Risk of urinary bladder cancer: a case-control analysis of industry and occupation

BMC Cancer, Dec 2009

Background Uncertainty remains about urinary bladder cancer (UBC) risk for many occupations. Here, we investigate the association between occupation, industry and UBC. Methods Lifetime occupational history was collected by in-person interview for 604 newly diagnosed UBC patients and 604 cancer-free controls. Each job title was assigned a two-digit industry code and a three-digit occupation code. Odds ratios (ORs) for UBC associated with ever being employed in an industry or occupation were calculated by unconditional logistic regression adjusting for age, gender and smoking status. We also examined UBC risk by duration of employment (>0 to <10, ≥10 years) in industry or occupation. Results Significantly increased risk of UBC was observed among waiters and bartenders (OR 2.87; 95% CI 1.05 to 7.72) and occupations related to medicine and health (OR 2.17; 95% CI 1.21 to 3.92), agricultural production, livestock and animal specialties (OR 1.90; 95% CI 1.03 to 3.49), electrical assembly, installation and repair (OR 1.69; 95% CI 1.07 to 2.65), communications (OR 1.74; 95% CI 1.00 to 3.01), and health services (OR 1.58; 95% CI 1.02 to 2.44). For these occupations we also observed a significant excess risk of UBC for long-term work (i.e. ≥10 years), with the exception of waiters and bartenders. Employment for 10 years or more was associated with increased risk of UBC in general farmers (OR 9.58; 95% CI 2.18 to 42.05), agricultural production of crops (OR 3.36; 95% CI 1.10 to 10.27), occupations related to bench working (OR 4.76; 95% CI 1.74 to 13.01), agricultural, fishery, forestry & related (OR 4.58; 95% CI 1.97 to 10.65), transportation equipment (OR 2.68; 95% CI 1.03 to 6.97), and structural work (OR 1.85; 95% CI 1.16 to 2.95). Conclusions This study provides evidence of increased risk of UBC for occupations that were previously reported as at-risk. Workers in several occupation and industry groups have a significantly higher risk of UBC, particularly when duration of employment is 10 years or more.

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Risk of urinary bladder cancer: a case-control analysis of industry and occupation

BMC Cancer Risk of urinary bladder cancer: a case-control analysis of industry and occupation Adrian Cassidy 0 Wei Wang 0 Xifeng Wu 0 Jie Lin 0 0 Address: Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center , Houston, Texas , USA Background: Uncertainty remains about urinary bladder cancer (UBC) risk for many occupations. Here, we investigate the association between occupation, industry and UBC. Methods: Lifetime occupational history was collected by in-person interview for 604 newly diagnosed UBC patients and 604 cancer-free controls. Each job title was assigned a two-digit industry code and a three-digit occupation code. Odds ratios (ORs) for UBC associated with ever being employed in an industry or occupation were calculated by unconditional logistic regression adjusting for age, gender and smoking status. We also examined UBC risk by duration of employment (>0 to <10, ≥10 years) in industry or occupation. Results: Significantly increased risk of UBC was observed among waiters and bartenders (OR 2.87; 95% CI 1.05 to 7.72) and occupations related to medicine and health (OR 2.17; 95% CI 1.21 to 3.92), agricultural production, livestock and animal specialties (OR 1.90; 95% CI 1.03 to 3.49), electrical assembly, installation and repair (OR 1.69; 95% CI 1.07 to 2.65), communications (OR 1.74; 95% CI 1.00 to 3.01), and health services (OR 1.58; 95% CI 1.02 to 2.44). For these occupations we also observed a significant excess risk of UBC for long-term work (i.e. ≥10 years), with the exception of waiters and bartenders. Employment for 10 years or more was associated with increased risk of UBC in general farmers (OR 9.58; 95% CI 2.18 to 42.05), agricultural production of crops (OR 3.36; 95% CI 1.10 to 10.27), occupations related to bench working (OR 4.76; 95% CI 1.74 to 13.01), agricultural, fishery, forestry & related (OR 4.58; 95% CI 1.97 to 10.65), transportation equipment (OR 2.68; 95% CI 1.03 to 6.97), and structural work (OR 1.85; 95% CI 1.16 to 2.95). Conclusions: This study provides evidence of increased risk of UBC for occupations that were previously reported as at-risk. Workers in several occupation and industry groups have a significantly higher risk of UBC, particularly when duration of employment is 10 years or more. - Background Urinary bladder cancer (UBC) ranks the fourth most common cancer in men and ninth in women in the United States, accounting for an estimated 70,980 new cases in 2009[1]. Numerous studies have demonstrated that the primary modifiable risk factors for UBC are cigarette smoking and occupational exposure to carcinogens. An updated review of the literature estimates that between 5 and 25% of all UBC cases are attributable to workplace exposures[2]. The variance in attributable fraction suggests that, despite numerous studies investigating the association between UBC risk and occupational exposures, results have been inconsistent. To date, only a few occupations and industries, such as those exposed to aromatic amines, have been unequivocally associated with increased risk of UBC. Previous reported high-risk occupation/industry groups include dyestuff workers, rubber workers, painters, printers, metal workers, textile workers, truck drivers, chemical workers and employment in industries involving leather, petrochemical production, plastics production and hairdressing. [3-13] Excess risk of UBC has also been reported among health service workers and farmers[3,4,6,14-16]. However, uncertainty remains about UBC risk for many occupations[17]. Using data from a large on-going casecontrol study of UBC in Houston, Texas, we sought to investigate the association between occupation, industry and UBC, and to identify general patterns and trends in UBC risk in the study population. Methods Urinary bladder cancer patients were enrolled from an ongoing case-control study of UBC at M.D. Anderson Cancer Center, Houston, Texas, which began recruitment in 1999. The procedures for patient recruitment and eligibility criteria have been described elsewhere[18]. Briefly, UBC patients were recruited from the University of Texas M.D. Anderson Cancer Center and Baylor College of Medicine. Patients were defined as newly diagnosed and histopathologically confirmed UBC patients who had not previously received chemotherapy or radiotherapy. There were no recruitment restrictions on age, gender, ethnicity or cancer-stage. The controls were recruited in collaboration with the Kelsey-Seybold clinics, the largest private multi-specialty physician group consisting of more than 23 clinics and over 300 physicians in the Houston metropolitan area. The majority of controls visited the clinics for annual health check-ups. Controls were frequency matched to case by age (± 5 years), gender and ethnicity. Controls had no prior history of cancer (except nonmelanoma skin cancer). After obtaining written, informed consent from the patients and controls, trained M.D. Anderson Cancer Cente (...truncated)


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Adrian Cassidy, Wei Wang, Xifeng Wu, Jie Lin. Risk of urinary bladder cancer: a case-control analysis of industry and occupation, BMC Cancer, 2009, pp. 443, 9, DOI: 10.1186/1471-2407-9-443