title: Ovarian cancer and occupational exposure among pulp and paper employees in Norway.
abstract: OBJECTIVE
  A cohort study of female pulp and paper workers in Norway has shown a significantly increased risk of ovarian cancer. Other than the involvement of hormonal and reproductive factors, little is known of the etiology of ovarian cancer. Asbestos and talc are two agents hypothesized to influence the development of the disease. The present study aimed to investigate the association between ovarian cancer and occupational exposure to asbestos, talc, and total dust among Norwegian pulp and paper workers.
  
  
  METHODS
  Forty-six cases of ovarian cancer, with four controls each, were included in the study. Occupational exposure was assessed by combining work histories from personnel files, questionnaire information about production processes, and exposure assessments from the mills. To obtain information about possible confounders, cases and controls were invited to participate in a personal interview.
  
  
  RESULTS
  The odds ratio for asbestos exposure was 2.02, 95% confidence interval 0.72-5.66. For talc exposure, the odds ratio was 1.10, and for ever exposure to total dust, it was below 1.00. The risk estimates did not essentially differ after adjustment for possible confounding variables.
  
  
  CONCLUSIONS
  The results do not confirm an association between exposure to asbestos, talc, and total dust and ovarian cancer among Norwegian pulp and paper workers. However, the odds ratio for asbestos exposure was doubled, and control for established nonoccupational risk factors did not change the estimate. Therefore, the possibility that exposure to substances in the work environment contributes to the elevated risk cannot be rejected.
authors.affiliation: Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway. hilde.langseth@kreftregisteret.no
authors.forename: Hilde
authors.initials: H
authors.lastname: Langseth
authors.forename: Kristina
authors.initials: K
authors.lastname: Kjaerheim
mesh_terms: D001194:Asbestos; D016022:Case-Control Studies; D016001:Confidence Intervals; D004391:Dust; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D009664:Norway / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D010051:Ovarian Neoplasms / Q000209:etiology*; D010209:Paper; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013627:Talc
chemical_list: D004391:Dust; D001194:Asbestos; D013627:Talc