AIMS: To study cancer risk patterns among waiters in the Nordic countries.
METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population.
RESULTS: The SIR of all cancers in waiters, in the five countries combined, was 1.46 (95% CI 1.41-1.51) in men and 1.09 (1.07-1.11) in women. In male waiters, the SIR decreased from 1.79 (1.63-1.96) in 1961-1975, to 1.33 (1.26-1.40) in 1991-2005, but remained stable among women. The SIR among male waiters was highest for cancers in the pharynx (6.11; 95% CI 5.02-7.37), oral cavity (4.91; 95% CI 3.81-6.24) and tongue (4.36; 95% CI 3.13-5.92); and in female waiters, in the larynx (2.17; 95% CI 1.63-2.82), oral cavity (1.96; 95% CI 1.60-2.34) and lung (1.89; 95% CI 1.80-1.99).
CONCLUSIONS: The risk of cancer among waiters was higher than in the general population. The elevated incidence in some cancer sites can likely be explained by higher alcohol consumption, the prevalence of smoking and occupational exposure to tobacco smoke. Hopefully, the incidence of cancer among waiters will decrease in the future, due to the banning of tobacco smoking in restaurants and bars in the Nordic countries.
Smoking and drinking habits were registered by a self-administered questionnaire in 36th week of gestation in 11,698 pregnant women, more than 80 percent of all such women in two Danish cities 1984-87. Alcohol consumption of 120 g/week or more was associated with a greater reduction in the average birthweight in the babies of smokers than of non-smokers (about 40 grams for the non-smokers and about 200 grams for the smokers). This is particularly striking considering that the average birthweight for smokers is lower than for non-smokers. A birthweight difference of more than 500 grams was found between babies of mothers who neither smoked nor drank and mothers who smoked and drank heavily. Our data suggest that women's smoking habits should be taken into consideration when giving pregnant women advice about drinking.
INTRODUCTION: Smoking is the most important risk factor for morbidity and mortality in hospital patients. Patient contact with the healthcare system should include smoking cessation counselling. Emergency admissions are seldom given this opportunity. Objective: The aim of the study was to illustrate the implementation of motivational counselling in a department of acute surgery. METHODS: Between May 2003 and January 2004, 200 emergency patients were offered motivational counselling and a 6-week smoking cessation programme. RESULTS: We measured the number of patients who accepted motivational counselling. Of the initial 200 patients, 121 (61%) accepted motivational counselling. The only factor related to the level of motivation was age. The most motivated group had an average age of 45 years, whereas the average age of the least motivated group was 64. There was no correlation between the Fagerstrom score, pack-years, gender, illness, employment, or alcohol consumption and the outcome. Fifty-seven patients agreed to us following them up, of which 10% quit smoking for 6 months; 44% either quit or reduced their smoking for a shorter period of time, and 17% of the continuing smokers requested admission to the smoking cessation programme. CONCLUSION: The majority of smokers acutely admitted to an acute orthopaedic department accepted motivational counselling against smoking, the youngest being the most motivated. It appears possible to implement motivational counselling for smoking cessation in an acute orthopaedic department. It is relevant to consider how, and for which groups, a smoking intervention programme can be offered to acutely admitted patients.
INTRODUCTION: Tobacco smoke is the leading preventable cause of death in the world. A total of 50% of all smokers will die from a smoking-related disease with a major impact upon quality of life and health-care costs. Tobacco-controlling policies, including smoking cessation, have increasingly been implemented across European countries. Reported effectiveness data on smoking cessation interventions are important for decision making. OBJECTIVE: This study aimed to conduct a literature review on how the effectiveness (quit rates) of behavioural modification smoking cessation programmes (BMSCPs) - counselling, quitlines and quit-and-win contests - were analysed in Denmark, Sweden and Norway. METHODS: A systematic review was carried out by using the search engines Medline (U.S. National Library of Medicine, Bethesda, MD, USA), Cinahl (CINAHL Information Systems, EBSCO Industries, Ipswich, MA, USA), Embase (Elsevier, New York, NY, USA) and the grey literature. Following the Russell Standards, studies were selected according to design, analysis of data [intention-to-treat (ITT)/per protocol (PP)], documentation of abstinence and length of follow-up. Cochrane reviews of pharmacological studies were used as the benchmark. RESULTS: Although ITT analysis is the standard scientific approach advocated, most studies of BMSCPs reviewed were analysed by using the PP approach and were based on self-reported point prevalence estimates. This resulted in the reported 1-year quit rates between 16%-45% (PP) and 9%-23% (ITT). In contrast, pharmacological studies are conservative, as they are randomised, use ITT analysis and have continuous quit rates with biochemical verification of abstinence. Conclusion: This literature review reveals that quit rates of smoking cessation interventions are not always comparable. Scandinavian BMSCPs reported optimistic quit rates, confirmed by Cochrane literature review criteria. Care should be exercised when comparing smoking cessation interventions.
Aim: To evaluate occupational risk for cancer of the tongue, oral cavity or pharynx after adjustment for alcohol and tobacco use.
Materials and methods: The data covered 14.9 million people and 28,623 cases of cancer of the tongue, oral cavity and pharynx in the Nordic countries 1961-2005. Alcohol consumption by occupation was estimated based on mortality from liver cirrhosis and incidence of liver cancer. Smoking by occupation was estimated based on the incidence of lung cancer.
Results: Only few occupations had relative risks of over 1.5 for cancer of the tongue, oral cavity and pharynx. These occupations included dentists, artistic workers, hairdressers, journalists, cooks and stewards, seamen and waiters.
Conclusion: Several occupational categories, including dentists, had an increased relative risk of tongue cancer. This new finding remains to be explained but could be related to occupational chemical exposures, increased consumption of alcohol and tobacco products, or infection with human papilloma virus.
BACKGROUND: Occupational exposure has been identified as the most important risk factor for bladder cancer second to smoking. The objective of this study was to estimate the occupational variation in risk of bladder cancer that is not attributable to smoking.
MATERIAL AND METHODS: In the Nordic Occupational Cancer study (NOCCA), 111,458 cases of bladder cancer and 208,297 cases of lung cancer cases were observed among men in Denmark, Finland, Iceland, Norway and Sweden during 1961-2005. Relative smoking prevalence in an occupation was estimated based on standardized incidence ratio (SIR) for lung cancer in the given occupation. Crude and smoking-adjusted SIRs with 95% confidence intervals (CI) for bladder cancer were calculated for each occupation.
RESULTS: The smoking-adjusted SIR for most of the occupations was closer to 1.00 than the unadjusted SIR. The highest statistically significant smoking-adjusted SIRs were observed among chimney sweeps (SIR 1.29, 95% CI 1.05-1.56), waiters (1.22, 1.07-1.38) hairdressers (1.14, 1.02-1.26), cooks and stewards (1.12, 1.01-1.25), printers (1.11, 1.04-1.18) and seamen (1.09, 1.03-1.14).
CONCLUSIONS: Smoking is a strong risk factor for bladder cancer but there may also be other factors in some specific occupations in addition to smoking. The occupational variation in risk of bladder cancer is small when adjusted for smoking, but risk increasing factors are indicated in some occupations.
OBJECTIVES: The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada.
METHODS: In the Nordic Occupational Cancer study (NOCCA), 73?653 bladder cancer cases were observed during follow-up of 141.6?million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of?36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC.
RESULTS: Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort.
CONCLUSION: We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation.