Dr Deborah Lee: How does your work environment affect your risk of ovarian cancer?

Ovarian cancer is a much-dreaded disease. However, although some of the risk factors for ovarian cancer are well established, the cause is still not known.

How much could your work environment be adding to your risk? A recent 2002 Canadian case-control study has examined different kinds of occupations in relation to different work environments. Their findings are summarised below.

Read on and find out

• What are the current statistics for ovarian cancer?
• What causes ovarian cancer?
• How could the workplace be affecting your ovarian cancer risk?

What are the current statistics for ovarian cancer?

Just over 7000 women are diagnosed with ovarian cancer in the UK every year and 4000 women die from the disease. That’s 11 deaths every day. Over half of these deaths are in women aged 75 and older but it can affect women of any age.

1 in 3 women with ovarian cancer will live for 10 years or longer. Survival rates from ovarian cancer have doubled in the past 10 years. 11% of cases are believed to be preventable by modifying lifestyle measures.

What causes ovarian cancer?

The following are known risk factors for ovarian cancer  –

• Getting older – The risk starts to increase from age 45 and peaks between ages 74 and 79.
• Not having had children
• Not breastfeeding
• Having a close family history of ovarian cancer -This means a mother or a sister with the condition.
• Having had previous breast cancer -This is related to a faulty gene such as BRACA 1, BRACA 2, or Lynch syndrome.
• Smoking – This increases the risk of mucinous ovarian cancer.
• Asbestos exposure – This is from breathing in asbestos fibres in the past.
• Obesity – This is believed to account for 7% of cases of ovarian cancer.
• Having other medical conditions – The risk is increased in those with endometriosis or diabetes.
• HRT – This may increase the risk of ovarian cancer slightly, but studies are conflicting.

How could the workplace be affecting your ovarian cancer risk?

In the above 2022 case-control study, 491 cases of ovarian cancer diagnosed between 2011 and 2016 were identified, and compared to 897 healthy women without ovarian cancer. After a minimum of 10 years in the following occupations, statistically significant associations between the following  professions and ovarian cancer were found  –

• Accountants
• Hairdressers, Beauticians and related workers
• Sewers and embroiderers
• Salespeople, Shop Assistants and Demonstrators
• Retail Trade
• Construction industry

Data showed an association between ovarian cancer and exposure to the following products –

• Cosmetic talc
• Ammonia
• Hydrogen peroxide
• Hair dust
• Synthetic fibres
• Polyester fibres
• Organic dyes and pigments
• Cellulose
• Formaldehyde
• Propellant gases
• Ethanol
• Fluorocarbons
• Alkanes
• Polycyclic aromatic hydrocarbons (PAH)
• Bleaches

What do these results mean?

The authors made the following comments  –

Lack of physical exercise is a risk factor for ovarian cancer

The increased risk in accountants was suggested to be due to the lifestyle issues linked to the profession, due to long periods of being sedentary and lack of physical activity.

Asbestos is a class 1 carcinogen

Asbestos has the most research behind it. It has been classified as a class 1 carcinogen by the International Agency for Research on Cancer (IARC).

Cosmetic talc has been disproven as a cause of ovarian cancer

Cosmetic talc is no longer thought to be a cause of ovarian cancer. A 2020 literature review examined the evidence for the use of cosmetic talc and concluded there was no evidence of a direct link. Studies that have looked at industrial use of talc have had conflicting results.

Hairdressers are exposed to almost all the products identified as risk factors

Hairdressers are exposed to several possible carcinogens – formaldehyde, hydrogen peroxide and isopropanol – often used in hair straightening, bleaching and as a disinfectant/hand sanitiser. Almost all the products listed above are found in the hairdressing/beauty industry.

Inhalation of textile dust may be a risk factor for ovarian cancer

Synthetic fibres containing polyester, cellulose, alkanes and PAHs are present in textile dust and can be inhaled during sewing and similar related occupations, but the mechanism for causing ovarian cancer is unclear.

Nurses, other healthcare workers, teachers and those in the education industry were not at increased risk

Interestingly, no increase in ovarian cancer risk was found in women working as nurses or in other jobs in the healthcare industry, or teachers or those working in education.

Final thoughts

Before you get too worried, remember that not every piece of medical research should be taken at face value. Case-control studies are a type of observational study. They report an observation – but they cannot prove causation. Also, they are asking women to remember facts from many years in the past, so the results are subject to errors in memory and recall. The authors commented they did not have financial or socioeconomic details for the study subjects, or their level of educational attainment, and this data may well have altered their results. Further research is needed.

Your employer does have a duty to protect you from carcinogens and if these are present in your work environment, they must provide safety googles, impermeable gloves, a face shield, a respirator, a full-length lab coat, an impermeable apron and closed-toe shoes.

Any hazardous materials must be correctly stored, cleaned up in the case of a spillage/accident, and disposed of by the use of hazardous substances. All businesses such as hairdressers should have a COSHH policy – Control of Substances Hazardous for Health.

What can you do to help yourself?

Follow a healthy lifestyle, eat healthily, stop smoking, reduce or stop drinking alcohol, control your weight so your BMI is within normal limits (21-25) and take regular physical exercise.

Follow the COSHH policy at your place of work very carefully.

Taking the combined contraceptive pill reduces your risk of ovarian cancer by 50% while you are taking it and for 10 years after stopping.

Be aware of the symptoms of ovarian cancer which are often nonspecific – bloating, feeling full after meals, having tummy pain between your ribs and your pelvis, a swollen tummy, and needing to pee more often. See your GP without delay if you are experiencing these symptoms.

If you have a close family history of breast or ovarian cancer, ask your GP if you qualify for genetic cancer screening. If you carry a BRACA gene, you could opt for a prophylactic oophorectomy.

 For more information

• NHS – Ovarian Cancer

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Refs

https://oem.bmj.com/content/oemed/early/2023/06/01/oemed-2022-108557.full.pdf