| Titre : | Can we quantify "Avoidable Lung cancer" by socioeconomic position (SEP)? The example of occupation as a hidden determinant of social inequalities in health |
| Auteurs : | Walaa Ismail |
| Type de document : | Mémoire |
| Année de publication : | 2019 |
| Description : | 37p. / ann., tabl. |
| Langues: | Anglais |
| Classement : | MPH19/ (Master EHESP International master of public health - MPH) |
| Mots-clés : | Inégalité devant soins ; Cancer ; Poumon ; Facteur socioéconomique ; Exposition professionnelle ; Risque attribuable ; Indicateur santé ; Indicateur socioéconomique |
| Résumé : | Background. Many studies attempted to measure health inequalities based on the Socioeconomic position (SEP), where they seemed to be concentrated within lower SEP groups. Many indicators have been also used try to quantify the SEP based on education, occupation or income. However, occupation-based indicators tend to be less use, while they may better capture work-related inequalities. Previous studies observed an association between lung cancer and lower SEP, which could not be fully explained by behavioural factors such as smoking. Occupational exposures could contribute to these inequalities as many carcinogens are still present in workplaces till nowadays, even after the ban of asbestos in more and more countries. Aim. Apply the attributable risk approach to compare the burden of work-related lung cancer between different socio-economic groups taking three occupational exposures (e.g. asbestos, silica and Diesel Motor Exhaust (DME)) as well as smoking into account. Methods. Secondary analysis of the population-based case-control study ICARE study was conducted. The study included 2926 lung cancer cases and 3555 frequency-matched controls covering 13% of the French population. We applied different modelling strategies to compare 3 sources of variation in the attributable fractions estimates (exposure metrics, interaction with SEP and SEP indicator) using standard STATA packages (Aflogit). Results. The analysis was based on men-only due to the limited number of exposures among women. The population Attributable Fraction (PAF) for the whole study sample for the combined indicator of asbestos, silica and DME was 32.7% 95%CI (24.6-39.9), while the total PAFs for the exposed Blue-collar workers compared to non-exposed groups regardless of their SEP was 26.9% 95%CI (21.9- 31.7). Conclusion. The population health impact of these occupational exposures concentrates within lower SEP groups (Blue-collar workers and lower educated groups). Our results point to the necessity to combine SEP indicators and proximal risk factors into the PAF approach in order to capture work-related cancer inequalities.(R.A.) |
| Diplôme : | Master MPH of public health |
| Plan de classement simplifié : | Master of Public Health - master international de Santé Public (MPH) |
| En ligne : | http://documentation.ehesp.fr/memoires/2019/mph//Walaa Ismail.pdf |
Exemplaires (1)
| Code-barres | Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|---|
| T98064 | MPH19/0006 | Mémoire | Rennes | Salle des Glénan | Empruntable Disponible |
Documents numériques (1)
 MPH/ismail URL |