title: Association between occupational history of exposure to tobacco dust and risk of carcinoma cervix: A case-control study.
abstract: BACKGROUND
  Cervical cancer is the second most common malignancy among women in India. There is thus a need to identify unexplored risk factors such as occupational exposure to tobacco dust to justify its increasing trend so as to recommend suitable preventive measures.
  
  
  OBJECTIVE
  The aim was to study the association between occupational exposure to tobacco dust with development of carcinoma cervix.
  
  
  METHODS
  Case-control study done in two tertiary care hospitals in Mangalore.
  
  
  METHODS
  239 histologically confirmed new cases of cervical cancer and the equivalent number of age-matched controls from 2011 to 2012 were interviewed about occupational history of beedi rolling and related factors.
  
  
  METHODS
  Chi-square test, unpaired t-test, logistic regression.
  
  
  RESULTS
  Exposure rate to tobacco dust following beedi rolling was 63 (26.4%) among cases and 38 (15.9%) among controls (P = 0.005, odds ratio [OR] =1.893). The latent period from occupational exposure of tobacco dust subsequent to beedi rolling and development of cervical cancer was found to be 26.5 ± 8.5 years. Adjusted OR of beedi rolling with development of cervical cancer was found to be 1.913 (P = 0.005) after controlling the confounding effect of tobacco usage and was 1.618 (P = 0.225) after controlling the effects of all confounders. Three-quarters of beedi rollers were working in conditions of inadequate ventilation and hardy anybody used face mask during work. About a quarter of participants underwent voluntary screening for cervical cancer.
  
  
  CONCLUSIONS
  Occupational exposure to tobacco dust was found to be associated with risk of developing cervical cancer. Measures to promote awareness, timely screening of this disease along with the improvement in working conditions is required for improving the health status of beedi rollers and to minimize the incidence of carcinoma cervix in the community.
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: N
authors.initials: N
authors.lastname: Joseph
authors.forename: M
authors.initials: M
authors.lastname: Nelliyanil
authors.forename: K
authors.initials: K
authors.lastname: Supriya
authors.forename: Ypr
authors.initials: Y
authors.lastname: Babu
authors.forename: R
authors.initials: R
authors.lastname: Naik
authors.forename: K
authors.initials: K
authors.lastname: Purushothama
authors.forename: S M
authors.initials: SM
authors.lastname: Kotian
authors.forename: R
authors.initials: R
authors.lastname: Angeline
authors.forename: K
authors.initials: K
authors.lastname: Sharavathi
authors.forename: V
authors.initials: V
authors.lastname: Saralaya
authors.forename: U
authors.initials: U
authors.lastname: Bhaskaran
authors.forename: A
authors.initials: A
authors.lastname: Jain
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004391:Dust; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D014026:Nicotiana / Q000737:chemistry / Q000506:poisoning*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology
chemical_list: D004391:Dust