Cancer mortality and sectors of employment: a cohort study in Italy, 2011-2019

Abstract Background Cancer is known to be a multifactorial disease, i.e. a combination of multiple factors, such as genetic, environmental, and lifestyle factors influences its development (1, 2). The large impact of occupational exposures on the burden of cancer continues to be a paramount public health concern that deserves more attention. Methods The study aims at evaluating cancer-specific mortality risk in relation to sectors of employment by by using the cohort of Rome Longitudinal Study (ROLs) that has been linked with the National Social Insurance Agency (INPS) database to enrich it with information on working histories. A Cox regression models was used to examine the association between the cancer specific cause of death and the sector of employment in men and women. A similar analysis was performed considering the length of employment (£ 10 years versus ³ 10 years). Results The study population comprised 910,559 (52% of the total population of the cohort after linkage with INPS) 30+ yr employees (53% men and 47% women) followed for a mean period of about 7 million years. The outcomes confirmed some well-known associations (e.g. lung and pleura in construction, pleura in paper and printing, lung and prostate in wood and leather) and suggested possible high-risk sectors that have not been thoroughly investigated yet. In women, we found excess mortality risk in cleaning activities, chemical industry, transport, health services and agriculture. Conclusions The study concludes that occupational exposure in certain industrial sectors significantly influences cancer mortality rates among workers in Italy, in traditional sectors such as construction and wood and leather products and in unexpected sectors e.g. accommodation services and hairdressing. The adopted method proved to be effective in monitoring occupational risks and activating proper prevention initiatives.