Document 06bG5YZk3y50JNZK7zxy2eG0b

Deaths from primary brain cancers, lymphatic and haematopoietic cancers in agricultural workers in the Republic of Ireland The .MediceSocid Research Board oi Ireland, PO Box I85I. Bailsbrid~c.Dublin 4, Ireland G Dcvl C"rrc\po"dcnLL ' U Dr C Dcln \ C C L P I C ~ lor pblicruun \o,rrnbcr IOU3 Abstract S t u d y objective - To ascertain if agricul- t u r a l workers in t h e Republic of Ireland had a higher than expected mortality from brain and haematopoietic cancers -than occurred in the general population. Design The Central Statistics Office of Ireland provided computer analysis of all deaths coded as cancer of the brain, ICD 191, a n d of lymphatic a n d haematopietic cancers, ICD codes 2 W 1 0 8 , by socioeconomic, sex. a n d age groups, f r o m 1971 10 1987. The d e a t h s w e r e then a n a l y x d by socioeconomic group and compared with the expected number of deaths in the -general population. Setting A cluster of four deaths f r o m primary brain cancer, three from leukaemia, a n d o n e f r o m Hodgkin's disease, occurred in the research and technical staff of the f o r m e r Agricultural Institute of the Republic of Ireland in mcn under the age of 65. This raised the question, were f a r m e r s m o r e likely to get these forms of cancer due toexposure to herbi- -cides o r fertilircrs? Subjects ..\I1 deaths in the Republic of Ireland f r o m 1971 to 1987 by socioeco- -nomic group. .Main results Although deaths reported as due to primary brain cancers had increased in all socioeconomic groups in the two t i m e periods studied, there was no greater increase in f a r m e r s a n d a smaller increase in other agricultural workers and fishermen. Deaths f r o m Hodgkin's disease and multiple myeloma, and to a smaller extent from Ieukaemia, had also increased. The increase in reported mortality of these haematopoietic cancers in f a r m c r s was no g r e a t e r a n d in ocher agricultural workem i t was less t h a n in the -general population. Conclusion There was no evidence that farmers had any greater increase in mortality from these cancers than the general population. The cluster of brain and haematopoietic cancers in research and technical staff a t the Agricultural Institute of the Republic of Ireland docs not reflect a high risk of these cancers among the general farming population, but strongly s u p p o r t s the need for a compila- tion of a register of causes of death of laboratory workers in a n u m b e r of countries. An invesrigation in 1985 into the causes of death in male research and technical staff employed by che Agricultural Institute of Ire- land, showed that there were four deaths from primary brain cancer, three from leukaemia, and one from Hodgkin's disease among the 11 dezths from cmcer out of 28 total deaths.' Anothsr member of the In,:iturc's technical ng from 3 Iympharic cancer. T h e ;!uiier '>< ir.3:hs frnvn hr.m and haematopoi& imcers m o n g the research and technical rtaff, who h d worked in Jiffcrcnr branches of the Institute, could have been due to radiation from radioactive isotopes, a viral infecrion, or a chemical hazard from some substance used in agriculture or research, or it could have been a very unusual chance occurrence. ..\bout the m e rime it was reponed chat a cluster of rare cancers (sarcoma, lymphoma) was occurnng among laboratory workers at the Paswm Inyrirxc in P m c : 3 follow u p vudv showed an rxcns o i bone, pancreas and brain cancer dearhs bur rhc numhrrs were m a l l 2. 5 md 3.: The Orray Instirutc in P ~ r i salso reported a greater than expected number of - -brain tumours.'Rutty zr ~1 reported a cluster of brain cancers gliomas in rhree pathology laboratory rechnicians' and Hall cr d reponed increased mortality irvm gliomas among pathu1uc:s:s m d other mcdic.11 labmatory personnel.' P w r x zr ~1 reported an increased mortality from leukaemia in agnLulture and forestry workers in Sew Zealando and Belli cr a1 found an increased nsk for a number of cancers in a mortality study of research workers employed by the Italian Sational Jnstitute of Health, pointing to an excess nsk for some cancers.' L a h m t o r y workers in England aged 18-64 had d small but ,igniticantly increased mortahty frcm briin cmcer ' U V ~ I U ~th!e rslcarin wurken in Lie A g r i a l lure Institute in Ireland might have been .Iunduly r.xpo\ed to w m e ngricultural chemical. ruch $I. feniiiw ur pesticide, which might mcrcax the nsk of developing brain or haematopoieac cancer md which might he affecfing farmers in general in Ireland, a study was undertaken on deaths from these groups 01 sanccrs among farmers, relatives assisting farmers. and among f3rm managers socioeco- numic group 0 SEG 0:' and also m o n g other ~griculturalxcupatiuns and fishermen iSEG I , in i o m p m w n with the other socioeconomic groups and with the general population. .\lethod The Central Statistics Office (CSO:of Irelmd provided computer analysis of all deaths coded 1968-77 to 1819 in 1978-87. Deaths from lyn- as cancer of brain [ICD 191; and of the Iym- phoid cancer and Hodgkin's disease increased phatic and hacmatopoietic cancers :ICD codes from 1 1 0 9 to 1548 (1606 males, 1051 females), 200-208>by soaoeconomic, sex, and age group and those from multiple myeloma from 637 to from 1971 (the first year when this information ILWI, 3 9 4 males. 744 females,. was available' to 1987. These data were not The death rates per 100OOO vear from brain available for specific occupations but only by iylcrrs have been compared for farmers. rela- socioeconomic group. The lymphatic and hae- tives assisting farmers, and farm managers matopoietic cancers were subdivided into Iym- SEG 0 ) for two time periods, 1971-78 and phoid cancers and Hodgkin's disease ;ICD 1979-87, in comparison with that of the total 20&202), multiple myeloma ICD 203', lyn- population by sex and age group in table I. T h e phoid leukaemia 'ICD 204 ,myeloid leukaemia farmers do not have any significant difference in ICD 2 0 5 , and monocytic and other leuk- brain cancer monaliry in the different age aemias ICD 200-208 . In this k t group. death groups to rhat in the population a i a whole. The was usually described as from "leukaemia", greatest increase in hrain cancer deaths, both in wirh rhc rvpe not 5pecified farmers and in the general population, occurred The populationb dr rirk by SEG, res,m d dye dvcr !CI ~ g cL,< 63 ;.urh. group were obtained from the 1971 and 1981 For the last nine years of the study :1979-8T censuses. The SEG is haled on the gainful h e actual and especred number of deaths from occupation, past or present, stated at the cen- cancer of the brain have been calculated for all sus, where there is a specific question, and on SEGs :table 2 ) . There is an excess of deaths the death certificate. More people are dcscnbed among those in the "unknoun group" iSEG on their death certificate as "occuparion Y , compared wirh the expected number based unknown", "housewife", or "retired" than at on the populations ar nsk. For comparison the census. Farmers and their relatives SEG 0 purposes this cxcess has heen divided propor- wldorn retirc from their farms. so there are tionatelv .mung all the other socioeconomic rclativelv f o v farmer\ in thc u n k n c v n hL:G srciuj-, in rnc ia\t icilumn$1; !ne u h k . Fdrmcrh grcup SEG I' Thme in :he crour. "mhc: >agncultural occupations and tishermen" SEG I are mostly farm labourers. SEG (1 do not h r \ e qniricaniil- more brain ianccr deaths than cxpectcd - 2.W deaths and ?6+3 expected. If the excess proportion of The SEGs were only available from the Cen- deaths in the unknown SEG are added, then ual Sratisrics Ofice from 1971 onwards. Two !here would be 26t3 deaths among the farmers, time periods were. therefore. studied - lQ71-i8 compared u-irh ?Mcspected. MLI I'4i9-b;. Cumpdrib<ms a 5 ;hcn ;nd& AI:^ Dut!-.> frcm brxn imccr Jmmg "L)thc.r q r i - the rates hy sex and age group for JII de3rhs in cultural occupations and tishcrmcn" SEG 1 I thc Rcpublii d i I:c!.md .!u::cg !hc !*.vv I o !car Jrc \ignitianrly h e r 1h.m cspected 23 7 pcriods 1968-77 and I97M-87. p<O.OOI:. When SEG5 0 and I are taken together there were 267 male and female hrain cancer deaths, and 116.6 is the calculated Results cspccted number , ~ : =7 pi<:O01'. %Lost of The greatest increase in reported cancer deaths the men in SEG I are agricultural labourers and in the population of the Republic of Ireland has it seems probable that they are frequently de- been for brain cancer. During the 20 years scribed as "farmers" SEG 0 on the death 1968-87, 1280 male and 872 female deaths were certificate, but as farm labourers I SEG 1 ) at the reported as due IO primar?. brain cancer. and census the number *)ihrmn ;.inccr Jca:hc ~ o u b l e d T h e acru.il 2nd ~ S F K I C ~number ,>dieath, berueen IQhS-ii. i ? I Jearh5 and l O i \ $ 4 7 for J I I the ianccrs midied in farmer, .ind in .I.L1.4:;A. &.~:k:. . \ L ~J a>r I r>a %r~h c n :.A.IzI:J .~c.,i:;dJ : : i m j .!c.ir?.~ 'x.:: - ~ ~ .c: ud. i i d .I\ m \ c i $ d or l\mpnatii lcuk.icniiJ . i d !mer r .icricul:urd ~ ~ , < u p J t !. ~i dm C.hcrrncn ;omrincd Jre \ho\r.n h! w s dnd in :\!<, ,igu gruup, in x h l c 3 B,Lth in thc 1 5 4 4 JCC Icukacmia n p c not s t a i d I t JII Ionns ~ > f gn'uj- JnJ in the h i - age group in iarmcrs leukaemia are combined. thcrc is only a \mall S E t i O', there is no significant difference increase in leukaemia deaths - irvm 1570 in between [he actual dnd number of deaths and i i t Group 771 772 9 OY :u Y 5 1 55 7 53 ais 20 3 9 :o ? 143 I 565 56i 0 :4b : j 5 3 124 IM 2 :0: :JJ Y 31 b2 1 35 1 4..6 2LU 3 111; 0 I1378 the calculated expected number at all Republic haw !hc expected numhcr of deaths In a l l the of I r e l n d ratcs ft,r brain c3nier 2nd f c v cnch G$ 1'm;cr $roup> \txdied rlnd othcr agri;ultur3l the various yroups of lymphatic dnd haemaro- occqations and hshermen SEG 1 hare r ~ g n l - pmetic cancerc. The 4 y h t excess of 17 3c:uaI ficixl?. fcwcr of :hese cancer dentks cxiept for and I O expected deaths in females aged 65 A for lymphold leukaemia. For the other SEGs there "monocytic and other leukaemia" represents a is not a great difference between the actual and diagnosis of "leukaemia" on the death certifi- expected number of cancer deaths, although cate without reference to the type. Other agri- raking these cancers together, other non- cultural occupations and fishermen (SEG I) manual workers :SEG 7) and skilled manual show significantly fcwer deaths in males than workers (SEG 8) have fewer deaths than cxpecred in all the cancer groups studied, expected. .. .::% except for lymphoid leukaemia, and in females The excess of deaths where the SEG was not there are signifimtly fewer dcaths except for k n o w at death .SEG Y;, has k e n divided lvmphoid cancers and lymphoid leukaemia. prnportionatelv in the laqt column of table 4. > When both SEGs 0 and 1 rlrc iomhlned, Hcuuze rrlatively few farmers or farmers rclamales have significantly fewer brain cancer rive\ retire from their farm, in Ireland. most of dciths 195 b a n the i ~ l c u l r t e dcxpccted num- the Jciths in SEG Y occupanon unknown, . . bcr ,,22b.1, ~ - = 4 . 3pi13053 and fewer lym- were of people living in Dublin or other towns. t phatic and haematopoietic cancers (712) than Nevenheless, when the relative proportion of mpn-ted ,783 6 X" = 6 3 p 0.05' I. There are SEG deaths are added to the male farmers, r also fewer myeloid leukaemia deaths (151 1 than there IS still not a significant excess of haernato- C S ~ C C : C ~ ?, 1 3 7 7 'I:=;: p.:OOI ' whcn both poic:ii <anicr Jcath, in cach bubyraup. ~ 1 - \cxc\ rlrc :.ikcn together. t h o q h iherc IS :f 311 :hebe cancer groups .ire The K:UI dnd cspcited n u m h r 0 1 de.ith3. included rogcher. In multiple myeloma, atter age standardised for males and females, for adding the proportion of unknown deaths, the all socioeconomic groups and for the various calculated number of deaths in male farmers is lymphatic and haernaropietic cancer deaths 171 and the expected value is 146.4 ! f = 4 . I studied are shown in table 4. Farmers (SEG0) p<0.05). This difference is probably an .. / I 17 0 21 :1 5 5 5 7 1: I U 1 0: ? a 3 159 I Y ) I taken wp3ntCly. Other agricultunl OCCUpI i c w k Jnd rishermen .who arc mostly farm 1ah)urcrb. hjvc h c r Jmrhs from briin And h;iematopoieric ianccr than would be expeacd A iuriunal r.irr\ There is no evidence. therefore, that farming in Ireland increased the risk of developing brain cancer or lymphatic cancer, including Hodgkin's disease, multiple myeloma, or leukaemia, in comparison with the general populauon. T h c cluster of deaths from brain anccrs ~ n dhaemaropoietic cancers that has been noted among the rc-earch and techntcal staff of the former Agncultural Institutc of Ireland. 2nd in the Pasteur and Orsay Instrmtes cred hv anv :ncrease in these ng farmers in gencral in !\,ihlc [ha: rhere ma\- he J Ih3t h.i\c J high<: !IIAI: n<!rm;ll 71-ic \ s t Jc.\clLpng these ianccr). bur nlidtevcr :he c3u.c ot the clusrerr 01 JsJth, from rhcsr. i m c c n among research uivkers. rherc is no grcdtcr rtsk of developing these ianccrs in the general population of farmers in Ireland than occurs in the populatiun JS 3 WhOlC. Further srudies are being undertaken at an i n t c r u ~ i ~ ~ i!;:\s~i: !n dcicr:ain if rcsmrch workers are wbiect rd ~ n uynJuc riyk, cmmcer d ~ n k i ~ t cLvdirh their work and. if there IS\uch 3 .t hzr i t I\ .t> :hat it can he a d b) K<:t> i: -I/. (7.2 :!,., che L.dnur.' therc are good I,hurJtvr! worken should be wir,;;.A I:! .I nttmhcr o i iountrics. .4 rrrro~pcct~vccohiitr rtudy of personnel cmpliiyed u\cr 5.: g i v 2 0 yean in h~omcdicaol r agronomic teearch institutes in Europe has now becn set up under the Wgl\ of rhe IncernarIonal hgenc'y for Rocarch in Gncer l.%RCI,Lyon.'" 368 -. . I.