A population-based survey on the use of artificial tanning devices in the Province of Québec, Canada.

BACKGROUND: The suntanning industry has grown up over the last decade in North America, mainly because tanned skin is socially desirable and artificial tanning is perceived as a "safe tan." However, exposure to UV radiation is known to cause adverse health effects. OBJECTIVE: The purpose of this study was to estimate the prevalence of use of tanning equipment in the Province of Québec and to characterize people who reported using these devices. METHODS: In 1996, a telephone survey was carried out among adults from the two most densely populated regions (Montréal, Québec) of the Province of Québec. The final sample included 1003 white persons 18 to 60 years old. Interviewers used a standardized questionnaire to document the characteristics of the participant, skin phototype, and exposure habits to artificial UV radiation sources. RESULTS: During the last 5 years before the survey, 20.2% of the respondents reported they had used, at least once, a tanning device in a commercial tanning salon. The rate of use during the last 12 months before the study was 11.1%. A significantly higher proportion of female, young people (18 to 34 years old) and single persons was found among tanning bed users. Twenty-six percent of users experienced one or more acute adverse health effects from the artificial UV irradiation. Most of these were cases of skin burns. A high proportion (77.5%) of those who used tanning equipment during the last year before the study said they would return to tanning salons. The intention of returning to a tanning salon was not influenced by the occurrence of the acute adverse health effects. The most prevalent reason given for using tanning equipment was "to improve their appearance by a tan." Most people (60.4%) who used a tanning bed during the last 5 years before the study believe that tanning salons are not dangerous. CONCLUSION: This survey indicates that tanning bed use is very prevalent in the Province of Québec, mainly among young women. The high rate of acute adverse health effects related to artificial tanning, particularly skin burns, is of concern. Finally, our results underline the importance of changing attitudes and beliefs in the population regarding artificial tanning.

Physician based surveillance system for occupational respiratory diseases: the experience of PROPULSE, Québec, Canada.

OBJECTIVE: To evaluate the feasibility of implementing a physician based surveillance system of occupational respiratory diseases (PROPULSE) in Québec with regard to physician participation rate, characteristics of reported cases, and comparison with official statistics from the Workers' Compensation Board (WCB). METHODS: All chest physicians and allergists in Québec were asked to report suspected new cases of occupational respiratory diseases, on a monthly basis, between October 1992 and September 1993. For each case, personal information was collected and the physician's opinion on whether the condition was related to work was categorised as highly likely, likely, and unlikely. RESULTS: Of the 161 physicians initially approached, 68% participated. Physicians rated 48% of suspected cases as highly likely, 29% as likely, and 20% as unlikely. The most often reported diagnosis was asthma (63%), followed by diseases related to asbestos (16%). Silicosis was less frequent (5%) but it was reported for six workers under 40 of whom five were involved in sandblasting activities. The high proportion of cases of asthma probably reflects the increasing importance of this disease but may also reflect the different patterns of reporting among physicians with different expertise. The distribution of cases by diagnostic category is quite different between the PROPULSE system and that of the WCB (annual mean number of compensated cases during a four year period). Asthma and allergic alveolitis are more frequent in PROPULSE, reactive airways dysfunction syndrome are about the same in both systems, and other diseases are more frequent among compensated cases. The most frequent sensitising agents reported for asthma were the same in both systems (isocyanates, flour, and wood dust). 15% of the PROPULSE cases were not covered by the WCB, and therefore would not be found in the board's official statistics. CONCLUSIONS: A physician based reporting procedure can be implemented as part of a surveillance system to supplement data from other sources and thus provide a better understanding of the occurrence of occupational respiratory diseases.

[Could the Quebec Tumor Registry be used to identify risks of occupational cancers?]. / Peut-on utiliser le Fichier des Tumeurs du Québec pour identifier des risques de cancer professionnel?

Many countries have used their tumor registries to conduct studies on cancer and occupation. In the past, the Quebec Tumor Registry (QTR) has collected information on occupation of cases. The form currently in use has a space to include this information but it is not mandatory to do so. Among male cases of naso-sinusal, pleural and ocular cancer, diagnosed between 1975 and 1979, and aged 16 to 64, 72% had information on occupation. The occupation registered at the QTR and the occupation given by the case himself during epidemiological studies on bladder cancer and leukemia are respectively the same in 64% and 69% of cases. The association between mesothelioma and work in asbestos related industries was not found in the present study. Explanations and recommendations are given.

Increased incidence of malignant melanoma of the skin in workers in a telecommunications industry.

In 1982 physicians at a hospital melanoma clinic in Montreal noticed that among their patients there had been seven men working in a single telecommunications company. This raised suspicions that working in that industry might be associated with development of malignant melanoma of the skin (MMS). A preliminary gross comparison with general population rates indicated that there was an increased risk in this working group. To estimate the risk of MMS more accurately, a standardised incidence ratio (SIR) was calculated based on the rates of MMS in the local population of the Greater Metropolitan Montreal Area for the years 1976-83. During that period, among workers in all plants for the company, 10 male cases of MMS were observed for an expected number of 3.7 (SIR = 2.7; 95% CI = 1.31-5.02). No cases were observed among female workers (expected = 1.3). The excess was significant among cases with a short latency (less than 20 years since beginning of employment). There was no apparent pattern of exposure based on job titles or departments.

Obstructive and restrictive ventilatory impairment in polyvinylchloride fabrication workers.

Responses to a standardized respiratory symptom questionnaire, spirometry, and cross-shift decreases in lung function between 70 current employees of a polyvinylchloride (PVC) fabrication plant and a control group consisting of 48 men employed in a vegetable packing plant were compared. FEV1/FVC was significantly lower in the PVC workers. Cross-shift drops in Vmax75 of 15% or more were also more prevalent in the exposed group (p = .01). When examining the association between months of work within the exposed workforce and spirometric indices of airway obstruction, no relationship could be demonstrated. However, an inverse dose-response relationship was seen between level of FVC and duration of employment, suggesting a restrictive impairment. While the specific exposures have not been identified, it appears that employment in PVC fabrication may be associated with both obstructive and restrictive ventilatory effects.

Raynaud's phenomenon in forestry workers in Quebec.

A survey of 1540 forestry workers in Quebec found a prevalence of Raynaud's phenomenon of 30.5% among chain-saw users and 8.7% among nonusers. Prevalence was related directly to duration of use of the chain-saw. The mean interval (+/- the standard deviation) between the time the chain-saw was first used and the onset of Raynaud's phenomenon was 7.8 +/- 5.6 years. After 20 years of chain-saw use over 50% of the population had Raynaud's phenomenon. Relative risks among those using a chain-saw for more than 10 years were 3.60 for nonsmokers and 6.55 for smokers. Other factors associated with the phenomenon included a family history of nonoccupational Raynaud's phenomenon, previous injuries to the arms, climate and type of residence during the wood-cutting season. Decreased work capacity, interference with leisure activities and changes in professional orientation often resulted from this disease. These problems should be taken into account when disability compensation is being considered.

Reducing aluminum: an occupation possibly associated with bladder cancer.

A case-control study, undertaken to identify reasons for the exceptionally high incidence of bladder cancer among men in the Chicoutimi census division of the province of Quebec, revealed an increased risk associated with employment in the electrolysis department of an aluminum reduction plant. The estimated relative risk was 2.83 (95% confidence interval; 1.06 to 7.54). An interaction was found between such employment and cigarette smoking, resulting in a combined relative risk of 5.70 (95% confidence interval: 2.00 to 12.30). These findings suggest that employment in an aluminum reduction plant accounts for part of the excess of bladder cancer in the region studied.