Recent estimates indicate that only about 40 percent of breast cancer
cases can be explained by accepted and suspected risk factors.
Exposures to chemical and physical agents in the workplace of women have
not been studied adequately. Thus, the object of the present protocol
is to determine whether occupational exposures to selected chemical and
physical agents is associated with increased risks of pre- and
postmenopausal breast cancer. A population-based, case-control study
of pre-and postmenopausal breast cancer incidence among women aged 40
to 79 years was conducted in western New York State between 1986 and
1991. Only new, histologically-confirmed primary cases of malignant
breast cancer from all major hospitals in the region were enrolled (301
premenopausal and 439 postmenopausal). A population-based control group
was recruited and was frequency-matched to case subjects on age and
county of residence. Face-to-face interviews by trained nurse-
interviewers were carried out and information on a wide array of
accepted and potential risk factors was obtained. Standardized lifetime
occupational histories were also obtained and these included details
regarding place of employment, duties and activities associated with
each job. For all 1,550 subjects, the job histories will be sent to a
team of expert industrial hygienists and chemists at the Institut
Armand-Frappier who will then attribute exposure to about 300 agents
using a method developed by Siemiatycki and colleagues. The team has
considerable experience in coding these types of job histories and will
collaborate with hygienists in Buffalo. The occupational information
present in the job descriptions is sufficiently detailed to capture the
idiosyncracies of each person's job; thus, this system will minimize
exposure misclassification. Statistical analyses, including logistic
regression and generalized additive modeling techniques, will be carried
out to assess the role of occupational exposures with a focus on
polycyclic aromatic hydrocarbons, specific organic solvents and
electromagnetic fields. Analyses will be conducted separately for the
pre- and postmenopausal groups and will be combined where appropriate.
Identification of agents whose exposures are amenable to modification
may allow for new public health initiatives to reduce risk. This timely
investigation should make an important contribution to our limited
understanding of occupational risk factors for breast cancer.
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