A DEATH CERTIFICATE-BASED STUDY OF OCCUPATION AND MORTALITY FROM REPRODUCTIVE CANCERS AMONG WOMEN IN 24 US STATES

We conducted a study of occupation and mortality from reproductive can cers among women, based on death certificates from 24 US states for th e period 1984-1993. There were 9,523 cervical cancer deaths, 12,335 en dometrial cancer deaths, and 25, 212 ovarian cancer deaths. Usual occu pation and industry, which were obtained from death certificates, were coded using the 1980 Bureau of Census classification system. Morality odds ratios (MORs) and 95% confidence intervals (Cls) were calculated using all non-cancer deaths as the referent disease category. In gene ral, jobs involving professional or administrative occupations were re lated to increased risk of mortality from endometrial and ovarian canc er, while cervical cancer mortality was increased among women employed in manufacturing, service, farm work, and health care technician and aide occupations. Associations with some occupations involving exposur e to chemicals and metals, such as the associations between cervical c ancer and employment in printing; typesetting, and machine operating o ccupations, deserve further attention. Similarly, further investigatio ns should be made into the excess of ovarian cancer observed in severa l occupations in health care, an industry that has numerous hazardous exposures, including radiation, chemotherapeutic drugs, and viruses. T he study results reflect, in part, socioeconomic factors and reproduct ive patterns but may also indicate a possible etiologic role for occup ational chemical exposures.