Sperling Prostate Center

Do Transportation Jobs Increase Prostate Cancer Risk?

I wonder who first noticed that certain occupations are linked with getting prostate cancer (PCa). For example, I recently posted a blog on firefighting in which I described the theory that firefighters’ exposure to chemicals and toxic substances could be a PCa causal factor. That seems like an obvious risk.

But what about employment that has no clear carcinogenic exposures, yet correlates with an increase in PCa cases? I’m talking about work in transportation, construction, and manufacturing jobs. This includes men who professionally drive vehicles like taxis, rideshares, limos, trucks, buses, and operate heavy equipment. Rather than toxic substances, what harm do these occupations expose their workers to? The answer is whole body vibration (WBV). Numerous papers have been published on the impact of work related WBV and its relationship to PCa risk.

A 2007 study of WBV as a PCa risk factor involved 760 men who had been diagnosed with PCa between 1995-98, and 1632 age-matched controls without PCa. All complete questionnaires on their occupational history and self-reported exposure to a list of occupational hazards. According to the authors, their research did not “provide strong evidence for significant occupational risk factors for prostate cancer. However, whole-body vibration exposures, as well as physical activity, may be worth pursuing in future occupational studies.”[i]

Two years later, a 2009 paper included a review of 8 studies (1996-2004) on the risk of prostate cancer among men with occupations involving whole body vibration (WBV). The authors could not rule out WBV as a PCa risk factor, but they did note that the data was mixed because the studies also included “driving occupations with exposure to other risk factors for prostate cancer.”[ii]

In 2012, another team collected data on 447 PCa patients and 532 controls. All participants were interviewed to gain detailed task descriptions for every job held, and the type of equipment used. The authors write, “For each job, experts assessed the intensity and daily duration of WBV exposure,” which was then statistically analyzed to determine the “relationship between WBV exposure and prostate cancer, using various combinations of intensity, daily duration, and years of exposure. Potential confounders were also examined.” They found that for transport equipment operation, a job with WBV exposure, there was an increased (but not statistically significant) risk, suggesting that “workers in heavy equipment and transport equipment operation may have increased risk of prostate cancer. Further investigation is warranted.” Sure enough, further investigation was reported two years later by another group that assembled a study cohort of over one million individual records starting in 1991. All occupations and incidence of prostate cancer were correlated and tracked through 2003.

According to the authors,

17,922 incident prostate cancer cases were observed. WBV-exposed men in Natural and Applied Sciences Occupations had a 37% elevated risk of prostate cancer and WBV-exposed men in Trades, Transport, and Equipment Operators Occupations had a 9% reduced risk.[iii]

With such a marked discrepancy between elevated vs. reduced risk, they found no consistent relationship between WBV and PCa. They suggested future studies that focus on “other exposures or specific occupations in the studied categories” in hopes of explaining the differences.

Population-based studies like these shed light on statistical correlations, but they don’t address the mysterious ways by which WBV could spark PCa. In general, chronic vibration is not kind to the body. It is known to cause “both acute and chronic injury to a range of physiologic systems, including musculoskeletal, circulatory and nervous.”[iv] A 2018 paper on vibration as an occupational hazard adds gastrointestinal problems to the list, and notes that “… there are more recent data suggesting that occupational exposure to vibration may increase the risk of developing certain cancers.”

Indeed, WBV has been linked to “…fatigue, motion sickness (from vibration and impact that is transmitted to the neck and head), and the development of a number of chronic diseases including cardiovascular disease, type II diabetes and/or metabolic disorder, and prostate cancer (emphasis mine) … Although other factors such as long work hours, stress, and exposure to toxic chemicals may also contribute to the development of these diseases, animal studies suggest that vibration exposure alone can increase the expression of biomarkers for these diseases.”[v]

Clearly, science has not yet revealed how WBV may lead to cancerous cell mutations in men who drive long-distance rigs, operate bulldozers, work as fulltime chauffeurs, etc. I recommend that men in these jobs are faithful about annual PSA screening. At the earliest sign of suspicious test results, the next step should be 3T multiparametric MRI to detect and identify any possible PCa. When man’s source of livelihood puts his body’s wellness at risk, attending to both prevention and detection of PCa or any other health threat is key to preserving his longevity and quality of life.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Sass-Kortsak AM, Purdham JT, Kreiger N, Darlington G, Lightfoot NE. Occupational risk factors for prostate cancer. Am J Ind Med. 2007 Aug;50(8):568-76.
[ii] Young E, Kreiger N, Purdham J, Sass-Kortsak A. Prostate cancer and driving occupations: could whole body vibration play a role? Int Arch Occup Environ Health. 2009 Apr;82(5):551-6.
[iii] Jones MK, Harris MA, Peters PA, Tjepkema M, Demers PA. Prostate cancer and occupational exposure to whole body vibration in a national population-based cohort study. Am J Ind Med. 2014 Aug;57(8):896-905.
[iv] Muir J, Kiel DP, Rubin CT. Safety and severity of accelerations delivered from whole body vibration exercise devices to standing adults. J Sci Med Sport. 2013 Nov;16(6):526-31.
[v] Krajnak K. Health effects associated with occupational exposure to hand-arm or whole body vibration. J Toxicol Environ Health B Crit Rev. 2018;21(5):320-334.

 

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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