mining workers have experienced high rates of silicosis due to their high levels of exposure to silica dust. It is not surprising that the ODSS demonstrated that Ontario miners are at a high risk of this respiratory condition.

  • Mining foremen: 28x increased risk
  • Gold quartz miners: 22x increased risk
  • Uranium miners: 15x increased risk
  • Drilling and blasting occupations: 15x increased risk
  • Iron foundry workers: 7.5x increased risk

Processing Occupations

Occupations related to mineral, metal, clay, and chemical processing are at an increased risk of silicosis relative to other occupations. This finding is unsurprising given the nature of processing work, which would involve the cutting and handling of dusty raw materials, which would expose workers to high levels of various dusts, including crystalline silica.

  • Processing occupations (mineral, metal, clay, chemical): 2x increased risk

Transportation

Within the transportation sector are truck drivers, who are exposed to exhaust pollution and diesel, but typically do not have exposure to silica dust. The ODSS observed that truck drivers are at a decreased risk of silicosis, relative to other occupations.

Truck drivers: 0.6x decreased risk

Relative Incidence by Industry and Occupation

 

 

FIG1. Incidence of silicosis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

 

FIG2. Incidence of silicosis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

 

 

Table1. Surveillance of Silicosis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture <5 27,780
2/3 Forestry, Fishing and
Trapping
0 7,846
4 Mines, Quarries and
Oil Wells
29 18,105 9.65 (6.47, 14.4)
5 Manufacturing 101 565,241 1.25 (0.97, 1.62)
6 Construction 28 175,557 1.20 (0.80, 1.8)
7 Transportation, Communication
and Other Utilities
9 165,863 0.37 (0.19, 0.71)
8 Trade 24 357,119 0.54 (0.35, 0.82)
9 Finance, Insurance and
Real Estate
<5 19,374
10 Community, Business and
Personal Service
53 483,653 0.91 (0.66, 1.25)
11 Public Administration and
Defense
17 157,830 0.71 (0.44, 1.17)
* SIC: Standard Industrial Classification (1970)
† Hazard rate in each group relative to all others

Table2. Surveillance of Silicosis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
<5 26,751
21 Natural sciences, engineering
and mathematics
<5 22,780
23 Social sciences and
related fields
<5 24,933
25 Religion 0 110
27 Teaching and related 5 41,679 0.97 (0.40, 2.38)
31 Medicine and health 15 108,721 1.21 (0.70, 2.11)
33 Artistic, literary,
recreational and related
0 12,723
41 Clerical and related 12 162,055 0.56 (0.31, 1.01)
51 Sales 8 123,185 0.63 (0.31, 1.28)
61 Service 37 297,987 0.96 (0.68, 1.37)
71 Farming, horticultural
and animal husbandry
<5 40,929
73 Fishing, hunting,
trapping and related
0 463
75 Forestry and logging 0 7,724
77 Mining and quarrying,
including oil and gas field
26 10,005 16.10 (10.60, 24.40)
81 Processing
(mineral, metal, chemical)
19 67,193 2.18 (1.36, 3.49)
82 Processing
(food, wood, textile)
8 81,486 0.74 (0.37, 1.50)
83 Machining and related 35 161,762 1.49 (1.04, 2.15)
85 Product fabricating,
assembling and repairing
42 276,583 0.98 (0.70, 1.37)
87 Construction trades 22 181,269 0.78 (0.50, 1.22)
91 Transport equipment
operating
10 143,762 0.45 (0.24, 0.85)
93 Materials handling and related,
not elsewhere classified
15 128,454 0.88 (0.52, 1.48)
95 Other crafts and
equipment operating
5 23,380 1.34 (0.55, 3.24)
99 Other occupations not elsewhere classified 23 180,530 0.98 (0.64, 1.52)
* CCDO: Canadian Classification Dictionary of Occupations (1971)
† Hazard rate in each group relative to all others

ASBESTOSIS

Background

What is Asbestosis?

Asbestosis is a non-malignant respiratory condition that results in the scarring and stiffening of lung tissue. Asbestosis is caused by inhalation of asbestos fibers and is a separate condition from mesothelioma, another disease directly related to asbestos exposure. Patients diagnosed with asbestosis are at an increased risk of developing lung cancer and mesothelioma given their past history of asbestos exposure. Smokers who are exposed to asbestos are at a greater risk of asbestosis than non-smokers who are exposed to asbestos fibers.

Risk Factors

      • Asbestos fibers (all types)
      • Asbestos is the only risk factor for asbestosis. Workers within occupations with exposure to asbestos fibers are at an increases risk of this disease. Construction workers, such as insulators, electricians, and plumbers are several of the occupations that have experienced high rates of this condition. Metal workers and platers and boilermakers are also at an increased risk of asbestosis.
Key Findings

Construction Sector

The construction industry and trades occupations require workers to handle insulation or work in close proximity to insulation. Occupations that may put workers into contact with asbestos include insulators, electricians, and plumbers. ODSS detected increased risks of asbestosis among home-related building and repairing occupations that may be exposed to asbestos in the work environment.

      • Insulators: 23x increased risk
      • Pipefitters and plumbers: 8x increased risk
      • Electricians and repairmen: 3x increased risk

    Education and Related Services

    Workers within the education and related services sector include not only teachers and administrative staff, but also custodial workers. These workers are possibly exposed to asbestos that was installed as pipe insulation in older buildings. The degradation of these buildings can lead to water damage, which can volatilize asbestos and pose a health risk to staff. ODSS results indicate that education and related services workers are at an increased risk of asbestosis.

        • Education and related services: 1.5x increased risk

      Manufacturing

      The manufacturing industry covers a wide spectrum of subgroups, including wood and textile industries, chemical production, and primary metal work. Within the metalworking industry, iron and steel mill workers are required to operate machinery including boilerplates, furnaces, and other heating apparatuses.  Asbestos was commonly used as an insulating material in metalworking machinery. When these materials are disturbed or degrade asbestos fibers are released into the air. ODSS results demonstrate that some manufacturing workers are at an increased risk of asbestosis.

          • Boilermakers: 8.5x increased risk
          • Primary metal workers: 2x increased risk
Relative Incidence by Industry and Occupation

 

FIG1. Incidence of asbestosis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

 

FIG2. Incidence of asbestosis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

Table1. Surveillance of Asbestosis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture <5 27,783
2/3 Forestry, Fishing and
Trapping
<5 7,846
4 Mines, Quarries and
Oil Wells
15 18,129 0.97 (0.58, 1.61)
5 Manufacturing 322 565,202 1.00 (0.87, 1.14)
6 Construction 190 175,495 2.30 (1.95, 2.71)
7 Transportation, Communication
and Other Utilities
82 165,845 0.89 (0.71, 1.12)
8 Trade 90 357,103 0.62 (0.50, 0.77)
9 Finance, Insurance and
Real Estate
15 19,373 1.47 (0.88, 2.45)
10 Community, Business and
Personal Service
133 483,631 0.83 (0.68, 1.00)
11 Public Administration and
Defense
73 157,818 0.85 (0.67, 1.08)
* SIC: Standard Industrial Classification (1970)
† Hazard rate in each group relative to all others


Table2. Surveillance of Asbestosis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
8 26,751 0.75 (0.37, 1.51)
21 Natural sciences, engineering
and mathematics
6 22,772 0.53 (0.24, 1.19)
23 Social sciences and
related fields
7 24,930 1.42 (0.67, 3.01)
25 Religion 0 110
27 Teaching and related 9 41,677 0.71 (0.37, 1.38)
31 Medicine and health 17 108,718 0.66 (0.4, 1.08)
33 Artistic, literary,
recreational and related
<5 12,723
41 Clerical and related 39 162,047 0.63 (0.46, 0.87)
51 Sales 36 123,176 1.02 (0.73, 1.43)
61 Service 89 297,981 0.73 (0.58, 0.91)
71 Farming, horticultural
and animal husbandry
6 40,929 0.38 (0.17, 0.85)
73 Fishing, hunting,
trapping and related
0 463
75 Forestry and logging <5 7,725
77 Mining and quarrying,
including oil and gas field
9 10,032 1.09 (0.56, 2.10)
81 Processing
(mineral, metal, chemical)
44 67,186 1.33 (0.98, 1.80)
82 Processing
(food, wood, textile)
22 81,486 0.61 (0.40, 0.93)
83 Machining and related 108 161,742 1.12 (0.91, 1.37)
85 Product fabricating,
assembling and repairing
149 276,575 0.91 (0.76, 1.09)
87 Construction trades 263 181,199 3.07 (2.64, 3.57)
91 Transport equipment
operating
52 143,752 0.57 (0.43, 0.76)
93 Materials handling and related,
not elsewhere classified
28 128,453 0.45 (0.31, 0.65)
95 Other crafts and
equipment operating
14 23,376 1.00 (0.59, 1.70)
99 Other occupations not elsewhere classified 79 180,526 0.92 (0.73, 1.16)
* CCDO: Canadian Classification Dictionary of Occupations (1971)
† Hazard rate in each group relative to all others

 

MESOTHELIOMA

Disease Background

 

What is mesothelioma?

Mesothelioma is a cancer of the tissue lining the lungs and other organs. Mesothelioma is the most well-known modern occupational cancer dating back to the 1950s when asbestos miners experienced high rates of this highly fatal disease. It is characterized by a long latency, upwards of 40 years, after exposure to asbestos fibers. There is no cure and survival is extremely poor with only 10% of cases living five years after being diagnosed. Men are more likely to be diagnosed than women, but second-hand exposure to asbestos through clothing washing is a historic risk factor for mesothelioma in women. The diagnostic difference in sex is due to more men working in environments with asbestos than men being more susceptible to women.

Risk factors

  • Asbestos fibers
  • Ionizing radiation

Approximately 80% of mesothelioma cases are attributable to occupational asbestos exposures.  There are several types of asbestos fiber, including chrysotile asbestos, which is the most widely used fiber. All fiber types are known to cause mesothelioma. Asbestos was heavily mined in the early and mid 20th century and used across a variety of applications due to its favourable thermal and tensile properties.

Why are we interested?

There are multiple occupations and industries that have consistently shown increased risks of mesothelioma. The recent national asbestos ban (link) is a positive step to reduce the health burden of mesothelioma, but exposure to asbestos is an ongoing concern. Using the occupational disease surveillance system (ODSS), we sought to identify workplace trends for mesothelioma in Ontario.

Key Findings

Within the construction industry, ODSS results indicate that insulating occupations, pipefitters and plumbers, electricians and repairmen and carpenters are all at elevated risks of mesothelioma. Insulating occupations require workers to handle asbestos materials when either installing or removing insulation materials from homes. Pipefitters and plumbers as well as electricians and repairmen are required to work within wall spaces in buildings, which potentially exposes them to insulating materials, such as asbestos. Disturbing these materials can lead to the inhalation of asbestos fibers.

Workers within the education and related services sector include teachers and administrative staff. These workers are possibly exposed to asbestos that was installed as pipe insulation in older school and university buildings. The degradation of these buildings can lead to water damage, which can volatilize asbestos and pose a health risk to staff. ODSS results indicate that university and college staff as well as elementary and secondary school staff are at increased risks of mesothelioma. While these findings may not appear obvious given the clerical and teaching tasks of education workers, these associations have been previously observed and are supported in the scientific literature.

Unlike Quebec, Ontario’s asbestos mining was not a large industry. Nevertheless, ODSS results indicate that asbestos miners in Ontario are at a dramatically increased risk of mesothelioma relative to other Ontario workers. This is expected given the known etiology of mesothelioma and the extraordinarily high levels of exposure asbestos miners would incur.

Iron and steel mill workers are required to operate machinery, including boilerplates, furnaces, and other heating apparatuses.  Asbestos was commonly used as an insulating material in metalworking machinery. When these materials are disturbed or degrade asbestos fibers are released into the air. ODSS results demonstrate that iron and steel workers are at an increased risk of mesothelioma relative to other Ontario workers.

Risk by Industry and Occupation

FIG1. Incidence of Mesothelioma diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of Mesothelioma diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

Table1. Surveillance of Mesothelioma: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture 11 35,119 0.81 (0.45, 1.47)
2/3 Forestry, Fishing and
Trapping
<5 10,722
4 Mines, Quarries and
Oil Wells
21 23,230 1.63 (1.06, 2.52)
5 Manufacturing 340 694,923 1.10 (0.95, 1.26)
6 Construction 170 211,572 1.87 (1.58, 2.22)
7 Transportation, Communication
and Other Utilities
83 197,583 1.00 (0.80, 1.26)
8 Trade 93 429,967 0.55 (0.44, 0.68)
9 Finance, Insurance and
Real Estate
6 24,021 0.76 (0.34, 1.70)
10 Community, Business and
Personal Service
126 600,448 0.89 (0.74, 1.09)
11 Public Administration and
Defense
82 191,139 1.24 (0.99, 1.56)
         
         
* SIC: Standard Industrial Classification (1970)    
† Hazard rate in each group relative to all others    

Table2. Surveillance of Mesothelioma: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related
15 31,037 2.73 (1.64, 4.56)
21 Natural sciences, engineering
and mathematics
12 26,369 1.28 (0.73, 2.27)
23 Social sciences and
related fields
<5 30,728
25 Religion 0 129
27 Teaching and related 9 48,524 1.43 (0.74, 2.77)
31 Medicine and health 17 135,475 1.04 (0.63, 1.71)
33 Artistic, literary,
recreational and related
<5 15,009
41 Clerical and related 35 197,593 0.62 (0.44, 0.87)
51 Sales 20 148,272 0.59 (0.38, 0.93)
61 Service 77 371,368 0.74 (0.58, 0.94)
71 Farming, horticultural
and animal husbandry
12 50,269 0.62 (0.35, 1.09)
73 Fishing, hunting,
trapping and related
0 558
75 Forestry and logging <5 10,710
77 Mining and quarrying,
including oil and gas field
7 13,046 0.97 (0.46, 2.04)
81 Processing
(mineral, metal, chemical)
33 79,386 0.97 (0.68, 1.37)
82 Processing
(food, wood, textile)
19 99,382 0.50 (0.32, 0.79)
83 Machining and related 109 189,800 1.20 (0.98, 1.47)
85 Product fabricating,
assembling and repairing
157 328,825 1.05 (0.89, 1.26)
87 Construction trades 223 216,117 2.55 (2.18, 2.98)
91 Transport equipment
operating
54 168,487 0.69 (0.53, 0.92)
93 Materials handling and related,
not elsewhere classified
55 153,323 0.80 (0.61, 1.06)
95 Other crafts and
equipment operating
20 28,360 1.61 (1.03, 2.51)
99 Other occupations not elsewhere classified 85 215,629 0.90 (0.72, 1.13)
         
         
* CCDO: Canadian Classification Dictionary of Occupations (1971)  
† Hazard rate in each group relative to all others