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. 1996 Jun;104(6):642–650. doi: 10.1289/ehp.96104642

A nested case-control study of kidney cancer among refinery/petrochemical workers.

J F Gamble 1, E D Pearlman 1, M J Nicolich 1
PMCID: PMC1469371  PMID: 8793353

Abstract

A nested case-control study was designed to evaluate whether a nearly twofold excess of kidney cancer among workers at a refinery/petrochemical plant was associated with cumulative exposure to C2-C5 saturated, C2-C5 unsaturated, C6-C10 aliphatic saturated, C6-C10 aliphatic unsaturated, and C6-C10 aromatic process streams. Nonoccupational risk factors were body mass index (BMI), blood pressure (both measured at about age 28), and smoking. There was no significant association with cumulative exposure or tenure as estimated by conditional logistic regression and adjusted for nonoccupational risk factors. Categorical analysis showed increased odds ratios only in the second (low) and fourth (high) quartiles compared to the first quartile reference group of lowest exposed workers, and a three-quarter-fold increased odds ratio for > 32 years' tenure compared to the < 25-year reference group. The number of cases was small with wide confidence intervals around estimate of risk, so the possibility of an exposure-response trend cannot be ruled out. Multivariate analysis identified overweight (high BMI; p < 0.01) as the most important risk factor in this data set, followed by tenure and increased blood pressure. There was a weak association with current smoking, but not with pack-years smoked. The risk of kidney cancer for a nonsmoker with normal blood pressure but 25% overweight was increased about 2.6-fold (95% CI = 1.2-5.4). The risk of kidney cancer for a nonsmoker of normal weight with high blood pressure (e.g., 150/110), was increased about 4.5 (95% CI, 0.8-26).

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armenian H. K., Khoury M. J. Age at onset of genetic diseases: an application for Sartwell's model of the distribution of incubation periods. Am J Epidemiol. 1981 May;113(5):596–605. doi: 10.1093/oxfordjournals.aje.a113137. [DOI] [PubMed] [Google Scholar]
  2. Armenian H. K., Lilienfeld A. M. Incubation period of disease. Epidemiol Rev. 1983;5:1–15. doi: 10.1093/oxfordjournals.epirev.a036254. [DOI] [PubMed] [Google Scholar]
  3. Armenian H. K., Lilienfeld A. M. The distribution of incubation periods of neoplastic diseases. Am J Epidemiol. 1974 Feb;99(2):92–100. doi: 10.1093/oxfordjournals.aje.a121599. [DOI] [PubMed] [Google Scholar]
  4. Armstrong B., Garrod A., Doll R. A retrospective study of renal cancer with special reference to coffee and animal protein consumption. Br J Cancer. 1976 Feb;33(2):127–136. doi: 10.1038/bjc.1976.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Asal N. R., Geyer J. R., Risser D. R., Lee E. T., Kadamani S., Cherng N. Risk factors in renal cell carcinoma. II. Medical history, occupation, multivariate analysis, and conclusions. Cancer Detect Prev. 1988;13(3-4):263–279. [PubMed] [Google Scholar]
  6. Asal N. R., Risser D. R., Kadamani S., Geyer J. R., Lee E. T., Cherng N. Risk factors in renal cell carcinoma: I. Methodology, demographics, tobacco, beverage use, and obesity. Cancer Detect Prev. 1988;11(3-6):359–377. [PubMed] [Google Scholar]
  7. Bennington J. L., Laubscher F. A. Epidemiologic studies on carcinoma of the kidney. I. Association of renal adenocarcinoma with smoking. Cancer. 1968 Jun;21(6):1069–1071. doi: 10.1002/1097-0142(196806)21:6<1069::aid-cncr2820210607>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  8. Borghoff S. J., Short B. G., Swenberg J. A. Biochemical mechanisms and pathobiology of alpha 2u-globulin nephropathy. Annu Rev Pharmacol Toxicol. 1990;30:349–367. doi: 10.1146/annurev.pa.30.040190.002025. [DOI] [PubMed] [Google Scholar]
  9. Brownson R. C. A case-control study of renal cell carcinoma in relation to occupation, smoking, and alcohol consumption. Arch Environ Health. 1988 May-Jun;43(3):238–241. doi: 10.1080/00039896.1988.9934940. [DOI] [PubMed] [Google Scholar]
  10. Checkoway H. Methods of treatment of exposure data in occupational epidemiology. Med Lav. 1986 Jan-Feb;77(1):48–73. [PubMed] [Google Scholar]
  11. Copeland K. T., Checkoway H., McMichael A. J., Holbrook R. H. Bias due to misclassification in the estimation of relative risk. Am J Epidemiol. 1977 May;105(5):488–495. doi: 10.1093/oxfordjournals.aje.a112408. [DOI] [PubMed] [Google Scholar]
  12. Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Domiano S. F., Vena J. E., Swanson M. K. Gasoline exposure, smoking, and kidney cancer. J Occup Med. 1985 Jun;27(6):398–399. [PubMed] [Google Scholar]
  14. Edelman D. A. Does asbestos exposure increase the risk of urogenital cancer? Int Arch Occup Environ Health. 1992;63(7):469–475. doi: 10.1007/BF00572113. [DOI] [PubMed] [Google Scholar]
  15. Fraser G. E., Phillips R. L., Beeson W. L. Hypertension, antihypertensive medication and risk of renal carcinoma in California Seventh-Day Adventists. Int J Epidemiol. 1990 Dec;19(4):832–838. doi: 10.1093/ije/19.4.832. [DOI] [PubMed] [Google Scholar]
  16. Goodman M. T., Morgenstern H., Wynder E. L. A case-control study of factors affecting the development of renal cell cancer. Am J Epidemiol. 1986 Dec;124(6):926–941. doi: 10.1093/oxfordjournals.aje.a114482. [DOI] [PubMed] [Google Scholar]
  17. Grove J. S., Nomura A., Severson R. K., Stemmermann G. N. The association of blood pressure with cancer incidence in a prospective study. Am J Epidemiol. 1991 Nov 1;134(9):942–947. doi: 10.1093/oxfordjournals.aje.a116178. [DOI] [PubMed] [Google Scholar]
  18. Halder C. A., Holdsworth C. E., Cockrell B. Y., Piccirillo V. J. Hydrocarbon nephropathy in male rats: identification of the nephrotoxic components of unleaded gasoline. Toxicol Ind Health. 1985 Nov;1(3):67–87. doi: 10.1177/074823378500100305. [DOI] [PubMed] [Google Scholar]
  19. Hanis N. M., Shallenberger L. G., Donaleski D. L., Sales E. A. A retrospective mortality study of workers in three major U.S. refineries and chemical plants. Part 1: Comparisons with U.S. population. J Occup Med. 1985 Apr;27(4):283–292. [PubMed] [Google Scholar]
  20. Hard G. C., Rodgers I. S., Baetcke K. P., Richards W. L., McGaughy R. E., Valcovic L. R. Hazard evaluation of chemicals that cause accumulation of alpha 2u-globulin, hyaline droplet nephropathy, and tubule neoplasia in the kidneys of male rats. Environ Health Perspect. 1993 Mar;99:313–349. doi: 10.1289/ehp.9399313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Kadamani S., Asal N. R., Nelson R. Y. Occupational hydrocarbon exposure and risk of renal cell carcinoma. Am J Ind Med. 1989;15(2):131–141. doi: 10.1002/ajim.4700150202. [DOI] [PubMed] [Google Scholar]
  22. Kolonel L. N. Association of cadmium with renal cancer. Cancer. 1976 Apr;37(4):1782–1787. doi: 10.1002/1097-0142(197604)37:4<1782::aid-cncr2820370424>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  23. Maclure M. Asbestos and renal adenocarcinoma: a case-control study. Environ Res. 1987 Apr;42(2):353–361. doi: 10.1016/s0013-9351(87)80200-1. [DOI] [PubMed] [Google Scholar]
  24. Maclure M., Willett W. A case-control study of diet and risk of renal adenocarcinoma. Epidemiology. 1990 Nov;1(6):430–440. doi: 10.1097/00001648-199011000-00004. [DOI] [PubMed] [Google Scholar]
  25. Marshall J. R., Priore R., Graham S., Brasure J. On the distortion of risk estimates in multiple exposure level case-control studies. Am J Epidemiol. 1981 Apr;113(4):464–473. doi: 10.1093/oxfordjournals.aje.a113114. [DOI] [PubMed] [Google Scholar]
  26. McCredie M., Ford J. M., Stewart J. H. Risk factors for cancer of the renal parenchyma. Int J Cancer. 1988 Jul 15;42(1):13–16. doi: 10.1002/ijc.2910420104. [DOI] [PubMed] [Google Scholar]
  27. McLaughlin J. K., Blot W. J., Fraumeni J. F., Jr Diuretics and renal cell cancer. J Natl Cancer Inst. 1988 May 4;80(5):378–378. doi: 10.1093/jnci/80.5.378. [DOI] [PubMed] [Google Scholar]
  28. McLaughlin J. K., Mandel J. S., Blot W. J., Schuman L. M., Mehl E. S., Fraumeni J. F., Jr A population--based case--control study of renal cell carcinoma. J Natl Cancer Inst. 1984 Feb;72(2):275–284. [PubMed] [Google Scholar]
  29. Melnick R. L. An alternative hypothesis on the role of chemically induced protein droplet (alpha 2u-globulin) nephropathy in renal carcinogenesis. Regul Toxicol Pharmacol. 1992 Oct;16(2):111–125. doi: 10.1016/0273-2300(92)90052-b. [DOI] [PubMed] [Google Scholar]
  30. Melnick R. L. Mechanistic data in scientific public health decisions. Regul Toxicol Pharmacol. 1992 Oct;16(2):109–110. doi: 10.1016/0273-2300(92)90051-a. [DOI] [PubMed] [Google Scholar]
  31. Partanen T., Heikkilä P., Hernberg S., Kauppinen T., Moneta G., Ojajärvi A. Renal cell cancer and occupational exposure to chemical agents. Scand J Work Environ Health. 1991 Aug;17(4):231–239. doi: 10.5271/sjweh.1708. [DOI] [PubMed] [Google Scholar]
  32. Percy C., Stanek E., 3rd, Gloeckler L. Accuracy of cancer death certificates and its effect on cancer mortality statistics. Am J Public Health. 1981 Mar;71(3):242–250. doi: 10.2105/ajph.71.3.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Raynor W. J., Jr, Shekelle R. B., Rossof A. H., Maliza C., Paul O. High blood pressure and 17-year cancer mortality in the Western Electric Health Study. Am J Epidemiol. 1981 Apr;113(4):371–377. doi: 10.1093/oxfordjournals.aje.a113105. [DOI] [PubMed] [Google Scholar]
  34. Shallenberger L. G., Acquavella J. F., Donaleski D. An updated mortality study of workers in three major United States refineries and chemical plants. Br J Ind Med. 1992 May;49(5):345–354. doi: 10.1136/oem.49.5.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Smith A. H., Shearn V. I., Wood R. Asbestos and kidney cancer: the evidence supports a causal association. Am J Ind Med. 1989;16(2):159–166. doi: 10.1002/ajim.4700160207. [DOI] [PubMed] [Google Scholar]
  36. Swenberg J. A., Short B., Borghoff S., Strasser J., Charbonneau M. The comparative pathobiology of alpha 2u-globulin nephropathy. Toxicol Appl Pharmacol. 1989 Jan;97(1):35–46. doi: 10.1016/0041-008x(89)90053-7. [DOI] [PubMed] [Google Scholar]
  37. Weir J. M., Dunn J. E., Jr Smoking and mortality: a prospective study. Cancer. 1970 Jan;25(1):105–112. doi: 10.1002/1097-0142(197001)25:1<105::aid-cncr2820250115>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  38. West K. M. Computing and expressing degree of fatness. JAMA. 1980 Apr 11;243(14):1421–1422. doi: 10.1001/jama.1980.03300400011008. [DOI] [PubMed] [Google Scholar]
  39. Williams R. R., Horm J. W. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. J Natl Cancer Inst. 1977 Mar;58(3):525–547. doi: 10.1093/jnci/58.3.525. [DOI] [PubMed] [Google Scholar]
  40. Wong O., Raabe G. K. Critical review of cancer epidemiology in petroleum industry employees, with a quantitative meta-analysis by cancer site. Am J Ind Med. 1989;15(3):283–310. doi: 10.1002/ajim.4700150305. [DOI] [PubMed] [Google Scholar]
  41. Wynder E. L., Mabuchi K., Whitmore W. F., Jr Epidemiology of adenocarcinoma of the kidney. J Natl Cancer Inst. 1974 Dec;53(6):1619–1634. [PubMed] [Google Scholar]
  42. Yu M. C., Mack T. M., Hanisch R., Cicioni C., Henderson B. E. Cigarette smoking, obesity, diuretic use, and coffee consumption as risk factors for renal cell carcinoma. J Natl Cancer Inst. 1986 Aug;77(2):351–356. [PubMed] [Google Scholar]

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