Breast Cancer Risk in Relation to Occupations with Exposure to Carcinogens and Endocrine Disruptors:a Canadian Case-Control Study

Background

Endocrine disrupting chemicals and carcinogens, some of which may not yet have been classified as such, are present in many occupational environments and could increase breast cancer risk. Prior research has identified associations with breast cancer and work in agricultural and industrial settings. The purpose of this study was to further characterize possible links between breast cancer risk and occupation, particularly in farming and manufacturing, as well as to examine the impacts of early agricultural exposures, and exposure effects that are specific to the endocrine receptor status of tumours.

Methods

1005 breast cancer cases referred by a regional cancer center and 1147 randomly-selected community controls provided detailed data including occupational and reproductive histories. All reported jobs were industry- and occupation-coded for the construction of cumulative exposure metrics representing likely exposure to carcinogens and endocrine disruptors. In a frequency-matched case?control design, exposure effects were estimated using conditional logistic regression.

Results

Across all sectors, women in jobs with potentially high exposures to carcinogens and endocrine disruptors had elevated breast cancer risk (OR = 1.42; 95% CI, 1.18-1.73, for 10 years exposure duration). Specific sectors with elevated risk included: agriculture (OR = 1.36; 95% CI, 1.01-1.82); bars-gambling (OR = 2.28; 95% CI, 0.94-5.53); automotive plastics manufacturing (OR = 2.68; 95% CI, 1.47-4.88), food canning (OR = 2.35; 95% CI, 1.00-5.53), and metalworking (OR = 1.73; 95% CI, 1.02-2.92). Estrogen receptor status of tumors with elevated risk differed by occupational grouping. Premenopausal breast cancer risk was highest for automotive plastics (OR = 4.76; 95% CI, 1.58-14.4) and food canning (OR = 5.70; 95% CI, 1.03-31.5).

Conclusions

These observations support hypotheses linking breast cancer risk and exposures likely to include carcinogens and endocrine disruptors, and demonstrate the value of detailed work histories in environmental and occupational epidemiology.

History of Child Welfare and Protection Social Work in Northern Ireland: Finding Continuity amongst Discontinuity in Case Files from 1950-1968

This article reports on research carried out on 200 child welfare files from the largest welfare authority in Northern Ireland from 1950-1968. The literature review provides a commentary on some of the major debates surrounding child welfare and protection social work from the perspective of its historical development. The report of the research which follows offers an insight into one core, and less well-known period of child welfare history in Northern Ireland between the two Children and Young Persons Acts (1950 & 1968). Using a method of discourse analysis influenced by Michel Foucault, a detailed description of the nature of practice is offered. This paper is offered as a work in progress, with further work being planned for dissemination of more detailed analysis of the method and outcomes. The research seeks to ask a few core questions based on problems identified in the present with our current understandings of child welfare and protection histories. While recognising the limitations of this study and the need for broader analysis of the wider context surrounding child welfare practice at the moment, it is argued that some salient conclusions can be drawn about continuity and discontinuity in practice which are of interest to practitioners and students of child welfare social work.

Ascending Out of Poverty: An analysis of family histories in Kenya

This paper looks at inheritance through minimally-structured interviews with several generations of Kenyan families, seeking to explain that the how and why of poverty can be understood in the wider family context. Five main routes for ascending out of poverty were identified: (1) the gradual accumulation of resources due to income deriving from cash crops; (2) the gradual accumulation of resources due to income from non-farm work, including remittances from family member who have moved away for work; (3) the role of education, particularly skills training opposed to academic qualification, in helping provide employment; (4) accessing financial assets through support both from extended family members and from informal support mechanisms; (5) stability and benefits accruing from long-term strategic planning, including entrepreneurial activity. Both the ascent out of and the descent into poverty can be better conceived as processes, rather than due to chains of discrete events or specific ‘shocks’.

Criminal Conversations: Rogues, Words and the World in the Work of Daniel Defoe

Even as Daniel Defoe's roguish protagonists notably Moll Flanders and Colonel Jack try to separate themselves from illicit itinerants, they are implicated further in deviance. Moll and Jack both embody and exploit ambiguous moral and spatial arrangements, and use hybrid linguistic formulations, all of which collocate the roguish and the reputable. By brilliantly realizing this interpenetration of words and worlds, Defoe problematises eighteenth-century efforts to demarcate the illicit and itinerant along the lines of space, rank, gender and language. Such efforts facilitated deviant mobility as much as they demonised it. Much scholarship has attended to Defoe's representations of criminality and poverty. This article develops such research to re-position him in a tradition of rogue-writing that stylishly problematises normative discriminatory practices.

Merely Birds of Passage: Lady Hariot Dufferin's Travel Writings and Medical Work in India, 1884-88

This article examines the travel writings and medical work in India of Lady Hariot Dufferin, Vicereine of India between 1884 and 1888. Lady Dufferin accompanied her husband, the Viceroy Lord Dufferin, through various social and political engagements in India, and carved her own niche in colonial and postcolonial history as a pioneer in the medical training of women in India. The article examines her travel writings on India and explores the nature of her complicity in the Raj, as well as the gendered nature of the separate public role she created for herself in relation to her 'zenana work' in providing medical care for the women of India. The author suggests that, through her work, Lady Dufferin challenges and extends the theoretical paradigms of postcolonialist and feminist critiques of empire.

Hidden Gems: systematically searching electronic databases for research publications for social work and social care.

Context: Electronic bibliographic databases are a key source for professional publications about social work and community care more generally. This article describes and evaluates a method of identifying relevant articles as part of a systematic review of research evidence. Decision making about institutional and home care services for older people is used as an example. Method: Four databases (Social Science Citation Index, Medline, CINAHL, and Caredata) that abstract publications relevant to health and social services were searched systematically to identify relevant research studies. The items retrieved were appraised independently using a standard form developed for the purpose. The searches were compared in terms of sensitivity, precision, overlap between databases, and inter-rater reliability. Results: The search retrieved 525 articles, of which 276 were relevant. The four databases retrieved 55%, 41%, 19%, and 1% of the relevant articles respectively, achieving these sensitivities with precision levels of 54%, 48%, 84% and 94%. The databases retrieved 116, 73, 24 and 15 unique relevant articles respectively, showing the need to use a range of databases. Discussion: A general approach to creating a search to retrieve relevant research has been developed. The development of an international, indexed database dedicated to literature relevant to social services is a priority to enable progress in evidence-based policy and practice in social work. Editors and researchers should consider using structured abstracts in order to improve the retrieval and dissemination of research.

Accessing Social Work Case Files for Research Purposes: Some Issues and Problems

The use of social work case files as an important research resource is being threatened by the increasing regulation of both the research process and access to personal identifiable information. While these developments can be seen as a reaction to specific incidents of inappropriate research and the misuse of personal information, it is argued that the pendulum has swung too far the other way, and in seeking to protect the rights of vulnerable individuals, the lives of these same individuals may go unstudied with the consequence that they receive less appropriate services. Drawing upon the current research of the authors, this article explores the difficulties encountered in gaining access to social work case files for research purposes without the explicit consent of service users and highlights the uncertainty surrounding this issue. Suggestions are made for improvements in the situation.

Gaining Access to Data Sources in Statutory Social Work Agencies: The Long and Winding Road

This paper details a researcher's experience of gaining access to three statutory social work agencies in order to conduct a study examining how social workers respond to family support cases and how parents and carers experience the intervention of social workers in these cases. The stages in gaining access are outlined, the gate-keepers involved at each stage are identified and some of the difficulties encountered are highlighted and discussed. The paper concludes that researchers need to give greater priority to access considerations and that social work agencies need to give greater priority to co-operation with researchers.