We conducted a nationwide case-control study in Finland to identify oc
cupational risk factors for pancreatic cancer. We constructed the occu
pational exposure histories for 595 incident cases of primary exocrini
c cancer of the pancreas and of 1,622 cancer controls, using three dif
ferent methods. We found elevated odds ratios (OR) for ionizing radiat
ion [OR = 4.3; 95% confidence interval (CI) = 1.6-11.4], nonchlorinate
d solvents (OR = 1.6-1.8), and pesticides (OR = 1.7; 95% CI = 0.8-3.4)
. Asbestos, chromates, cleaning agents, waxes, polishes, and most othe
r exposures were not meaningfully associated with pancreatic cancer. I
norganic dust containing crystalline silica (OR = 2.0; 95% CI = 1.2-3.
5), heat stress (OR = 2.2; 95% CI = 0.8-6.6), and rubber chemicals inc
luding acrylonitrile (OR = 2.1; 95% CI = 0.9-4.7) emerged as previousl
y unsuspected risk factors. Occupational exposure probably has a small
role in the etiology of pancreatic cancer in the present-day industri
alized or Postindustrial work environment.