Case-cohort study of Cancers in Excess in Poultry Workers

摘要：某些病毒通常会感染家禽并导致癌症。人类接触到这些病毒几乎是 普遍存在，通过以下途径发生：1)接触活家禽及其血液、分泌物、粪便、生肉和鸡蛋；2)通过 进食生的或未煮熟的禽肉和禽蛋；3)接种通过种植 被这些病毒污染的鸡蛋中的疫苗病毒，如麻疹、腮腺炎和黄热病疫苗；4) 在职业方面，如饲养、屠宰和销售生禽产品；兽医；厨师等。众所周知 这种病毒可以在体外感染人类细胞并将其转化为癌细胞，并可以感染并导致肿瘤 灵长类动物。在人类中的血清学测试表明，普通人群普遍感染。然而，确凿的证据是 缺乏病毒导致人类癌症的部分原因是缺乏对癌症的分析性流行病学研究 暴露在风险中的个人。我们假设，如果这些病毒导致人类癌症，这将是最明显的 家禽屠宰和加工厂中接触这些制剂的人最多的工人。因此， 我们在这些工人的三个独立队列中进行了癌症死亡率研究。结果表明出现了过量的情况。 10个癌症地点的死亡人数。我们目前正在对其中7个进行NIOSH资助的RO1病例队列研究 癌症部位(肺癌、胰腺、肝、脑、卵巢、口腔、鼻腔和咽部、造血和淋巴 系统)。这项应用是这项研究的延伸，在这项研究中，我们计划调查这些致癌禽类的作用 病毒发生在其余三个部位中的两个，即食道和宫颈。研究这两个问题是非常重要的。 另外，癌症也是因为它们与HPV感染有关，HPV感染在 家禽工人。对于对照，我们将使用正在进行的病例队列研究中使用的同一对照组。 因此，这项提议将允许以大大降低的成本对这两个癌症部位进行调查。建议的目的是 研究有4个方面：1)调查与高暴露于家禽致癌病毒、HPV、 和职业化学致癌暴露(多环芳烃、杂环胺、亚硝胺、 苯等)和这两个癌症部位的发生，同时调整和同时调查 其他潜在的职业和非职业危险因素；2)协助提供关键的流行病学证据 将禽类致癌病毒与人类癌症的发生联系起来；3)检查不同地区尖锐湿疣的高发情况 家禽从业人员的身体部位是这些癌症的危险因素；4)确定这两种癌症的主要活检样本 癌症，可用于未来的实验室研究，以确认这些病毒的作用。这项建议属于下列范围 NIOSH Nora研究部门的“批发和零售贸易研究计划”，以及跨部门的“癌症等”。它的目标是 识别与工人整体健康相关的危害。所获得的知识将传达给UFCW 通过我们的最终报告和出版物向国际联盟提供援助。有了这些信息，为所有人制定政策的联盟 当地人将与雇主联系，以便他们采取措施保护工人免受这些危险。这一职业 尽管接触过如此危险的致癌物质，但这组人以前从未被研究过癌症。

SUMMARY: Certain viruses commonly infect and cause cancer in poultry. Human exposure to these viruses is virtually universal, and occurs through: 1) contact with live poultry, their blood, secretions, feces, raw meat, and eggs; 2) through ingestion of raw or inadequately cooked poultry meat and eggs; 3) inoculation with vaccines manufactured by growing the vaccine virus in chicken eggs contaminated with these viruses, such as measles, mumps, and yellow-fever vaccines; 4) occupationally in jobs such as raising, slaughtering, and sale of raw poultry products; veterinarians; cooks; etc. It is known that the viruses can infect human cells in vitro and transform them into cancerous cells, and can infect and cause tumors in primates. Serological tests in humans indicate widespread infection of the general population. However, definitive proof that the viruses cause cancer in humans is lacking partly because of the absence of analytic epidemiologic studies of cancer risk in exposed individuals. We hypothesize that if these viruses cause cancer in humans, it will be most readily evident in workers in poultry slaughtering & processing plants who have the highest human exposures to these agents. Accordingly, we conducted cancer mortality studies in three separate cohorts of these workers. The results indicate an excess occurrence of deaths from 10 cancer sites. We are currently conducting a NIOSH-funded RO1 case-cohort study of seven of these cancer sites (lung, pancreas, liver, brain, ovary, buccal & nasal cavities & pharynx, and hemopoietic & lymphatic systems). This application is an extension of this study in which we plan to investigate the role of these poultry oncogenic viruses in the occurrence of two of the remaining three sites, viz., esophagus and cervix. It is important to study these two cancers separately also, because of their known association with HPV infection that is abnormally highly prevalent in poultry workers. For controls we will utilize the same control group that is being used in the ongoing case-cohort study. Thus this proposal will permit investigation of these two cancer sites at much reduced costs. The purpose of the proposed study is 4-fold: 1) to investigate the link between tasks associated with high exposure to poultry oncogenic viruses, HPV, and occupational chemical carcinogenic exposures (polycyclic aromatic hydrocarbons, heterocyclic amines, nitrosamines, benzene, etc.) and the occurrence of these two cancer sites, while adjusting for and concurrently investigating the roles of other potential occupational and non-occupational risk factors; 2) to assist in providing the critical epidemiologic evidence linking avian oncogenic viruses with cancer occurrence in humans; 3) to examine the high occurrence of warts in different parts of the body of poultry workers as a risk factor for these cancers; 4) to identify prime biopsy samples of these two cancers that could be used in future laboratory-based studies to confirm the role of these viruses. This proposal falls under NIOSH NORA research sector “Wholesale and Retail Trade Research Program”, and cross-sector “Cancer, etc.”. It aims to identify hazards related to the total health of workers. The knowledge gained will be communicated to the UFCW International Union through our final reports and publications. With this information, the Union which sets policy for all its locals will contact the employers so that they can take steps to protect workers against these hazards. This occupational group has not been studied before for cancer in spite of having such significantly hazardous carcinogenic exposures.