Tumors of the urinary bladder: an analysis of the occupations of 1,030 patients in Leeds, England.
01 Nov 1970-Journal of the National Cancer Institute (Oxford University Press)-Vol. 45, Iss: 5, pp 879-895
TL;DR: Over 20% of bladder tumors in men in this series could be occupational in origin, and the results confirmed the risk to dye workers and revealed risks to medical workers, to tailors, tailors' pressers, and some groups of engineers and textile workers (associated with long-term employment only), and possibly also to hairdressers and Tailors' cutters.
Abstract: The whole-life occupational histories of 1,030 patients (812 men and 218 women) with papilloma and carcinoma of the bladder were analyzed. Bladder tumor patients whose smoking habits were known were matched with surgical control patients (340 men and 50 women) and with other cancer patients (312 men and 39 women) for sex, age decade, habitat, and smoking habits. Numbers in the matched pairs in different occupations (Registrar General's Classification of Occupations, 1966) were compared for predominant occupation, occupied at any time, and for 20 years or more. Results were confirmed from the distribution of occupations among the unmatched bladder tumor patients (429 men and 161 women) and from a comparison of expected and observed numbers in different occupations for the patients living in the City of Leeds (519 men and 146 women). The results confirmed the risk to dye workers and revealed risks to medical workers (mainly nurses), to tailors, tailors' pressers, and some groups of engineers and textile workers (associated with long-term employment only), and possibly also to hairdressers and tailors' cutters. Tumor occurred at younger ages in men who had been employed as dye workers, tailors' cutters (P = < 0.025), or hairdressers (not significant), but not in the other suspect occupations. Over 20% of bladder tumors in men in this series could be occupational in origin.
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TL;DR: The authors conclude that the epidemiologic pattern of bladder cancer cannot be fully accounted for by cigarette smoking and occupational exposure and suggest a series of metabolic studies to assess the role of additional factors, such as nutrition.
Abstract: A case-control study among 574 male and 158 female bladder cancer patients and equal numbers of matched controls was conducted between 1969 and 1974 in 17 hospitals in six United States cities. We determined that cigarette smokers of both sexes were at higher relative risk than nonsmokers. Cigarette smoking was responsible for about one-half of male and one-third of female bladder cancer. There was an excess of bladder cancer patients with some previous occupational exposure, such as rubber, chemicals, and textiles. A weak association with coffee drinking, which appeared to be independent of smoking, was found for males. Users of artificial sweetners were not over-represented among the cases. The authors conclude that the epidemiologic pattern of bladder cancer cannot be fully accounted for by cigarette smoking and occupational exposure and suggest a series of metabolic studies to assess the role of additional factors, such as nutrition.
285 citations
TL;DR: Occupational exposure to aromatic amines could not be shown to be as strong a risk factor for urothelial carcinomas as in the past and the results strengthen the evidence that PAH may have a carcinogenic potential for the Urothelium.
Abstract: Background This multicentre population-based case-control study was conducted to estimate the urothelial cancer risk for occupational exposure to aromatic amines, polycyclic aromatic hydrocarbons (PAH), and chlorinated hydrocarbons besides other suspected risk factors. Methods In a population-based multicentre study, 1035 incident urothelial cancer cases and 4298 controls matched for region, sex, and age were interviewed between 1991 and 1995 for their occupational history and lifestyle habits. Exposure to the agents under study was self-assessed as well as expert-rated with two job-exposure matrices and a job task-exposure matrix. Conditional logistic regression was used to calculate smoking adjusted odds ratios (OR) and to control for study centre and age. Results Urothelial cancer risk following exposure to aromatic amines was only slightly elevated. Among males, substantial exposures to PAH as well as to chlorinated solvents and their corresponding occupational settings were associated with significantly elevated risks after adjustment for smoking (PAH exposure, assessed with a job-exposure matrix: OR = 1.6, 95% CI: 1.1-2.3, exposure to chlorinated solvents, assessed with a job task-exposure matrix: OR = 1.8, 95% CI: 1.2-2.6). Metal degreasing showed an elevated urothelial cancer risk among males (OR = 2.3, 95% CI: 1.4-3.8). In females also, exposure to chlorinated solvents indicated a urothelial cancer risk. Because of small numbers the risk evaluation for females should be treated with caution. Conclusions Occupational exposure to aromatic amines could not be shown to be as strong a risk factor for urothelial carcinomas as in the past. A possible explanation for this finding is the reduction in exposure over the last 50 years. Our results strengthen the evidence that PAH may have a carcinogenic potential for the urothelium. Furthermore, our results indicate a urothelial cancer risk for the use of chlorinated solvents.
253 citations
TL;DR: The data suggest increased risk in 2 occupation groups not previously suspected: cooks and kitchen workers and clerical workers and cooks and restaurant workers, both of which were previously suspected of having a bladder tumor.
Abstract: Lifetime occupation histories were elicited from 461 persons with transitional or squamous-cell carcinoma of the lower urinary tract, 94% of whom had a bladder tumor. This was a sample of all such persons newly diagnosed in a designated area in eastern Massachusetts during a recent 18-month period. A sample of 485 persons from the population of the entire study area provided comparable histories and serves as a control group. Occupations were classified according to two schemes developed for this study. Among men, excess risk of lower urinary tract cancer was found in 5 of 8 occupation categories where this was suspected a priori: dyestuffs, rubber, leather and leather products, and paint and organic chemicals. Although suspected, excess risk was not confirmed for 3 categories: printing, petroleum, and chemicals other than organic. The relative risks for men ever employed in the rubber industry (1.63) and in the leather industry (2.25) are statistically significant, p < 0.05. In absolute terms, the 5 risk categories account annually for 7.3 cases of lower urinary tract cancer per 100,000 men aged 20–89; this is about 18% of male bladder cancer. Among women, the comparable figures are 0.8 cases and 6% of the disease. None of the associations of bladder cancer with occupation results from any indirect association with cigarette smoking. Although requiring cautious interpretation, the data suggest increased risk in 2 occupation groups not previously suspected: cooks and kitchen workers and clerical workers.
249 citations
TL;DR: Occupational exposure to hair dyes was associated with an increased risk of bladder cancer in this study and subjects who worked for 10 or more years as hairdressers or barbers experienced a 5‐fold increase in risk compared to individuals not exposed.
Abstract: A population-based case-control study was conducted in Los Angeles, California, which involved 1,514 incident cases of bladder cancer and an equal number of age-, sex- and ethnicity-matched controls. Information on personal use of hair dyes was obtained from 897 cases and their matched controls. After adjustment for cigarette smoking, a major risk factor for bladder cancer, women who used permanent hair dyes at least once a month experienced a 2.1-fold risk of bladder cancer relative to non-users (p for trend = 0.04). Risk increased to 3.3 (95% CI = 1.3-8.4) among regular (at least monthly) users of 15 or more years. Occupational exposure to hair dyes was associated with an increased risk of bladder cancer in this study. Subjects who worked for 10 or more years as hairdressers or barbers experienced a 5-fold (95% CI = 1.3-19.2) increase in risk compared to individuals not exposed.
204 citations
TL;DR: Confirmation of this hypothesis is being pursued by examination of industrial populations in an effort to obtain an empirical estimate of relative risk for slow and rapid acetylator phenotypes.
Abstract: A variable but often significant proportion of urinary bladder cancer in urban areas can be attributed to occupational and cultural (cigarette smoking) situations associated with exposures to vario...
201 citations