Here are some key findings…

FIG1. Incidence of dermatitis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of dermatitis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table1. Surveillance of Dermatitis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table2. Surveillance of Dermatitis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

Product Fabricating, Assembling, and Repairing

ODSS detected that painters and decorators are at an elevated risk of asthma, which includes workers in the automobile industry. The well-established risk in automotive painters is attributable to isocyanates, the most common cause of occupational asthma in many industrialized countries. In contrast, ODSS results indicate that other groups of painters such as those in construction industries are at a decreased risk of asthma. Construction worker painters typically work with water-based paints that lack isocyanates. Also within this sector are cabinet and wood furniture makers who are at an increased risk of asthma. These workers likely experience exposure to wood dust, which is an established risk factor for asthma.

• • • Painters and decorators (not in construction): 1.6x increased risk
    • Painters and paperhangers (within construction): 0.8x decreased risk
    • Cabinet and wood furniture makers: 1.3x increased risk

Food and Beverage

Within the food and beverage industry are a varied array of occupations including service staff and cooks. ODSS results indicate that bakers and confectionary makers are a subgroup of the food and beverage industry that are an increased risk of asthma.

• • • Bakers and confectionary makers: 1.6x increased risk

Construction Sector

Within the construction sector, ODSS detected that concrete finishers are at an increased risk of asthma. Concrete finishers are workers with possible exposure to inorganic dusts, such as silica, which may be respiratory irritants and induce asthma.

• • • Concrete finishers and related workers: 1.9x increased risk

FIG1. Incidence of asthma diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of asthma diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table1. Surveillance of Asthma: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table2. Surveillance of Asthma: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

Mining Sector

The mining sector is at a 2-fold increased risk of IPF relative to other industries. Nested within the mining sector are specific occupations and types of mining that demonstrated increased risk of IPF. Gold quartz and uranium mining are at increased risks of IPF, as are drilling and blasting occupations and cutting and loading occupations. These occupations and industries would likely have significant metal dust exposure, as well as other exposures, including diesel exhaust and silica dust.

• Gold quartz mining: 3x increased risk
• Uranium mining: 3x increased risk
• Drilling and blasting: 2x increased risk

Forestry and Papermaking

Within the forestry sector, workers within the logging and pulp and papermaking industries are at increased risks of IPF. These workers are likely exposed to high levels of wood dust, which is a possible risk factor for IPF.

• Logging: 1.5x increased risk
• Occupations in elemental work, pulp and papermaking: 3x increased risk

Transportation

While the overall transportation sector did not show an increased risk of IPF, the ODSS detected that bus drivers are at an increased risk. Bus drivers are regularly exposed to exhaust fumes, however, this is not a recognized or possible risk factor for this disease. It is unclear why bus drivers are at an increased risk of IPF given the current understanding of this condition.

• Bus drivers: 1.5x increased risk

Food and Beverage

The food and beverage industry houses a number of service occupations including bartenders, waiters/waitresses, and cooks and chefs. Cooks and chefs work in kitchen environments that may expose workers to organic dusts and cooking fumes. Within the ODSS cohort, cooks and chefs were at a 1.5-fold increased risk of IPF, relative to other occupations. Organic dusts, such as flour and confectionary materials are known risk factors for other respiratory conditions, but it is not known whether they pose a risk for IPF.

Chefs/cooks: 1.5x increased risk

FIG1. Incidence of interstitial pulmonary fibrosis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 2006-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of interstitial pulmonary fibrosis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 2006-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table1. Surveillance of Interstitial Pulmonary Fibrosis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table2. Surveillance of Interstitial Pulmonary Fibrosis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

The greatest risks of lung cancer are observed among workers employed in mining, construction, and transportation occupations. Occupational variation in smoking may also explain some differences in observed lung cancer risk.

Mining

Workers in mining and quarrying are exposed to a number of lung carcinogens including crystalline silica, radon, asbestos, and diesel engine exhaust. Workers in most mine types and jobs appeared to have increased risk of lung cancer.

• • Mines, quarries and oil wells: 1.36 times the risk
    • Quarries and sand pits: 1.77 times the risk
    • Metal mines: 1.34 times the risk
      • Uranium mines: 1.88 times the risk
      • Gold quartz mines: 1.45 times the risk
    • Non-metal mines: 1.09 times the risk
      • Asbestos mines: 3.96 times the risk
  • Mining and quarrying occupations: 1.39 times the risk
    • Rock and soil-drilling: 1.62 times the risk
    • Cutting, handling and loading occupations: 1.50 times the risk

Construction

Construction workers are involved in a wide variety of jobs and work settings with potential exposure to a wide range of lung carcinogens including diesel engine exhaust, crystalline silica dust, and asbestos-containing materials including insulation. In addition, painters, who may be exposed to chemicals in paints, solvents and adhesives are at increased risk [8].

• • Construction trades occupations: 1.10 times the risk
    • Excavating, grading, paving & related: 1.38 times the risk

• • • Other construction trades: 1.11 times the risk
      • Painters and paperhangers: 1.35 times the risk
      • Insulators: 2.01 times the risk
      • Structural metal erectors: 1.35 times the risk
      • Glaziers: 1.30 times the risk
      • Roofing, waterproofing and related occupations: 1.43 times the risk
      • Plasterers and related occupations: 1.23 times the risk

Primary metal industries and metal manufacturing

Workers in these industries are exposed to aluminum, arsenic, beryllium, cadmium, chromium, nickel compounds, silica dust, and PAHs. IARC has also classified iron and steel founding as having an increased risk of lung cancer. Boilermakers may be exposed to asbestos and moulding, coremaking and metal casting may involve exposure to crystalline silica.

• • Primary Metal Industries: 1.17 times the risk
    • Iron foundries: 1.49 times the risk
    • Aluminum rolling, casting and extruding: 1.40 times the risk
    • Smelting and refining: 1.25 times the risk

• • Metal processing occupations: 1.26 times the risk
    • Metal heat treating occupations: 1.59 times the risk
    • Metal processing and related occupations (foremen): 1.58 times the risk
    • Moulding, coremaking and metal casting occupations: 1.40 times the risk

• • Metal shaping occupations: 1.19 times the risk
    • Forging occupations: 1.40 times the risk
    • Boilermakers, platers and structural metal workers: 1.39 times the risk
    • Metalworking-machine operators: 1.21 times the risk

Transportation sector

Workers employed in the transportation sector may be exposed to elevated levels of diesel engine exhaust through work in or around diesel-powered equipment.

• • Transportation industry: 1.23 times the risk
    • Taxicab operations: 1.53 times the risk
    • Truck transport: 1.49 times the risk

Logging and wood processing

Workers in these occupations may be exposed to exhaust from diesel-powered equipment, as well as wood dusts, arsenic-containing insecticides, and other wood preservatives.

• • Logging industry: 1.25 times the risk
    • Log hoisting, sorting, moving and related occupations: 1.46 times the risk
    • Timber cutting and related occupations: 1.23 times the risk
  • Wood manufacturing industries: 1.10 times the risk
    • Sawmills, planning mills and shingle mills: 1.31 times the risk
    • Labouring and other elemental work in wood processing: 1.44 times the risk

Bartending and food service

Workers in these occupations were exposed to high levels of second-hand tobacco smoke in the workplace until smoking was banned in bars and restaurants in Ontario in 2006 and patios in 2015 [2,12]. Differences in occupational rates of smoking may also contribute to the excess risks observed for these groups.

• • Bartenders: 1.71 times the risk
  • Waiters, hostesses and stewards, food and beverage: 1.10 times the risk

Historically, lung cancer rates have been higher in men than women. However, this gap has decreased over time as smoking rates have declined faster among men than women, contributing to a faster decline in lung cancer incidence rates among men than women [13-15]. Although occupational exposure is a significant contributor to lung cancer burden, little research has focused on gender or sex differences in occupational lung cancer [16,17]. Here we highlight elevated risks of lung cancer among female workers in select occupations.

Machining and related occupations

Female workers in machining and related occupations showed a greater increase in lung cancer risk than male workers. While those employed in this area may include workers who shape various types of materials, those performing metal machining or related metal work may be exposed to dusts and fumes containing metals and their compounds [17,18]. Some examples of carcinogenic exposures among these workers include welding fumes, nickel compounds, cadmium, and chromium VI [3,6,8].

Construction

Although both male and female workers in construction trades occupations overall are at an increased risk of lung cancer compared to workers in other occupations, this is more pronounced among female workers in certain construction trades. Construction workers have the potential to be exposed to a variety of lung carcinogens such as silica, asbestos, and diesel engine exhaust [3,5].

Mining

Although an increased risk of lung cancer is well documented among mining workers, previous studies have often included only limited information on female mining workers [16]. Based on ODSS results, female workers in mining occupations face a disproportionately elevated risk of lung cancer. Workers in mining occupations are exposed to numerous lung carcinogens including crystalline silica, radon, asbestos, and diesel engine exhaust [3,5].

Motor transport operating occupations

Female workers were at an increased risk for lung cancer in transportation-related occupations, where exposure to diesel engine exhaust is common [5].

Service occupations

Lung cancer risks were elevated in female service workers but reduced in male workers across many service jobs. Other studies have found mixed results for risk of lung cancer in these workers due to the diversity of tasks in the service industry [19]. Some service workers in restaurant settings may have been exposed to second-hand smoke, especially prior to bans on smoking in restaurants and patios [20]. Some research indicates that polycyclic aromatic hydrocarbons (PAHs, found in cooking fumes) may increase lung cancer risk [8,11]. There may also be other exposures unaccounted for in these workers.

Potential contributors to sex differences in lung cancer risk

There are several of factors that could cause female workers to experience different hazards or different levels of exposure than male workers. For example, gender roles may influence the specific tasks male and female workers perform within a given occupation, leading to differences in exposure [21-23]. Personal protective equipment is often not designed with female-specific fit in mind, and may not have the same effectiveness on female bodies as male bodies [16,24]. Female workers may also find it more physically demanding to use protective equipment [16]. Part-time workers, who are more likely to be women, may receive less training on how to properly use protective equipment [16]. Further research is also needed to understand how sex-related factors such as height, reach and strength might impact exposure and the effectiveness of control strategies other than personal protective equipment [16,22].

Biological factors, such as hormonal and metabolic differences between male and female workers, may impact the effect of occupational exposures. Based on some studies of sex differences in smoking-related lung cancer risk, it is possible that female workers may be more susceptible to the carcinogenic effects of some occupational exposures than male workers [25,26].

Cancer risk may also be affected by behavioural differences. Smoking is more common among workers in manual and industrial occupations compared to other workers and this difference may be greater among females than males [27,28]. It is possible that other behavioural differences such as physical activity and dietary patterns may also contribute to observed sex differences in lung cancer risk.

Figure 1. Risk of lung cancer diagnosis among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2020

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater risk of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Figure 2. Risk of lung cancer diagnosis among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2020 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater risk of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table 1. Surveillance of Lung Cancer: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table 2. Surveillance of Lung Cancer: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

Here are some key findings…

FIG1. Incidence of prostate cancer diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of prostate cancer diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table1. Surveillance of Prostate Cancer: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table2. Surveillance of Prostate Cancer: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

Mining Sector

The mining, quarrying, and oil well industry is at a significantly increased risk of silicosis relative to other industries. Nested within the mining sector are several occupations and industries where the risk of silicosis is high. Gold quartz and uranium mining industries are at high risks of silicosis, as are drilling and blasting occupations. The highest risk of silicosis is observed among mining foremen, who are longstanding workers within the mining industry who have likely incurred significant exposure to dusts. Historically, mining workers have experienced high rates of silicosis due to their high levels of exposure to silica dust. It is not surprising that the ODSS demonstrated that Ontario miners are at a high risk of this respiratory condition.

• Mining foremen: 28x increased risk
• Gold quartz miners: 22x increased risk
• Uranium miners: 15x increased risk
• Drilling and blasting occupations: 15x increased risk
• Iron foundry workers: 7.5x increased risk

Processing Occupations

Occupations related to mineral, metal, clay, and chemical processing are at an increased risk of silicosis relative to other occupations. This finding is unsurprising given the nature of processing work, which would involve the cutting and handling of dusty raw materials, which would expose workers to high levels of various dusts, including crystalline silica.

• Processing occupations (mineral, metal, clay, chemical): 2x increased risk

Transportation

Within the transportation sector are truck drivers, who are exposed to exhaust pollution and diesel, but typically do not have exposure to silica dust. The ODSS observed that truck drivers are at a decreased risk of silicosis, relative to other occupations.

Truck drivers: 0.6x decreased risk

FIG1. Incidence of silicosis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of silicosis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table1. Surveillance of Silicosis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table2. Surveillance of Silicosis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

Construction Sector

The construction industry and trades occupations require workers to handle insulation or work in close proximity to insulation. Occupations that may put workers into contact with asbestos include insulators, electricians, and plumbers. ODSS detected increased risks of asbestosis among home-related building and repairing occupations that may be exposed to asbestos in the work environment.

• • • Insulators: 23x increased risk
    • Pipefitters and plumbers: 8x increased risk
    • Electricians and repairmen: 3x increased risk

  Education and Related Services

  Workers within the education and related services sector include not only teachers and administrative staff, but also custodial workers. These workers are possibly exposed to asbestos that was installed as pipe insulation in older buildings. The degradation of these buildings can lead to water damage, which can volatilize asbestos and pose a health risk to staff. ODSS results indicate that education and related services workers are at an increased risk of asbestosis.

  • • • Education and related services: 1.5x increased risk

    Manufacturing

    The manufacturing industry covers a wide spectrum of subgroups, including wood and textile industries, chemical production, and primary metal work. Within the metalworking industry, iron and steel mill workers are required to operate machinery including boilerplates, furnaces, and other heating apparatuses.  Asbestos was commonly used as an insulating material in metalworking machinery. When these materials are disturbed or degrade asbestos fibers are released into the air. ODSS results demonstrate that some manufacturing workers are at an increased risk of asbestosis.

    • • • Boilermakers: 8.5x increased risk
        • Primary metal workers: 2x increased risk

FIG1. Incidence of asbestosis diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of asbestosis diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table1. Surveillance of Asbestosis: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table2. Surveillance of Asbestosis: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

Within the construction industry, ODSS results indicate that insulating occupations, pipefitters and plumbers, electricians and repairmen and carpenters are all at elevated risks of mesothelioma. Insulating occupations require workers to handle asbestos materials when either installing or removing insulation materials from homes. Pipefitters and plumbers as well as electricians and repairmen are required to work within wall spaces in buildings, which potentially exposes them to insulating materials, such as asbestos. Disturbing these materials can lead to the inhalation of asbestos fibers.

Workers within the education and related services sector include teachers and administrative staff. These workers are possibly exposed to asbestos that was installed as pipe insulation in older school and university buildings. The degradation of these buildings can lead to water damage, which can volatilize asbestos and pose a health risk to staff. ODSS results indicate that university and college staff as well as elementary and secondary school staff are at increased risks of mesothelioma. While these findings may not appear obvious given the clerical and teaching tasks of education workers, these associations have been previously observed and are supported in the scientific literature.

Unlike Quebec, Ontario’s asbestos mining was not a large industry. Nevertheless, ODSS results indicate that asbestos miners in Ontario are at a dramatically increased risk of mesothelioma relative to other Ontario workers. This is expected given the known etiology of mesothelioma and the extraordinarily high levels of exposure asbestos miners would incur.

Iron and steel mill workers are required to operate machinery, including boilerplates, furnaces, and other heating apparatuses.  Asbestos was commonly used as an insulating material in metalworking machinery. When these materials are disturbed or degrade asbestos fibers are released into the air. ODSS results demonstrate that iron and steel workers are at an increased risk of mesothelioma relative to other Ontario workers.

FIG1. Incidence of Mesothelioma diagnoses among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

FIG2. Incidence of Mesothelioma diagnoses among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1983-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater incidence of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table1. Surveillance of Mesothelioma: Number of cases, workers employed, and hazard ratios in each industry (SIC)

Table2. Surveillance of Mesothelioma: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group