title: Chromosome damage and cancer risk in the workplace: the example of cytogenetic surveillance in Croatia.
abstract: The use of cytogenetic assays in the surveillance of populations occupationally exposed to genotoxic carcinogens originates from the assumption that chromosomal alterations might be causally involved in early stages of carcinogenesis. Historical cohort studies have since 1990s consistently reported an association between the level of chromosomal aberrations (CA) in peripheral lymphocytes of healthy subjects and the risk of cancer. Only in few cases, have these results been transformed into a regulatory tool for improving occupational safety. The cytogenetic surveillance program adopted for more than two decades in the Republic of Croatia is one of these few examples. Croatian workers exposed to genotoxic agents were systematically screened for CA, to identify occupational settings needing a priority intervention. Significant increases of mean CA frequency were observed in groups exposed to ionizing radiation, chemical agents, and mixed exposures when compared with a group of unexposed referents. CA data on 736 men and 584 women, monitored between 1987 and 2000, have been associated with cancer incidence. Although the small size of the cohort did not allow for reaching statistical significance, the medium tertile of the CA frequency distribution was associated with a doubling of cancer incidence rate ratio (IRR=2.40; 95% CI 0.85-6.77) when compared with the lowest tertile. For chromosome-type CA, IRR was non-significantly increased for both the medium (IRR 1.53, 95% CI 0.58-3.99) and high categories (IRR 1.69; 95% CI 0.61-4.72). Recommendations for future strategies comprise the inclusion of predictive biomarkers in surveillance programs, the definition of a regulatory framework, and their possible use for the identification of individual risk profiles.
authors.affiliation: Institute for Medical Research and Occupational Health, Ksaverska c 2, Zagreb, Croatia. afucic@imi.hr
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Fucić
authors.forename: Ariana
authors.initials: A
authors.lastname: Znaor
authors.forename: Marija
authors.initials: M
authors.lastname: Strnad
authors.forename: Olga
authors.initials: O
authors.lastname: van der Hel
authors.forename: Anastasija
authors.initials: A
authors.lastname: Aleksandrov
authors.forename: Snjezana
authors.initials: S
authors.lastname: Miskov
authors.forename: Josip
authors.initials: J
authors.lastname: Grah
authors.forename: Miljenko
authors.initials: M
authors.lastname: Sedlar
authors.forename: Ana Marija
authors.initials: AM
authors.lastname: Jazbec
authors.forename: Marcello
authors.initials: M
authors.lastname: Ceppi
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Hannu
authors.initials: H
authors.lastname: Norppa
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonassi
mesh_terms: D000328:Adult; D002274:Carcinogens, Environmental / Q000009:adverse effects*; D002471:Cell Transformation, Neoplastic / Q000187:drug effects* / Q000235:genetics; D002869:Chromosome Aberrations / Q000139:chemically induced*; D015331:Cohort Studies; D017523:Croatia / Q000453:epidemiology; D020732:Cytogenetic Analysis; D004784:Environmental Monitoring / Q000379:methods*; D062665:Epidemiological Monitoring; D005260:Female; D005819:Genetic Markers; D017408:Guidelines as Topic; D006801:Humans; D015994:Incidence; D008297:Male; D009153:Mutagens / Q000009:adverse effects*; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics; D016273:Occupational Exposure / Q000706:statistics & numerical data; D016272:Occupational Health; D011159:Population Surveillance; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D017132:Workplace
chemical_list: D002274:Carcinogens, Environmental; D005819:Genetic Markers; D009153:Mutagens