Case-cohort study of Cancers in Excess in Poultry Workers

某些病毒通常感染家禽并导致癌症。人类接触这些病毒几乎是 普遍存在，并通过以下途径发生：1）接触活禽，其血液，分泌物，粪便，生肉和鸡蛋; 2）通过 摄入生的或未充分煮熟的家禽肉类和鸡蛋; 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） 在职业上，例如饲养、屠宰和生家禽产品的销售;兽医;厨师等。 这些病毒可以在体外感染人类细胞，并将其转化为癌细胞，也可以在体内感染并导致肿瘤。 灵长类动物人类血清学检测表明，一般人群普遍感染。然而，确凿的证据表明， 病毒导致人类癌症的证据缺乏，部分原因是缺乏对癌症的分析流行病学研究 风险暴露的个人。我们假设，如果这些病毒在人类中引起癌症， 家禽屠宰和加工厂的工人是人类接触这些制剂最多的人。因此，委员会认为， 我们对这些工人的三个不同队列进行了癌症死亡率研究。结果表明， 10个癌症部位的死亡人数。我们目前正在进行一项由NIOSH资助的RO 1病例队列研究， 癌症部位（肺、胰腺、肝、脑、卵巢、口腔和鼻腔和咽，以及造血和淋巴 系统）。本申请是本研究的延伸，我们计划研究这些家禽致癌基因的作用。 病毒在其余三个位点中的两个位点出现，即，食道和子宫颈。研究这两个很重要 癌症也是分开的，因为它们与HPV感染的已知关联， 家禽工人。对于对照组，我们将使用正在进行的病例队列研究中使用的相同对照组。 因此，这一建议将允许调查这两个癌症的网站在大大降低成本。建议的目的 这项研究有4个方面：1）调查与高暴露于家禽致癌病毒HPV相关的任务之间的联系， 和职业性化学致癌接触（多环芳烃，杂环胺，亚硝胺， 苯等）以及这两个癌症部位的发生，同时调整并同时研究 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）检查不同人群中疣的高发生率， 家禽工人的身体部位作为这些癌症的危险因素; 4）确定这两种癌症的主要活检样本 这些癌症可以用于未来的实验室研究，以确认这些病毒的作用。这项提案属于福尔斯 NIOSH诺拉研究部门的“批发和零售贸易研究计划”，以及跨部门的“癌症等"。它旨在 识别与工人总体健康相关的危害。获得的知识将传达给UFCW 通过我们的最后报告和出版物。有了这些信息，为所有人制定政策的联盟 区内居民会与雇主联络，以便他们采取措施，保护工人免受这些危险。这种职业 尽管有如此严重的致癌危险暴露，但之前从未对这一群体进行过癌症研究。

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.