ABSTRACT Background The Canadian Armed Forces (CAF) includes a large workforce with a diverse spectrum of military occupations and potentially related exposures. The objective was to examine associations between service in distinct military occupations and the subsequent development of cancer. Methods This retrospective cohort study used CAF administrative data linked to national cancer registry data. Personnel and Veterans with at least 2 years of CAF service between 1990 and 2017 were identified ( N = 19,660 females and 129,840 males). Service in common military occupations was categorized using military occupation codes. Associations with incident primary cancer diagnoses (all cancers combined and specific cancer types) between 1990 and 2017 were analyzed using sex‐stratified Cox proportional hazards models with age as the timeline for analysis, adjusted for enrollment era. Results For most military occupations, no significant associations with all cancers combined or specific cancer types were observed in females or males. Exceptions included occupation as an aviation systems technician, which in females was associated with an increased likelihood of breast cancer, and in males with all cancers combined as well as oral, colorectal, Hodgkin lymphoma, non‐Hodgkin lymphoma, and kidney/renal cancers. Positive associations were also observed in females for colorectal cancer in supply technicians, and in males for non‐Hodgkin lymphoma in gunners, pancreatic cancer in infanteers, and lung/bronchus cancer in supply technicians. Conclusions These findings can inform health protection measures, benefits and services for military personnel and Veterans. Future research should examine specific factors linked to the increased risks observed.
Background Construction workers are exposed to airborne particulates, organic solvents, and metals-agents linked to elevated risk of chronic kidney disease (CKD). Few studies have evaluated whether construction trade work is associated with longitudinal changes in estimated glomerular filtration rate (eGFR), a key indicator of kidney function. This study examined the relationship between construction-related exposures and eGFR decline.Methods The cohort included 9192 participants in the Building Trades National Medical Screening Program (BTMed). An index of exposure to vapors, gases, dusts, and fumes (VGDF) was developed (measure = standard deviation increases in the log index). Mixed models estimated annual eGFR decline (mL/min/1.73 m2 per year) while adjusting for established CKD risk factors. Sensitivity analyses used inverse propensity score weighted (IPSW) regression to balance covariates between construction trade workers and an internal comparison group. Secondary analyses assessed CKD incidence using Cox proportional hazards models.Results Construction work was significantly associated with faster annual eGFR decline (-0.22, 95% CI = -0.33 to -0.11). VGDF exposure was also associated with greater decline (-0.07, 95% CI = -0.09 to -0.05). CKD incidence was associated with construction work (Hazard Ratio [HR] = 1.46, 95% CI = 1.05-2.03) and VGDF exposure (HR = 1.07, 95% CI = 1.00-1.16). IPSW analyses supported these findings.Conclusions Construction trade work and VGDF exposure were associated with accelerated eGFR decline and increased CKD incidence, indicating broad renal impacts of mixed construction-related exposures. Primary and secondary prevention efforts to reduce VGDF exposures and to identify workers with rapid eGFR decline may help reduce the risk of progression to end-stage renal disease.
BACKGROUND Trauma registry data have unique characteristics differentiating them from traditional occupational injury surveillance data sources. This study analyzed trauma injury admissions (which includes emergency department encounters regardless of discharge disposition) in the American College of Surgeons National Trauma Data Bank (NTDB) to compare worker and injury characteristics of work-related and non-work-related admissions. METHODS This cross-sectional study analyzed admissions among patients aged 14 years and older from the NTDB during 2017-2022. We calculated frequencies for demographic, injury, and outcome characteristics stratified by work-relatedness (injury occurrence during paid employment). Multivariable logistic regression assessed the relationship between demographic and injury characteristics with work-relatedness as the outcome, adjusted for age, sex, race/ethnicity, and mechanism of injury. RESULTS Of 5,901,246 injuries, 241,328 injuries (4.1%) were work-related. More work-related injuries were in males (87.6% vs. 59.5% of non-work-related) and were unintentional (95.6% vs. 85.1%). The highest proportion of work-related injuries were in the construction industry (29.6%). More work-related admissions required the operating room (19.8% vs. 10.9%). Patients ages 25-44 years and men had higher odds of sustaining work-related injuries compared with other age groups and women. The mechanism of injury with the highest odds of work-relatedness compared to falls (reference) was from machinery (ORadj 9.39, 95% CI 8.63-10.22). CONCLUSIONS Trauma registry data can contribute to occupational injury research and surveillance. Strengths include a large sample size, industry and occupation coding, and data on severity, demographics, injury mechanisms, and outcomes. NTDB data could be used to study occupational injury trends among U.S-workers.
