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Hematologic malignancy in tanker crewmembers: a case‐referent study among male Swedish seafarers
Department of Occupational and Environmental Medicine, Sahlgrenska Academy, Gothenburg.ORCID-id: 0000-0002-4625-2401
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
Department of Occupational and Environmental Medicine, Sahlgrenska Academy, Gothenburg.
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2020 (Engelska)Ingår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 63, nr 8, s. 685-692Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Work on Swedish petroleum tankers before the late 1980s has been associated with an increased risk of hematologic malignancy (HM). Since then, ship modernizations have decreased occupational exposure to gases, including the carcinogen benzene. We explored the risk of HMs in Swedish seafarers who had worked on newer types of tankers.

METHODS: A case-referent study in male seafarers from a cohort of all Swedish seafarers was set up by record linkage with the Swedish Cancer Registry using the subjects' personal identification number. For each case (N = 315), five referents were randomly chosen from within the cohort, matched by birth year and three different periods of first sea service (<1985, 1985-1991, and ≥1992). Information on the type of ship and dates of service was retrieved from the Swedish Seafarers' Registry. Odds ratios (OR) were calculated by conditional logistic regression together with 95% confidence intervals (CI).

RESULTS: The OR of HM was 1.07 (95% CI, 0.80-1.42) for work on tankers. In seafarers that had started to work on tankers ≥1985, the OR was 0.85 (95% CI, 0.50-1.43). For those who started to work on tankers before 1985, the OR was 1.17 (95% CI, 0.84-1.21) and 1.32 (95% CI, 0.86-2.03) if the cumulative time on tankers exceeded 5 years of service. In this last group, the OR of multiple myeloma was 5.39 (95% CI, 1.11-26.1).

CONCLUSION: Although limited by crude exposure contrast and a short follow-up, work on tankers after 1985 was not associated with an increased risk of HM among Swedish seafarers.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2020. Vol. 63, nr 8, s. 685-692
Nyckelord [en]
benzene, leukemia, lymphoma, multiple myeloma, tanker
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Identifikatorer
URN: urn:nbn:se:umu:diva-167248DOI: 10.1002/ajim.23122ISI: 000534816400001PubMedID: 32445513Scopus ID: 2-s2.0-85085594325OAI: oai:DiVA.org:umu-167248DiVA, id: diva2:1385310
Anmärkning

Originally included in thesis in manuscript form with the title: "Hematologic malignancy on tankers: A case -referent study among male Swedish seafarers"

Tillgänglig från: 2020-01-14 Skapad: 2020-01-14 Senast uppdaterad: 2020-08-27Bibliografiskt granskad
Ingår i avhandling
1. Health hazards and cancer in relation to occupational exposures among Swedish seafarers
Öppna denna publikation i ny flik eller fönster >>Health hazards and cancer in relation to occupational exposures among Swedish seafarers
2018 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

This thesis explores health hazards for seafarers in the Swedish merchant fleet, and occupational risks for lung cancer, mesothelioma and hematologic malignancy (HM). A special focus has been exposure to benzene and biomarker levels for work on product or chemical tankers during the mid-1990’ies.

In a case report, we describe two cases of mesothelioma and two cases of lung cancer having worked in the engine room. Cumulative exposure to asbestos were up to 5 fibreyears. Other exposures were carcinogenic PAHs and nitroarenes. A web-based survey to active seafarers in the Swedish merchant fleet revealed noise, the risk of accidents, whole-body vibrations and ergonomic strain as main work environment problems. General health, work ability and safety climate were all rated high. Associations were found between lower airway symptoms and soot (PR 2.4, 95% CI 1.1-5.1) and between hearing impairment and noise exposure (PR 1.5; 95% CI 1.3–1.7). Iso-strain was especially common in the service department. Twenty-two percent of men and 45% of women had been subjected to harassments. The tanker study showed a geometric mean for benzene exposure of 0.45 mg/m3 (4hTWA) during a work shift, with a wide range (0.02-143 mg/m3). Correlations were found between exposure and benzene in alveolar air (p<0.0001), unmetabolised benzene in urine (p<0.0001) and ttMA in urine (p=0.0011). All biomarkers increased significantly during work (p<0.002). In a case-referent study with the observation period 1985 to 2014, the OR for HM was 1.32 (95% CI 0.86-2.02) if work on tankers had started before 1985 and with a cumulated tanker service of at least five years. If work on tankers had started after 1985, the OR was 0.85 (95% CI 0.51-1.43).

In conclusion, health hazards in today’s seafaring relate to physical, chemical and psychosocial factors. Work on tankers with mixed open and closed cargo systems might have led to important benzene up-take. Possibly, the risk for HM for seafarers on tankers has decreased during the last decades.

Ort, förlag, år, upplaga, sidor
Göteborg: Sahlgrenska Academy, University of Gothenburg, 2018. s. 63
Nyckelord
seafarer, work environment, mesothelioma, lung cancer, hematologic malignancy, benzene
Nationell ämneskategori
Arbetsmedicin och miljömedicin Allmänmedicin
Forskningsämne
epidemiologi; toxikologi; allmänmedicin
Identifikatorer
urn:nbn:se:umu:diva-167250 (URN)978-91-7833-217-5 (ISBN)978-91-7833-218-2 (ISBN)
Disputation
2018-12-11, Sal Europa, Wallenbergs konferenscentrum., Medicinaregatan 20A, Göteborg, 13:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2020-06-01 Skapad: 2020-05-29 Senast uppdaterad: 2022-12-21Bibliografiskt granskad

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Forsell, KarlBjör, OveJärvholm, Bengt

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