Toenail concentrations of trace elements and occupational history in pancreatic cancer
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Abstract
Background: Some occupations potentially entailing exposure to cadmium, arsenic, lead, selenium, nickel, and
chromium have been associated with an increased risk of exocrine pancreatic cancer (EPC), but no studies have
assessed whether body concentrations of such compounds differed among subjects occupationally exposed and
unexposed. No studies which found that exposure to such metals increased the risk of EPC assessed whether past
occupations were the source of exposure.
Objective: The aim was to analyse the relationship between toenail concentrations of trace elements and occupational
history in EPC patients.
Methods: The study included 114 EPC cases personally interviewed on occupational history and lifestyle factors.
Occupations were coded according to the International Standard Classification of Occupations 1988. Selected
occupational exposures were assessed by two industrial hygienists and with the Finnish job-exposure matrix
(Finjem). Concentrations of 12 trace elements were determined in toenail samples by inductively coupled plasma
mass spectrometry. Adjusted geometric means (aGMs) and 95% confidence intervals (95% CI) were calculated.
Results: Patients occupationally exposed to aromatic hydrocarbon solvents (AHs) had higher concentrations of
cadmium, manganese, lead, iron and vanadium. The aGM of cadmium concentrations for cases exposed to any
pesticide was 0.056 μg/g [95% CI: 0.029–0.108], and, for unexposed cases, 0.023 μg/g [0.017–0.031]. Patients
occupationally exposed to pesticides had higher concentrations of cadmium and manganese. Higher concentrations
of vanadium, lead and arsenic were related to exposure to formaldehyde. Vanadium and lead were
also associated with exposure to chlorinated hydrocarbon solvents, and arsenic was related to exposure to
polycyclic aromatic hydrocarbons (PAHs).
Conclusions: Patients occupationally exposed to AHs, pesticides, chlorinated hydrocarbon solvents, formaldehyde,
volatile sulphur compounds and PAHs had higher concentrations of several metals. These elements
may account for some of the occupational risks previously reported for pancreatic cancer.
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Bibliographic citation
Camargo, J., Pumarega, J. A., Alguacil Ojeda, J. ... Sanz Gallén, P. (2019). Toenail concentrations of trace elements and occupational history in pancreatic cancer. Environment International, 127, 216–225. DOI: https://doi.org/10.1016/j.envint.2019.03.037













