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. 1 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 2 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. 3 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 RhôneAlpes 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 Nos partenaires Avec soutien de : Pour tout abonnement/désabonnement à cet e-bulletin ou pour nous faire part d'informations à diffuser dans les prochains numéros, n’hésitez pas à nous écrire à l'adresse suivante : [email protected] Afin de respecter la législation sur la propriété intellectuelle, le bulletin de veille électronique renvoie l’internaute à la source d’origine de chacune des ressources répertoriées. Il propose systématiquement des liens vers d’autres sites qui ne relèvent pas de son autorité. Il est à noter qu’il n’est pas responsable du contenu de ces sites, des liens qui y sont suggérés et des changements ou mises à jour qu’ils subissent. « La relecture et sélection des publications de ce bulletin électronique est réalisée par des membres du comité éditorial du portail cancer-environnement.fr avec la participation des professionnels de santé du Centre Léon Bérard et ses partenaires, sur la base de leur pertinence dans le champ ‘cancer, environnement et nutrition’. Dans la mesure où le contenu des sources et des informations recensées dans ce e-bulletin n’engagent que leurs auteurs, il appartient au lecteur d’en évaluer la qualité. » E-Bulletin réalisé par le Comité Editorial du portail http://www.cancer-environnement.fr/48-Qui-sommes-nous.ce.aspx 4