Environment and Breast Cancer: Science Review
	Cancer incidence among Icelandic nurses
	Gunnarsdottir, H., Rafnsson, V. J Occup Environ Med. 1995. 37:3, 307-12.
	 Topic area
Environmental pollutant - Occupation
Environmental pollutant - Occupation
	 Study design
Cohort
Cohort
	 Funding agency
Not reported
Not reported
Study Participants
	 Menopausal Status
	
Post menopausal
 The menopausal status of women included in this study is listed here.
	Pre menopausalPost menopausal
	 Participant selection: Inclusion and exclusion criteria
	
 Criteria used to select participants in the study.
	2159 female nurses during 1920-1979 identified from the Books of Nurses.  Men, nuns, nurses educated abroad excluded.  Compared with Icelandic rate.
	 Comment about participation selection
58% graduated in or after 1970. Fertility rate and age at first birth similar to national statistics.
58% graduated in or after 1970. Fertility rate and age at first birth similar to national statistics.
Exposure Investigated
	 Exposures investigated
Work in nursing
Work in nursing
	 How exposure was measured
Job history
Job history
	 Exposure assessment comment
Chemicals associated with exposure are not identified.
Chemicals associated with exposure are not identified.
	 Breast cancer outcome investigated
Primary breast cancer from 1955-1989
Primary breast cancer from 1955-1989
	 Ethnic groups with separate analysis
	
 If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
	No
	 Confounders considered
	
 Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
	Not adequately controlled.  
	 Genetic characterization included
	
 If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
	No
	 Description of major analysis
Standardized incidence ratio
Standardized incidence ratio
	 Strength of associations reported
Risk is elevated for no and all lag times and statistically significantly elevated for lag time of 20 years or more.
20 years lag time SIR 1.53 (1.06-2.16)
30 years lag time SIR 1.70 (1.05-2.59)
40 years lag time SIR 1.97 (1.02-3.44)
50 years lag time SIR 3.30 (1.12-7.18)
at least 20 years employment SIR 1.52 (0.96-2.28)
Risk is elevated for no and all lag times and statistically significantly elevated for lag time of 20 years or more.
20 years lag time SIR 1.53 (1.06-2.16)
30 years lag time SIR 1.70 (1.05-2.59)
40 years lag time SIR 1.97 (1.02-3.44)
50 years lag time SIR 3.30 (1.12-7.18)
at least 20 years employment SIR 1.52 (0.96-2.28)
	 Author address
Department of Occupational Medicine, Administration of Occupational Safety and Health, Reykjavik, Iceland.
Department of Occupational Medicine, Administration of Occupational Safety and Health, Reykjavik, Iceland.