OCCUPATIONAL RISK-FACTORS FOR CANCER OF THE GASTRIC CARDIA - ANALYSISOF DEATH CERTIFICATES FROM 24 US STATES

We evaluated the risk of gastric cardia cancer by occupation and indus try in a case-control study using information from death certificates for 24 US states in 1984-1992. One thousand fifty-six cases of gastric cardia cancer were identified among men aged 20 years or more, includ ing 1,023 whites and 33 blacks. Controls were 5,280 subjects who died of nonmalignant diseases, 5:1 matched to cases by geographic region, r ace, gender, and 5-year age group. Among white men, occupations with e levated risk included financial managers (odds ratio [OR] = 6.1; 95% c onfidence interval [CI], 1.3-28.8), janitors and cleaners (OR = 1.7; 9 5% CI, 1.0-2.9), production inspectors (OR = 3.2; 95% CI, 1.5-6.9), an d truck drivers (OR= 1.5; 95% CI, 1.0-2.2). Industries with elevated r isk included pulp and paper mills (OR = 2.0; 95% CI, 1.0-37), newspape r publishing and printing (OR = 2.6; 95% CI, 1.0-6.3), industrial and miscellaneous chemicals (OR = 2.0; 95% CI, 1.0-3.9), water supply and irrigation (OR = 5.6; 95% CI, 1.6-19.9). Among black men, risks were n onsignificantly increased for subjects employed in railroads (3 cases, 2 controls) and for carpenters (3 cases, 0 controls). We created job- exposure matrices for asbestos, inorganic dust, metal dust, lead, poly cyclic aromatic hydrocarbons, nitrogen oxides, nitrosamines, sulfuric acid fertilizers, herbicides, other pesticides, and wood dust. Among w hite men, a consistent pattern of risk increase by level and probabili ty of exposure was observed only for sulfuric acid mists, with a twofo ld excess (95% CI, 0.6-7.3) associated with high probability of high i ntensity exposure. A significant 30 % increase in risk was observed fo r those subjects with a high probability of exposure (all levels combi ned) to lead and a 60% increase was observed for subjects with high-le vel exposure to lead tall probabilities combined). However, crosstabul ation of gastric cardia cancer risk by probability and level of exposu re to lead did not show consistent trends. Asbestos exposure also show ed an overall 50% increase but no consistent trends among white men. N one of the 12 occupational hazards showed an association with risk for black men.