Ellie Darcey

The future excess fraction of occupational cancer among those exposed to carcinogens at work in Australia in 2012

BACKGROUND Studies in other countries have generally found approximately 4% of current cancers to be attributable to past occupational exposures. This study aimed to estimate the future burden of cancer resulting from current occupational exposures in Australia. METHODS The future excess fraction method was used to estimate the future burden of occupational cancer (2012-2094) among the proportion of the Australian working population who were exposed to occupational carcinogens in 2012. Calculations were conducted for 19 cancer types and 53 cancer-exposure pairings, assuming historical trends and current patterns continued to 2094. RESULTS The cohort of 14.6 million Australians of working age in 2012 will develop an estimated 4.8 million cancers during their lifetime, of which 68,500 (1.4%) are attributable to occupational exposure in those exposed in 2012. The majority of these will be lung cancers (n=26,000), leukaemias (n=8000), and malignant mesotheliomas (n=7500). CONCLUSIONS A significant proportion of future cancers will result from occupational exposures. This estimate is lower than previous estimates in the literature; however, our estimate is not directly comparable to past estimates of the occupational cancer burden because they describe different quantities - future cancers in currently exposed versus current cancers due to past exposures. The results of this study allow us to determine which current occupational exposures are most important, and where to target exposure prevention.

Prevalence of occupational exposure to asthmagens derived from animals, fish and/or shellfish among Australian workers

Objective Several animal, fish and/or shellfish derived substances encountered in the workplace can initiate or exacerbate asthma. The aims of this study were: to produce a population-based estimate of the current prevalence of occupational exposure to animal, fish and/or shellfish derived asthmagens, to identify the main circumstances of exposures and to identify occupations with the highest proportions of exposed respondents. Methods We used data from the Australian Work Exposure Study-Asthma, a national telephone survey that investigated the current prevalence of occupational exposure to asthmagens among Australian workers. A web-based tool was used to collect job task information and assign exposure to asthmagens, including animal, fish and/or shellfish derived asthmagens. Prevalence ratios to determine risk factors for exposure were estimated using modified Poisson regression. Results Of the 4878 respondents, 12.4% were exposed to asthmagens derived from animals, fish and/or shellfish. Exposure to these asthmagens was significantly higher in workers residing in regional and remote areas, compared with major cities. The main circumstance of exposure to animal derived asthmagens was through cleaning up rat/mice infestations, while the main circumstance of exposure to fish and/or shellfish derived asthmagens was through preparing and cooking salmon. Occupational groups with the highest proportion of exposure to animal or fish and/or shellfish derived asthmagens were farmers/animal workers and food workers, respectively. Conclusions This is the first study investigating occupational exposure to animal, fish and/or shellfish derived asthmagens in a nationwide working population. The results of this study can be used to inform the direction of occupational interventions and policies to reduce work-related asthma.

Latex glove use among healthcare workers in Australia

HighlightsLatex gloves were used by 22% of Australian workers.Occupations with the highest use of latex gloves included carers and hairdressers.63% of healthcare workers used latex gloves, and 26% wore powdered latex gloves.Latex gloves were more commonly used by healthcare workers in micro companies.Latex exposure in healthcare workers contributed 3% of the asthma‐related burden. Background: Exposure to natural rubber latex, primarily through the use of gloves, is a well‐recognized cause of occupational asthma. We investigated latex glove use among Australian workers and estimated the resultant burden of occupational asthma among healthcare workers (HCWs). Methods: Data were collected in 2014 as part of the Australian Work Exposures Study‐Asthma, a telephone survey investigating the prevalence of current occupational exposure to asthmagens, including latex. We estimated adjusted prevalence ratios (aPRs) to determine variables associated with the use of latex gloves among HCWs and calculated the asthma‐related disability‐adjusted life years due to latex exposure among HCWs. Results: Latex gloves were used by 22% of respondents. Almost two‐thirds (63%) of HCWs reported wearing latex gloves, with 26% using powdered latex gloves. The use of latex gloves was more common among those employed in micro companies (less than 5 employees) than large companies (200+ employees) (aPR = 1.5, 95% confidence interval 1.1‐2.0). Latex exposure in HCWs was estimated to contribute 3% of the total asthma‐related burden. Discussion: Latex gloves are widely used by Australian workers and by HCWs in particular. Conclusions: This is the first estimate of the burden of asthma attributable to occupational exposure to latex among HCWs. These results can be used to guide decisions regarding the control of occupational exposure to latex.

Occupational exposure to carcinogens in Australian road transport workers.

BACKGROUND Road transport workers (RTWs) are at high risk of exposure to several occupational carcinogens. However, there are gaps in knowledge regarding the extent and the circumstances of exposure. As a sub-study of the Australian Work Exposures Study, this study investigated the prevalence of occupational exposure in Australian RTWs. METHODS A random sample of Australian working population was invited to a telephone interview regarding their current jobs. An automated expert-assessment procedure was applied to self-reported job-related tasks using a web-based application. 162 RTWs were included in this study. RESULTS RTWs were exposed to diesel exhaust (97%), solar ultraviolet radiation (78%), environmental tobacco smoke (55%), benzene (29%), silica (15%), and asbestos (10%) at work. Besides driving on roads, vehicle maintenance-related tasks were the major source of carcinogen exposures among RTWs. DISCUSSION Most RTWs are exposed to at least one carcinogen at work. We have identified tasks where the use of control measures could potentially reduce exposures.

Workplace psychosocial stressors experienced by migrant workers in Australia: A cross-sectional study

Objective To explore work-related psychosocial stressors among people of Chinese, Vietnamese and Arabic-speaking backgrounds currently working in Australia. Methods In 2015, a telephone survey of 585 Vietnamese, Chinese and Arabic-speaking workers asked about workplace bullying, ethnic discrimination, job complexity, degree of control, security and fairness of payment along with demographic and employment information. Estimates of job-related psychosocial stressors were derived and regression analyses used to identify significant associations. Results At least one workplace stressor was reported by 83% of the workers in the study. Education was significantly associated with experiencing any psychosocial stressor and also with the total number of stressors. Workers aged 45 years and older were more likely to be bullied or experience racial discrimination compared with younger workers of any ethnicity. There was a greater likelihood of reporting low control over a job when the interview was conducted in a language other than English and the workers were either Chinese or Arabic. Workers on a fixed-term contract, independent of ethnicity were more likely to report a job with low security. Overall psychosocial job quality decreased with education and was associated with occupation type which interacted with ethnicity and gender. Conclusions The results suggest that job-related psychosocial stressors are widespread but not uniform across ethnic groups. Further research into what drives differences in work experience for migrant groups would provide information to guide both employers and migrants in ways to reduce workplace psychosocial stressors.

Isocyanates in Australia: Current exposure to an old hazard

ABSTRACT Exposure to isocyanates has consistently been reported as the most common cause of occupational asthma. The objectives of this study were to assess how many Australian workers are currently exposed to isocyanates, identify the occupations with highest proportion of exposed workers and identify the main circumstances of exposures. Data comes from the Australian Workplace Exposure Study-Asthma, a national telephone survey which explored the prevalence of current occupational exposure to 227 asthmagens, grouped into 27 groups, among current Australian workers aged 18–65 years. A web-based tool, OccIDEAS, was used to collect job task information and to assign exposure to asthmagens, including isocyanates. Of the 4,878 eligible participants, 2.5% of them were deemed to be probably exposed to isocyanates at work in their current job (extrapolated to 3.0% of the Australian working population). The majority of those exposed were males (90.8%). The most common tasks undertaken that led to these exposures were using expanding foam fillers/sprays and isocyanate and/or polyurethane paints. Exposure occurred mainly among construction workers, wood workers, and painters or printers. This study investigating occupational exposure to isocyanates in a national working population provides information that can be used to inform the direction of occupational interventions and policies to decrease occupational asthma.

Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis

BACKGROUND While a number of studies indicate tobacco smoking has a detrimental impact on survival and recurrence after a prostate cancer diagnosis, there has been no quantitative review of this literature and it is unclear whether tobacco smoking affects clinical populations differentially. We conducted a systematic review and meta-analysis to investigate the associations between tobacco smoking and overall (OM) and prostate cancer-specific (PSM) mortality and recurrence after a prostate cancer diagnosis. METHODS EMBASE and ISI Web of Science were searched for English-language studies, published up to August 17, 2017, which conducted a survival analysis to estimate the association between tobacco smoking and OM, PSM and/or recurrence. A random-effects meta-analysis was conducted to estimate the summary hazard ratios (HRs) for the associations between tobacco smoking and the three outcomes. RESULTS A total of 28 studies met the inclusion criteria. The results of the primary meta-analysis indicate current smokers have significantly poorer overall survival (Summary HR = 1.96, 95% CI = 1.69, 2.28), prostate cancer-specific survival (Summary HR = 1.79, 95% CI = 1.47, 2.20) and recurrence-free survival (Summary HR = 1.48, 95% CI = 1.28, 1.72) than never smokers. Similar results were found in population-based studies and in studies conducted in specific clinical populations. CONCLUSIONS The results of this systematic review and meta-analysis indicate that tobacco smoking at prostate cancer diagnosis is associated with a significantly increased risk of overall mortality, prostate-cancer specific mortality and recurrence. We recommend future studies collect more detailed information about tobacco smoking to further understanding of the association between tobacco smoking and PCa prognosis. In addition, further research should concentrate on the impact of smoking cessation post-diagnosis and post-treatment on prognosis, and the feasibility and effectiveness of smoking cessation programs.

Does the Size of a Company Make a Difference in the Prevalence of Exposure to Asthmagens and in the Use of Respiratory Protective Equipment

Introduction About half of all workers in high-income countries work in small companies. However, regulatory bodies and researchers predominantly work with large companies because they are more convenient to study and easier to reach. We aimed to estimate the prevalence of exposure to asthmagens and the use of respiratory protective equipment (RPE) by company size. Methods This analysis used data from the Australian Work Exposures Study-Asthma, a telephone survey which investigated exposure to 27 asthmagen groups. Results Among 4844 respondents, 18.8, 19.9, 31.9, and 29.4% of workers reported working in micro (<5 employees), small (5-19 employees), medium (20-200 employees), and large (>200 employees) companies, respectively. Compared to workers in large companies, workers in micro, small, or medium companies had higher prevalence of exposure to most asthmagens and lesser use of RPE. Conclusion Our results suggest that policy actions and regulatory measures should target micro/small companies in order to have the greatest effect.

The prevalence of exposure to high molecular weight asthmagens derived from plants among workers in Australia

BACKGROUND Limited information is available on exposure to high molecular weight (HMW) asthmagens derived from plants and on the main occupations and tasks that result in such exposure among workers. METHODS Data were collected as part of the Australian Work Exposures Study-Asthma. We estimated adjusted prevalence ratios (aPR) using modified Poisson regression models to determine which factors were associated with exposure. RESULTS A 12.8% of 4878 workers were exposed to HMW asthmagens derived from plants. The highest prevalence of exposure was found among farmers/animal workers, education workers, and food processing workers. The main circumstances of exposure were through handling flour, freesias, or through raising livestock. Exposure was more common among female workers (aPR = 1.26, 1.10-1.43) than males, while it was lower among workers born overseas (aPR = 0.70, 0.57-0.86) than those born in Australia. CONCLUSION Prevention of exposure to HMW asthmagens derived from plants requires a broad strategy targeting different tasks and occupations.

Australian work exposures studies: occupational exposure to pesticides

Background Pesticides are widely used in some occupational settings. Some pesticides have been classified as carcinogens; however, data on the number of workers exposed to pesticides are not available in Australia. The main aim of this study was to estimate the current prevalence of pesticide exposure in Australian workplaces. Methods The analysis used data from the Australian Work Exposures Study, a series of nationwide telephone surveys which investigated work-related prevalence and exposure to carcinogens and asthmagens, including pesticides, among current Australian workers. Information about the respondents’ current job and various demographic factors was collected in a telephone interview using the web-based tool OccIDEAS. Workers were considered exposed to pesticides if they reported applying or mixing pesticides in their current job. Results Of the 10 371 respondents, 410 (4%) respondents were assessed as being exposed to pesticides in the workplace, with exposure being more likely among males, individuals born in Australia, individuals with lower education level and those residing in regional or remote areas. Glyphosate was the most common active ingredient used by workers. Conclusions This is the first study to describe the prevalence of occupational pesticide exposure in Australia and one of the few recent studies internationally.