Bulletin électronique de veille Cancer Environnement N° 6 du 12/02/2014

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Bulletin électronique de veille Cancer Environnement
N° 6 du 12/02/2014
Ce bulletin de veille signale mensuellement une sélection de documents identifiés dans le cadre de la
veille cancer environnement. La méthodologie mise en œuvre est présentée dans la fiche du site cancer
environnement : http://www.cancer-environnement.fr/334-Veille-scientifique.ce.aspx
Publications récentes
Bladder cancer incidence among workers exposed to o-toluidine, aniline and nitrobenzene at a
rubber chemical manufacturing plant.
Incidence du cancer de la vessie chez des travailleurs exposés à l'o-toluidine, l’aniline et au nitrobenzène
dans une usine de fabrication de produits chimiques en caoutchouc.
Carreón T et al., Occup Environ Med., 2013
An earlier investigation found increased bladder cancer incidence among workers at a rubber chemical
manufacturing plant that used o-toluidine, aniline and nitrobenzene. The cohort was expanded to include
additional workers (n=1875) and updated through 2007 to assess bladder cancer with improved exposure
characterisation.
METHODS: Work histories were updated and exposure categories and ranks were developed for o-toluidine,
aniline and nitrobenzene combined. Incident cancers were identified by linkage to six state cancer registries.
Residency in time-dependent cancer registry catchment areas was determined. SIR and standardised rate ratios
for bladder cancer were calculated by exposure category and cumulative rank quartiles for different lag periods.
Cox regression was used to model bladder cancer incidence with estimated cumulative rank, adjusting for
confounders. Indirect methods were used to control for smoking.
RESULTS: Excess bladder cancer was observed compared to the New York State population (SIR=2.87, 95%
CI 2.02 to 3.96), with higher elevations among workers definitely exposed (moderate/high) (SIR=3.90, 95% CI
2.57 to 5.68), and in the highest cumulative rank quartile (SIR=6.13, 95% CI 2.80 to 11.6, 10-year lag). Bladder
cancer rates increased significantly with estimated cumulative rank (10-year lag). Smoking only accounted for an
estimated 8% elevation in bladder cancer incidence.
CONCLUSIONS: Bladder cancer incidence remains elevated in this cohort and significantly associated with
estimated cumulative exposure. Results are consistent with earlier findings in this and other cohorts. Despite
other concurrent chemical exposures, we consider o-toluidine most likely responsible for the bladder cancer
incidence elevation and recommend a re-examination of occupational exposure limits.

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Interventions to improve exercise behaviour in sedentary people living with and beyond cancer:
a systematic review.
Interventions pour améliorer la pratique de l’activité physique chez des personnes sédentaires atteintes de
cancer et après un cancer: une revue systématique.
Bourke L et al., Br J Cancer., 2013 Dec
Background : To systematically review the effects of interventions to improve exercise behaviour in sedentary
people living with and beyond cancer.Methods:Only randomised controlled trials (RCTs) that compared an
exercise intervention to a usual care comparison in sedentary people with a homogeneous primary cancer
diagnosis, over the age of 18 years were eligible. The following electronic databases were searched: Cochrane
Central Register of Controlled Trials MEDLINE; EMBASE; AMED; CINAHL; PsycINFO; SportDiscus; PEDro
from inception to August 2012.Results:Fourteen trials were included in this review, involving a total of 648
participants. Just six trials incorporated prescriptions that would meet current recommendations for aerobic
exercise. However, none of the trials included in this review reported intervention adherence of 75% or more for
a set prescription that would meet current aerobic exercise guidelines. Despite uncertainty around adherence in
many of the included trials, the interventions caused improvements in aerobic exercise tolerance at 8-12 weeks
(SMD=0.73, 95% CI=0.51-0.95) in intervention participants compared with controls. At 6 months, aerobic
exercise tolerance is also improved (SMD=0.70, 95% CI=0.45-0.94), although four of the five trials had a high
risk of bias; hence, caution is warranted in its interpretation.Conclusion:Expecting the majority of sedentary
survivors to achieve the current exercise guidelines is likely to be unrealistic. As with all well-designed exercise
programmes, prescriptions should be designed around individual capabilities and frequency, duration and
intensity or sets, repetitions, intensity of resistance training should be generated on this basis.
Active and passive cigarette smoking and breast cancer risk: Results from the EPIC cohort
Tabagisme actif et passif et risque de cancer du sein : résultats de la cohorte EPIC
Dossus L et al., Int J Cancer, April 2014
Recent cohort studies suggest that increased breast cancer risks were associated with longer smoking duration,
higher pack-years and a dose-response relationship with increasing pack-years of smoking between menarche
and first full-term pregnancy (FFTP). Studies with comprehensive quantitative life-time measures of passive
smoking suggest an association between passive smoking dose and breast cancer risk. We conducted a study
within the European Prospective Investigation into Cancer and Nutrition to examine the association between
passive and active smoking and risk of invasive breast cancer and possible effect modification by known breast
cancer risk factors. Among the 322,988 women eligible for the study, 9,822 developed breast cancer (183,608
women with passive smoking information including 6,264 cases). When compared to women who never smoked
and were not being exposed to passive smoking at home or work at the time of study registration, current, former
and currently exposed passive smokers were at increased risk of breast cancer (hazard ratios (HR) [95%
confidence interval (CI)] 1.16 [1.05–1.28], 1.14 [1.04–1.25] and 1.10 [1.01–1.20], respectively). Analyses
exploring associations in different periods of life showed the most important increase in risk with pack-years
from menarche to FFTP (1.73 [1.29–2.32] for every increase of 20 pack-years) while pack-years smoked after
menopause were associated with a significant decrease in breast cancer risk (HR = 0.53, 95% CI: 0.34–0.82 for
every increase of 20 pack-years). Our results provide an important replication, in the largest cohort to date, that
smoking (passively or actively) increases breast cancer risk and that smoking between menarche and FFTP is
particularly deleterious

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Case-control study of the association between malignant brain tumours diagnosed between 2007
and 2009 and mobile and cordless phone use.
Étude cas-témoin de l'association entre les tumeurs cérébrales malignes diagnostiquées entre 2007 et 2009
et l’utilisation de téléphone portable et de téléphone sans fil
Hardell L et al., Int J Oncol., 2013
Previous studies have shown a consistent association between long-term use of mobile and cordless phones and
glioma and acoustic neuroma, but not for meningioma. When used these phones emit radiofrequency
electromagnetic fields (RF-EMFs) and the brain is the main target organ for the handheld phone. The
International Agency for Research on Cancer (IARC) classified in May, 2011 RF-EMF as a group 2B, i.e. a
'possible' human carcinogen. The aim of this study was to further explore the relationship between especially
long-term (>10 years) use of wireless phones and the development of malignant brain tumours. We conducted a
new case-control study of brain tumour cases of both genders aged 18-75 years and diagnosed during 2007-2009.
One population-based control matched on gender and age (within 5 years) was used to each case. Here, we
report on malignant cases including all available controls. Exposures on e.g. use of mobile phones and cordless
phones were assessed by a self-administered questionnaire. Unconditional logistic regression analysis was
performed, adjusting for age, gender, year of diagnosis and socio-economic index using the whole control
sample. Of the cases with a malignant brain tumour, 87% (n=593) participated, and 85% (n=1,368) of controls in
the whole study answered the questionnaire. The odds ratio (OR) for mobile phone use of the analogue type was
1.8, 95% confidence interval (CI)=1.04-3.3, increasing with >25 years of latency (time since first exposure) to an
OR=3.3, 95% CI=1.6-6.9. Digital 2G mobile phone use rendered an OR=1.6, 95% CI=0.996-2.7, increasing with
latency >15-20 years to an OR=2.1, 95% CI=1.2-3.6. The results for cordless phone use were OR=1.7, 95%
CI=1.1-2.9, and, for latency of 15-20 years, the OR=2.1, 95% CI=1.2-3.8. Few participants had used a cordless
phone for >20-25 years. Digital type of wireless phones (2G and 3G mobile phones, cordless phones) gave
increased risk with latency >1-5 years, then a lower risk in the following latency groups, but again increasing
risk with latency >15-20 years. Ipsilateral use resulted in a higher risk than contralateral mobile and cordless
phone use. Higher ORs were calculated for tumours in the temporal and overlapping lobes. Using the
meningioma cases in the same study as reference entity gave somewhat higher ORs indicating that the results
were unlikely to be explained by recall or observational bias. This study confirmed previous results of an
association between mobile and cordless phone use and malignant brain tumours. These findings provide support
for the hypothesis that RF-EMFs play a role both in the initiation and promotion stages of carcinogenesis.
Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge
gaps and future research directions.
Recommandations en matière d’activité physique fondées sur les données actuelles à destination des
personnes atteintes de cancer : recommandations actuelles, lacunes en termes de connaissances et
perspectives de recherche.
Buffart LM et al., Cancer Treat Rev., 2014
Physical activity during and after cancer treatment has beneficial effects on a number of physical and
psychosocial outcomes. This paper aims to discuss the existing physical activity guidelines for cancer survivors
and to describe future research directions to optimize prescriptions. Studies on physical activity during and after
cancer treatment were searched in PubMed, Clinicaltrials.gov, Australian New Zealand Clinical Trials Registry,
and Dutch Trial registry. Physical activity guidelines for cancer survivors suggest that physical activity should be
an integral and continuous part of care for all cancer survivors. However, the development of these guidelines
has been limited by the research conducted. To be able to develop more specific guidelines, future studies should
focus on identifying clinical, personal, physical, psychosocial, and intervention moderators explaining 'for
whom' or 'under what circumstances' interventions work. Further, more insight into the working mechanisms of
exercise interventions on health outcomes in cancer survivors is needed to improve the efficacy and efficiency of
interventions. Finally, existing programs should embrace interests and preferences of patients to facilitate
optimal uptake of interventions. In conclusion, current physical activity guidelines for cancer survivors are
generic, and research is needed to develop more personalized physical activity guidelines.

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Actualités et lettres d’information des acteurs Santé Environnement
Région Rhône-Alpes
National
Agence Régionale de Santé Rhône-Alpes
Agence nationale de sécurité sanitaire, de
l’alimentation, de l’environnement et du
travail
Air Rhône-Alpes
Bulletin de veille bibliographique Nota Bene
Cancer de l’Institut National du Cancer
(INCa)
Lettre d’information de l’INCa
Espace Régional de Santé Publique Rhône-
Alpes
Institut national de recherche en sciences et
technologies pour l’environnement et
l’agriculture
Fédération Rhône-Alpes de Protection de la
Nature
Lettre d’information de l’Institut National de
Recherche et de Sécurité pour la prévention
des accidents du travail et des maladies
professionnelles
Institut de Recherche en Santé Publique
Lettre d’information “Ademe et vous”
Lettre Santé-Environnement Rhône-Alpes de
l’ORS Rhône-Alpes
La lettre de la Société Française de Santé
Environnement
Société Française de Santé Publique Bulletin
Flash e-mail SFSP
Société Française de Médecine du Travail
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