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This systematic review characterises associations between employment in specific industries and occupations and SGC risk, alongside exposure to key occupational and environmental hazards. Studies published up to September 2023 were collected from three databases, screened against inclusion criteria, and reviewed to extract effect estimates and 95% CIs, assessing bias influence and study quality. Industry and occupation links and hazards including silica dust, cement dust, chlorinated solvents, formaldehyde, and white spirits were identified, while environmental evidence was more limited.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/occupational-and-environmental-risk-factors-for-salivary-gland-cancer-a-systematic-literature-review/350495/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/occupational-and-environmental-risk-factors-for-salivary-gland-cancer-a-systematic-literature-review/350495.png","ImageObject",300,407,{"name":92,"@type":93},"Jasmine","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main aim of this systematic review?","Question",{"text":112,"@type":113},"To characterise the relationship between employment in specific industries or occupations and the risk of salivary gland cancer, and to evaluate exposure to key occupational and environmental hazards.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were studies selected and analysed?",{"text":117,"@type":113},"Studies published up to September 2023 were collected from three electronic databases and screened systematically using pre-established inclusion and exclusion criteria. Eligible studies were reviewed in depth to extract effect estimates and 95% confidence intervals, with bias influence assessed.",{"name":119,"@type":110,"acceptedAnswer":120},"Which industries, occupations, and exposures showed the strongest associations with SGC?",{"text":121,"@type":113},"Industries and occupations with the strongest relationships included cleaning services, material handling, food services, rubber/plastics production, engineering, and construction/painting. Exposures with the strongest relationships included silica dust, cement dust, chlorinated solvents, formaldehyde, and white spirits.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},350495,1790156007,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336478487870,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Systematic review  \n► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi](https://doi). org/10.1136/oemed-2025- 110485) .  \n1Occupational Health Clinics for Ontario Workers, Inc, Toronto, Ontario, Canada  \n2Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Ontario, Canada  \n3Claxton Hepburn Medical Campus, Richard E Winter Cancer Center, Ogdensburg, New York, USA  \nCorrespondence to  \nDr Sarah McCormick Rhodes; [smcc.rhodes@gmail.com](smcc.rhodes@gmail.com)  \nDCh and KP contributed equally.  \nReceived 25 July 2025 Accepted 17 April 2026  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \nTo cite: Choi D,  \nPatel K, Zarnke A, et al.  \nOccup Environ Med Epub ahead of print: [please include Day MonthYear].doi:10.1136/ oemed-2025-110485  \nOccupational and environmental risk factors for salivary gland cancer: a systematic literature review  \nDenny Choi, 1 Khayati Patel, 1 Andrew Zarnke, 1,2 David Boyce-Fappiano,1,3 Donald Cole  , 1 Sarah McCormick Rhodes  1  \nAbSTRACT  \nOccupational and environmental risk factors for salivary gland cancer (SGC) are largely unrecognised. This systematic review is the first to characterise the relationship between employment in specific industries or occupations and risk of SGC, as well as exposure to key occupational and environmental hazards.  \nStudies published up to September 2023 were collected from three electronic databases and systematically screened. The Health Assessment Workplace Collaborative programme was used to tag studies based on pre-established inclusion and exclusion criteria. Studies eligible for inclusion (n=24) underwent an  \nin-depth review to extract key study characteristics and findings, including effect estimates and 95% CIs. Studies were evaluated for influence of key biases. To identify priority sectors and hazards for intervention, effect direction plots were created to analyse the number and quality of studies reporting elevated rates of SGC across industry, occupation and exposure groups.  \n24 articles were included for analysis. Exposure misclassification and confounding bias were a common concern across studies. Industry and occupation groups with the strongest relationship to SGC included cleaning services, material handling, food services, rubber/plastics production, engineering and construction/painting. Exposures with the strongest relationship to SGC included silica dust, cement dust, chlorinated solvents, formaldehyde and white spirits.  \nSeveral occupational exposures were associated with an elevated risk of SGC, whereas environmental evidence was more limited. Additional research involving larger cohorts with quantitative exposure data is needed to further establish relationships between occupational and environmental exposures and often-overlooked rare cancers like SGC.  \nPROSPERO registration number: CRD42023468037 .  \nINTRODUCTION  \nSalivary gland cancer (SGC) encompasses a heterogenous group of rare malignancies most often located in the head and neck (HN) region, with an estimated annual incidence rate ranging from 0.64 to 3 cases per 100 000 people.1 2 Almost 80% of salivary gland tumours occur in the parotid gland and the majority of these are benign in nature, whereas salivary tumours arising from the submandibular, sublingual or minor salivary glands have a higher propensity to be malignant.3 The most common histological types, representing over 50% of all SGCs, include adenoid cystic carcinoma and mucoepidermoid carcinoma.3 Malignant salivary gland tumours can present with pain and facial nerve  \nWHAT IS ALREADY KNOWN ON THIS TOPIC  \n\n| ⇒ Medical and behavioural risk factors for salivary gland cancer (SGC) are well established, whereas occupational and environmental factors are largely unrecognised. This is the first systematic review to investigate eme","cbCaijRqtnXFmwFb","https://ap.wps.com/l/cbCaijRqtnXFmwFb","pdf",1358231,11,"English","# Abstract\n# Introduction\n# What is already known on this topic\n# What this study adds\n# How this study might affect research, practice or policy","[{\"question\":\"What was the main aim of this systematic review?\",\"answer\":\"To characterise the relationship between employment in specific industries or occupations and the risk of salivary gland cancer, and to evaluate exposure to key occupational and environmental hazards.\"},{\"question\":\"How were studies selected and analysed?\",\"answer\":\"Studies published up to September 2023 were collected from three electronic databases and screened systematically using pre-established inclusion and exclusion criteria. Eligible studies were reviewed in depth to extract effect estimates and 95% confidence intervals, with bias influence assessed.\"},{\"question\":\"Which industries, occupations, and exposures showed the strongest associations with SGC?\",\"answer\":\"Industries and occupations with the strongest relationships included cleaning services, material handling, food services, rubber/plastics production, engineering, and construction/painting. Exposures with the strongest relationships included silica dust, cement dust, chlorinated solvents, formaldehyde, and white spirits.\"}]","Occupational and environmental risk factors for salivary gland cancer - a systematic literature review | PDF",1790089296,28]