View Abstract

A6077 - Lung Cancer Risks Across Different Industries and Occupations in Ontario, Canada: The Establishment of the Occupational Disease Surveillance System (ODSS)
Author Block: V. H. Arrandale1, J. Jung1, S. Feinstein1, L. Palma1, J. McLeod1, C. McLeod2, A. Peter3, P. A. Demers1; 1Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada, 2School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, 3Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.
INTRODUCTION:
Surveillance systems for occupational disease can make important contributions to prevention, but continue to be challenging to initiate. As a result of universal health care coverage, Canada has a wealth of linkable health databases that include the majority of the population. However, almost all lack information on employment (i.e., occupation and industry). The Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada to overcome this limitation and track a variety of occupational diseases. The aim of this study was to use ODSS to identify high-risk industry and occupation groups for lung cancer.
METHODS:
The Workplace Safety and Insurance Board (WSIB), Ontario’s workers’ compensation board, maintains a database of all allowed time-loss claims that includes information on both occupation and industry for the claimant. Workers in the database (1983-2014) eligible for inclusion (n=2,190,246) were linked to the Ontario Cancer Registry (through 2016) using subjects’ health insurance numbers, name, sex, birth date, and death date (if applicable). Workers who entered the cohort by filing a WSIB claim for any cancer (i.e., prevalent cancer cases) were excluded from analysis. Several occupations and industries known to be at increased risk were outlined a priori to examine whether ODSS could replicate these associations. Sex-stratified, age-adjusted Cox proportional hazard models compared the risk of lung cancer within one industry/occupation versus all other groups in the cohort.
RESULTS:
During follow-up, 34,646 workers in the cohort were diagnosed with lung cancer. Excesses were observed among expected high-risk industries, such as mining (HR=1.5, 95%CI=1.4-1.6) and construction (HR=1.1, 95%CI=1.1-1.2) and expected high-risk occupations, including mining and quarrying (HR=1.5, 95%CI=1.4-1.7), processing of metal/clay, glass, stone/chemicals (HR=1.2, 95%CI=1.1-1.3), machining and related (HR=1.1, 95%CI=1.1-1.2) and transport equipment operating (HR=1.4, 95%CI=1.4-1.5). The system has sufficient power to identify risks at a useful level of detail for surveillance, for example excesses were observed in iron foundries (HR=1.3, 95%CI=1.1-1.6), non-metallic mineral products manufacturing (HR=1.3, 95%CI=1.2-1.4), and welding shops (HR=1.3, 95%CI=1.0-1.6). In general, the results for women and men were consistent within high risk groups, although the smaller numbers of women in some groups resulted in less statistically-significant results and sometimes were below the threshold of 5 cases required to report results.
CONCLUSIONS:
This ODSS system identified many established high-risk groups for lung cancer, and can be used for ongoing surveillance of occupational lung cancer risk in Ontario, Canada. This model could be adopted in other jurisdictions with similar data resources.