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. 2000 Mar;57(3):180–187. doi: 10.1136/oem.57.3.180

Exposure to high concentrations of nitrosamines and cancer mortality among a cohort of rubber workers

K Straif 1, S Weiland 1, M Bungers 1, D Holthenrich 1, D Taeger 1, S Yi 1, U Keil 1
PMCID: PMC1739921  PMID: 10810100

Abstract

OBJECTIVES—To examine if the occurrence of different cancers was increased among rubber workers, as the highest known exposures of humans to nitrosamines have occurred in the rubber industry.
METHODS—A cohort of 8933 rubber workers (hired after 1 January 1950, still active or retired on 1 January 1981 and employed for at least 1 year in one of five study factories) was followed up for mortality from 1 January 1981 to 31 December 1991. Work histories were reconstructed with routinely documented cost centre codes, which allowed identification by employment in specific work areas. For each cost centre code time and factory specific, semi-quantitative exposures to nitrosamines (three levels: low, medium, high) and other compounds were estimated by industrial hygienists. Rate ratios for medium (RRm) and high (RRh) exposures and 95% confidence intervals (95% CIs) were calculated with Cox's proportional hazards models with the low exposure as reference.
RESULTS—Exposure to nitrosamines was significantly associated with an increased mortality from cancers of the oesophagus (13 deaths: RRm 1.7, 95% CI 0.3 to 10.3; RRh 7.3, 95% CI 1.9 to 27.8) and of the oral cavity and pharynx (17 deaths: RRm 0.8, 95% CI 0.2 to 4.1; RRh 3.9, 95% CI 1.4 to 11.1). A non-significant trend of increasing mortality with exposure to higher concentrations of nitrosamines was found for mortality from cancer of the prostate (26 deaths: RRm 1.4, 95% CI 0.5 to 3.8; RRh 2.2, 95% CI 0.9 to 5.6), and the brain (six deaths: RRm 3.9, 95% CI 0.3 to 42.6; RRh 6.0, 95% CI 0.6 to 57.6). No association was found between exposure to nitrosamines and cancer of the stomach (RRm 0.8, 95% CI 0.4 to 1.8; RRh 1.2, 95% CI 0.5 to 2.5) or lung (RRm 1.0, 95% CI 0.6 to 1.5; RRh 1.0, 95% CI 0.7 to 1.6).
CONCLUSIONS—Exposure to high concentrations of nitrosamines is associated with increased mortality from cancers of the oesophagus, oral cavity, and pharynx, but not with increased mortality from cancers of the stomach or lung.


Keywords: nitrosamines; cancer mortality; rubber industry

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Selected References

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  1. Anderson L. M., Koseniauskas R., Burak E. S., Moskal T. J., Gombar C. T., Phillips J. M., Sansone E. B., Keimig S., Magee P. N., Rice J. M. Reduced blood clearance and increased urinary excretion of N-nitrosodimethylamine in patas monkeys exposed to ethanol or isopropyl alcohol. Cancer Res. 1992 Mar 15;52(6):1463–1468. [PubMed] [Google Scholar]
  2. Anderson L. M., Souliotis V. L., Chhabra S. K., Moskal T. J., Harbaugh S. D., Kyrtopoulos S. A. N-nitrosodimethylamine-derived O(6)-methylguanine in DNA of monkey gastrointestinal and urogenital organs and enhancement by ethanol. Int J Cancer. 1996 Mar 28;66(1):130–134. doi: 10.1002/(SICI)1097-0215(19960328)66:1<130::AID-IJC22>3.0.CO;2-G. [DOI] [PubMed] [Google Scholar]
  3. Aze Y., Toyoda K., Furukawa F., Mitsumori K., Takahashi M. Enhancing effect of ethanol on esophageal tumor development in rats by initiation of diethylnitrosamine. Carcinogenesis. 1993 Jan;14(1):37–40. doi: 10.1093/carcin/14.1.37. [DOI] [PubMed] [Google Scholar]
  4. Bartsch H., Montesano R. Relevance of nitrosamines to human cancer. Carcinogenesis. 1984 Nov;5(11):1381–1393. doi: 10.1093/carcin/5.11.1381. [DOI] [PubMed] [Google Scholar]
  5. Bartsch H. N-nitroso compounds and human cancer: where do we stand? IARC Sci Publ. 1991;(105):1–10. [PubMed] [Google Scholar]
  6. Berger M. R., Schmähl D. Syncarcinogenesis at low exposure levels of three nitrosamines with a common target of carcinogenic action: preliminary results. IARC Sci Publ. 1987;(84):246–249. [PubMed] [Google Scholar]
  7. Bernardinelli L., de Marco R., Tinelli C. Cancer mortality in an Italian rubber factory. Br J Ind Med. 1987 Mar;44(3):187–191. doi: 10.1136/oem.44.3.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Bogovski P., Bogovski S. Animal Species in which N-nitroso compounds induce cancer. Int J Cancer. 1981;27(4):471–474. doi: 10.1002/ijc.2910270408. [DOI] [PubMed] [Google Scholar]
  9. Bovet P., Lob M. La mortalité par tumeur maligne chez les ouvriers d'une fabrique de caoutchouc en Suisse. Etude épidémiologique, 1955-1975. Schweiz Med Wochenschr. 1980 Aug 30;110(35):1277–1287. [PubMed] [Google Scholar]
  10. Burch J. D., Craib K. J., Choi B. C., Miller A. B., Risch H. A., Howe G. R. An exploratory case-control study of brain tumors in adults. J Natl Cancer Inst. 1987 Apr;78(4):601–609. [PubMed] [Google Scholar]
  11. CASE R. A., HOSKER M. E., McDONALD D. B., PEARSON J. T. Tumours of the urinary bladder in workmen engaged in the manufacture and use of certain dyestuff intermediates in the British chemical industry. I. The role of aniline, benzidine, alpha-naphthylamine, and beta-naphthylamine. Br J Ind Med. 1954 Apr;11(2):75–104. doi: 10.1136/oem.11.2.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. CASE R. A., HOSKER M. E. Tumour of the urinary bladder as an occupational disease in the rubber industry in England and Wales. Br J Prev Soc Med. 1954 Apr;8(2):39–50. doi: 10.1136/jech.8.2.39. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Cheng K. K., Day N. E., Duffy S. W., Lam T. H., Fok M., Wong J. Pickled vegetables in the aetiology of oesophageal cancer in Hong Kong Chinese. Lancet. 1992 May 30;339(8805):1314–1318. doi: 10.1016/0140-6736(92)91960-g. [DOI] [PubMed] [Google Scholar]
  14. Chhabra S. K., Souliotis V. L., Kyrtopoulos S. A., Anderson L. M. Nitrosamines, alcohol, and gastrointestinal tract cancer: recent epidemiology and experimentation. In Vivo. 1996 May-Jun;10(3):265–284. [PubMed] [Google Scholar]
  15. Crampton R. F. Carcinogenic dose-related response to nitrosamines. Oncology. 1980;37(4):251–254. doi: 10.1159/000225446. [DOI] [PubMed] [Google Scholar]
  16. De Stefani E., Deneo-Pellegrini H., Carzoglio J. C., Ronco A., Mendilaharsu M. Dietary nitrosodimethylamine and the risk of lung cancer: a case-control study from Uruguay. Cancer Epidemiol Biomarkers Prev. 1996 Sep;5(9):679–682. [PubMed] [Google Scholar]
  17. Delzell E., Louik C., Lewis J., Monson R. R. Mortality and cancer morbidity among workers in the rubber tire industry. Am J Ind Med. 1981;2(3):209–216. doi: 10.1002/ajim.4700020304. [DOI] [PubMed] [Google Scholar]
  18. Doll R., Peto R., Hall E., Wheatley K., Gray R. Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. BMJ. 1994 Oct 8;309(6959):911–918. doi: 10.1136/bmj.309.6959.911. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Doll R., Peto R., Wheatley K., Gray R., Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ. 1994 Oct 8;309(6959):901–911. doi: 10.1136/bmj.309.6959.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Dosemeci M., Wacholder S., Lubin J. H. Does nondifferential misclassification of exposure always bias a true effect toward the null value? Am J Epidemiol. 1990 Oct;132(4):746–748. doi: 10.1093/oxfordjournals.aje.a115716. [DOI] [PubMed] [Google Scholar]
  21. Druckrey H., Preussmann R., Ivankovic S., Schmähl D. Organotrope carcinogene Wirkungen bei 65 verschiedenen N-Nitroso-Verbindungen an BD-Ratten. Z Krebsforsch. 1967;69(2):103–201. [PubMed] [Google Scholar]
  22. Englund A., Ekman G., Zabrielski L. Occupational categories among brain tumor cases recorded in the cancer registry in Sweden. Ann N Y Acad Sci. 1982;381:188–196. doi: 10.1111/j.1749-6632.1982.tb50384.x. [DOI] [PubMed] [Google Scholar]
  23. Fajen J. M., Carson G. A., Rounbehler D. P., Fan T. Y., Vita R., Goff U. E., Wolf M. H., Edwards G. S., Fine D. H., Reinhold V. N-nitrosamines in the rubber and tire industry. Science. 1979 Sep 21;205(4412):1262–1264. doi: 10.1126/science.472741. [DOI] [PubMed] [Google Scholar]
  24. Fan T. Y., Morrison J., Rounbehler D. P., Ross R., Fine D. H., Miles W., Sen N. P. N-Nitrosodiethanolamine in synthetic cutting fluids: a part-per-hundred impurity. Science. 1977 Apr 1;196(4285):70–71. doi: 10.1126/science.841341. [DOI] [PubMed] [Google Scholar]
  25. Fuchs J., Burg J., Hengstler J. G., Bolm-Audorff U., Oesch F. DNA damage in mononuclear blood cells of metal workers exposed to N-nitrosodiethanolamine in synthetic cutting fluids. Mutat Res. 1995 Mar;342(1-2):95–102. doi: 10.1016/0165-1218(95)90094-2. [DOI] [PubMed] [Google Scholar]
  26. Goldsmith D. F., Smith A. H., McMichael A. J. A case-control study of prostate cancer within a cohort of rubber and tire workers. J Occup Med. 1980 Aug;22(8):533–541. doi: 10.1097/00043764-198008000-00010. [DOI] [PubMed] [Google Scholar]
  27. Greenland S., Finkle W. D. A critical look at methods for handling missing covariates in epidemiologic regression analyses. Am J Epidemiol. 1995 Dec 15;142(12):1255–1264. doi: 10.1093/oxfordjournals.aje.a117592. [DOI] [PubMed] [Google Scholar]
  28. Griciute L., Castegnaro M., Bereziat J. C. Influence of ethyl alcohol on the carcinogenic activity of N-nitrosodi-n-propylamine. IARC Sci Publ. 1982;(41):643–648. [PubMed] [Google Scholar]
  29. Gupta P. C., Murti P. R., Bhonsle R. B. Epidemiology of cancer by tobacco products and the significance of TSNA. Crit Rev Toxicol. 1996;26(2):183–198. doi: 10.3109/10408449609017930. [DOI] [PubMed] [Google Scholar]
  30. Gustavsson P., Evanoff B., Hogstedt C. Increased risk of esophageal cancer among workers exposed to combustion products. Arch Environ Health. 1993 Jul-Aug;48(4):243–245. doi: 10.1080/00039896.1993.9940366. [DOI] [PubMed] [Google Scholar]
  31. Gustavsson P., Jakobsson R., Johansson H., Lewin F., Norell S., Rutkvist L. E. Occupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden. Occup Environ Med. 1998 Jun;55(6):393–400. doi: 10.1136/oem.55.6.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Harris C. C., Autrup H., Stoner G. D., Trump B. F., Hillman E., Schafer P. W., Jeffrey A. M. Metabolism of benzo(a)pyrene, N-nitrosodimethylamine, and N-nitrosopyrrolidine and identification of the major carcinogen-DNA adducts formed in cultured human esophagus. Cancer Res. 1979 Nov;39(11):4401–4406. [PubMed] [Google Scholar]
  33. Hoffmann D., Melikian A. A., Wynder E. L. Scientific challenges in environmental carcinogenesis. Prev Med. 1996 Jan-Feb;25(1):14–22. doi: 10.1006/pmed.1996.0007. [DOI] [PubMed] [Google Scholar]
  34. Holmberg B., Westerholm P., Maasing R., Kestrup L., Gumaelius K., Holmlund L., Englund A. Retrospective cohort study of two plants in the Swedish rubber industry. Scand J Work Environ Health. 1983;9 (Suppl 2):59–68. [PubMed] [Google Scholar]
  35. Huang Q., Stoner G., Resau J., Nickols J., Mirvish S. S. Metabolism of N-nitrosomethyl-n-amylamine by microsomes from human and rat esophagus. Cancer Res. 1992 Jul 1;52(13):3547–3551. [PubMed] [Google Scholar]
  36. Huebner W. W., Schoenberg J. B., Kelsey J. L., Wilcox H. B., McLaughlin J. K., Greenberg R. S., Preston-Martin S., Austin D. F., Stemhagen A., Blot W. J. Oral and pharyngeal cancer and occupation: a case-control study. Epidemiology. 1992 Jul;3(4):300–309. doi: 10.1097/00001648-199207000-00005. [DOI] [PubMed] [Google Scholar]
  37. Kjaerheim K., Gaard M., Andersen A. The role of alcohol, tobacco, and dietary factors in upper aerogastric tract cancers: a prospective study of 10,900 Norwegian men. Cancer Causes Control. 1998 Jan;9(1):99–108. doi: 10.1023/a:1008809706062. [DOI] [PubMed] [Google Scholar]
  38. Kogevinas M., Sala M., Boffetta P., Kazerouni N., Kromhout H., Hoar-Zahm S. Cancer risk in the rubber industry: a review of the recent epidemiological evidence. Occup Environ Med. 1998 Jan;55(1):1–12. doi: 10.1136/oem.55.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Kristensen P. Bias from nondifferential but dependent misclassification of exposure and outcome. Epidemiology. 1992 May;3(3):210–215. doi: 10.1097/00001648-199205000-00005. [DOI] [PubMed] [Google Scholar]
  40. Kromhout H., Heederik D. Occupational epidemiology in the rubber industry: implications of exposure variability. Am J Ind Med. 1995 Feb;27(2):171–185. doi: 10.1002/ajim.4700270203. [DOI] [PubMed] [Google Scholar]
  41. Kromhout H., Swuste P., Boleij J. S. Empirical modelling of chemical exposure in the rubber-manufacturing industry. Ann Occup Hyg. 1994 Feb;38(1):3–22. doi: 10.1093/annhyg/38.1.3. [DOI] [PubMed] [Google Scholar]
  42. Lampérth-Seiler E. Harnweg- und Hirntumoren bei Gummiarbeitern. Schweiz Med Wochenschr. 1974 Nov 16;104(46):1655–1659. [PubMed] [Google Scholar]
  43. Lu S. H., Chui S. X., Yang W. X., Hu X. N., Guo L. P., Li F. M. Relevance of N-nitrosamines to oesophageal cancer in China. IARC Sci Publ. 1991;(105):11–17. [PubMed] [Google Scholar]
  44. MAGEE P. N., BARNES J. M. The production of malignant primary hepatic tumours in the rat by feeding dimethylnitrosamine. Br J Cancer. 1956 Mar;10(1):114–122. doi: 10.1038/bjc.1956.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Magee P. N. The experimental basis for the role of nitroso compounds in human cancer. Cancer Surv. 1989;8(2):207–239. [PubMed] [Google Scholar]
  46. McMichael A. J., Andjelkovic D. A., Tyroler H. A. Cancer mortality among rubber workers: an epidemiologic study. Ann N Y Acad Sci. 1976;271:125–137. doi: 10.1111/j.1749-6632.1976.tb23101.x. [DOI] [PubMed] [Google Scholar]
  47. McMichael A. J., Spirtas R., Gamble J. F., Tousey P. M. Mortality among rubber workers: Relationship to specific jobs. J Occup Med. 1976 Mar;18(3):178–185. doi: 10.1097/00043764-197603000-00012. [DOI] [PubMed] [Google Scholar]
  48. Mirvish S. S., Huang Q., Chen S. C., Birt D. F., Clark G. W., Hinder R. A., Smyrk T. C., DeMeester T. R. Metabolism of carcinogenic nitrosamines in the rat and human esophagus and induction of esophageal adenocarcinoma in rats. Endoscopy. 1993 Nov;25(9):627–631. doi: 10.1055/s-2007-1010418. [DOI] [PubMed] [Google Scholar]
  49. Mirvish S. S. Role of N-nitroso compounds (NOC) and N-nitrosation in etiology of gastric, esophageal, nasopharyngeal and bladder cancer and contribution to cancer of known exposures to NOC. Cancer Lett. 1995 Jun 29;93(1):17–48. doi: 10.1016/0304-3835(95)03786-V. [DOI] [PubMed] [Google Scholar]
  50. Monson R. R., Fine L. J. Cancer mortality and morbidity among rubber workers. J Natl Cancer Inst. 1978 Oct;61(4):1047–1053. [PubMed] [Google Scholar]
  51. Monson R. R., Nakano K. K. Mortality among rubber workers. I. White male union employees in Akron, Ohio. Am J Epidemiol. 1976 Mar;103(3):284–296. doi: 10.1093/oxfordjournals.aje.a112226. [DOI] [PubMed] [Google Scholar]
  52. Moulin J. J., Wild P., Mur J. M., Lafontaine M., Lefer M., Mercier-Gallay M., Villemot P., Whebi V., Coulon J. P. Risk of lung, larynx, pharynx and buccal cavity cancers among carbon electrode manufacturing workers. Scand J Work Environ Health. 1989 Feb;15(1):30–37. doi: 10.5271/sjweh.1885. [DOI] [PubMed] [Google Scholar]
  53. Murphy S. E., Carmella S. G., Idris A. M., Hoffmann D. Uptake and metabolism of carcinogenic levels of tobacco-specific nitrosamines by Sudanese snuff dippers. Cancer Epidemiol Biomarkers Prev. 1994 Jul-Aug;3(5):423–428. [PubMed] [Google Scholar]
  54. Negri E., Piolatto G., Pira E., Decarli A., Kaldor J., La Vecchia C. Cancer mortality in a northern Italian cohort of rubber workers. Br J Ind Med. 1989 Sep;46(9):624–628. doi: 10.1136/oem.46.9.624. [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Norell S., Ahlbom A., Lipping H., Osterblom L. Oesophageal cancer and vulcanisation work. Lancet. 1983 Feb 26;1(8322):462–463. doi: 10.1016/s0140-6736(83)91453-8. [DOI] [PubMed] [Google Scholar]
  56. Norseth T., Andersen A., Giltvedt J. Cancer incidence in the rubber industry in Norway. Scand J Work Environ Health. 1983;9 (Suppl 2):69–71. [PubMed] [Google Scholar]
  57. Nutt A. Rubber work and cancer--past, present and perspectives. Scand J Work Environ Health. 1983;9 (Suppl 2):49–57. [PubMed] [Google Scholar]
  58. Osborne J. W., Wolff M. S. Vacuum trituration of two amalgam alloys (Dispersalloy and Tytin): clinical and laboratory evaluation. Oper Dent. 1984 Summer;9(3):94–100. [PubMed] [Google Scholar]
  59. Oury B., Limasset J. C., Protois J. C. Assessment of exposure to carcinogenic N-nitrosamines in the rubber industry. Int Arch Occup Environ Health. 1997;70(4):261–271. doi: 10.1007/s004200050217. [DOI] [PubMed] [Google Scholar]
  60. Pour P. M. Prostatic cancer induced in MRC rats by N-nitrosobis(2-oxopropyl)-amine and N-nitrosobis(2-hydroxypropyl)amine. Carcinogenesis. 1983;4(1):49–55. doi: 10.1093/carcin/4.1.49. [DOI] [PubMed] [Google Scholar]
  61. Pour P., Lawson T. A., Cohen S. M. Proliferative changes in the prostate. Toxicol Appl Pharmacol. 1989 Dec;101(3):499–509. doi: 10.1016/0041-008x(89)90198-1. [DOI] [PubMed] [Google Scholar]
  62. Preston-Martin S., Correa P. Epidemiological evidence for the role of nitroso compounds in human cancer. Cancer Surv. 1989;8(2):459–473. [PubMed] [Google Scholar]
  63. Preston-Martin S. Evaluation of the evidence that tobacco-specific nitrosamines (TSNA) cause cancer in humans. Crit Rev Toxicol. 1991;21(4):295–298. doi: 10.3109/10408449109017915. [DOI] [PubMed] [Google Scholar]
  64. Preston-Martin S., Mack W. Gliomas and meningiomas in men in Los Angeles County: investigation of exposures to N-nitroso compounds. IARC Sci Publ. 1991;(105):197–203. [PubMed] [Google Scholar]
  65. Preston-Martin S., Mack W., Henderson B. E. Risk factors for gliomas and meningiomas in males in Los Angeles County. Cancer Res. 1989 Nov 1;49(21):6137–6143. [PubMed] [Google Scholar]
  66. Preston-Martin S., Yu M. C., Benton B., Henderson B. E. N-Nitroso compounds and childhood brain tumors: a case-control study. Cancer Res. 1982 Dec;42(12):5240–5245. [PubMed] [Google Scholar]
  67. Preussmann R. I.1 Public health significance of environmental N-nitroso compounds. IARC Sci Publ. 1983;(45):3–17. [PubMed] [Google Scholar]
  68. Preussmann R. Occurrence and exposure to N-nitroso compounds and precursors. IARC Sci Publ. 1984;(57):3–15. [PubMed] [Google Scholar]
  69. Reh B. D., Fajen J. M. Worker exposures to nitrosamines in a rubber vehicle sealing plant. Am Ind Hyg Assoc J. 1996 Oct;57(10):918–923. doi: 10.1080/15428119691014431. [DOI] [PubMed] [Google Scholar]
  70. Robertson G. S., Gibson P. J., London N. J., Johnson P. R., Iqbal S. J., Bell P. R. Does subclinical pancreatic inflammation occur after parathyroidectomy? Ann R Coll Surg Engl. 1995 Mar;77(2):102–106. [PMC free article] [PubMed] [Google Scholar]
  71. Rogers M. A., Vaughan T. L., Davis S., Thomas D. B. Consumption of nitrate, nitrite, and nitrosodimethylamine and the risk of upper aerodigestive tract cancer. Cancer Epidemiol Biomarkers Prev. 1995 Jan-Feb;4(1):29–36. [PubMed] [Google Scholar]
  72. Rounbehler D. P., Reisch J., Fine D. H. Nitrosamines in new motor-cars. Food Cosmet Toxicol. 1980 Apr;18(2):147–151. doi: 10.1016/0015-6264(80)90068-1. [DOI] [PubMed] [Google Scholar]
  73. Saffhill R., Badawi A. F., Hall C. N. Detection of O6-methylguanine in human DNA. IARC Sci Publ. 1988;(89):301–305. [PubMed] [Google Scholar]
  74. Schroeder J. C., Tolbert P. E., Eisen E. A., Monson R. R., Hallock M. F., Smith T. J., Woskie S. R., Hammond S. K., Milton D. K. Mortality studies of machining fluid exposure in the automobile industry. IV: A case-control study of lung cancer. Am J Ind Med. 1997 May;31(5):525–533. doi: 10.1002/(sici)1097-0274(199705)31:5<525::aid-ajim5>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  75. Selikoff I. J., Hammond E. C. Asbestos-associated disease in United States shipyards. CA Cancer J Clin. 1978 Mar-Apr;28(2):87–99. doi: 10.3322/canjclin.28.2.87. [DOI] [PubMed] [Google Scholar]
  76. Shirai T., Yamamoto A., Imaida K., Tamano S., Mori T., Hasegawa R. Lack of synergism among DMAB, BOP, and MNU in induction of carcinomas of the rat ventral prostate. Teratog Carcinog Mutagen. 1992;12(2):71–77. doi: 10.1002/tcm.1770120204. [DOI] [PubMed] [Google Scholar]
  77. Shirari T., Tamano S., Takahashi S., Ito N. Animal prostate carcinoma models: limited potential for vertebral metastasis. Adv Exp Med Biol. 1992;324:151–158. doi: 10.1007/978-1-4615-3398-6_15. [DOI] [PubMed] [Google Scholar]
  78. Smith T. J., Liao A., Wang L. D., Yang G. Y., Starcic S., Philbert M. A., Yang C. S. Characterization of xenobiotic-metabolizing enzymes and nitrosamine metabolism in the human esophagus. Carcinogenesis. 1998 Apr;19(4):667–672. doi: 10.1093/carcin/19.4.667. [DOI] [PubMed] [Google Scholar]
  79. Solionova L. G., Smulevich V. B. Mortality and cancer incidence in a cohort of rubber workers in Moscow. Scand J Work Environ Health. 1993 Apr;19(2):96–101. doi: 10.5271/sjweh.1491. [DOI] [PubMed] [Google Scholar]
  80. Sorahan T., Parkes H. G., Veys C. A., Waterhouse J. A., Straughan J. K., Nutt A. Mortality in the British rubber industry 1946-85. Br J Ind Med. 1989 Jan;46(1):1–10. doi: 10.1136/oem.46.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  81. Spiegelhalder B., Preussmann R., Hartung M. Biological monitoring in the metal working industry. IARC Sci Publ. 1984;(57):943–946. [PubMed] [Google Scholar]
  82. Spiegelhalder B., Preussmann R. Occupational nitrosamine exposure. 1. Rubber and tyre industry. Carcinogenesis. 1983 Sep;4(9):1147–1152. doi: 10.1093/carcin/4.9.1147. [DOI] [PubMed] [Google Scholar]
  83. Straif K., Weiland S. K., Keil U. Re: "Occupational risk factors for gastric cancer: an overview". Am J Epidemiol. 1998 Mar 15;147(6):608–610. doi: 10.1093/oxfordjournals.aje.a009497. [DOI] [PubMed] [Google Scholar]
  84. Straif K., Weiland S. K., Werner B., Chambless L., Mundt K. A., Keil U. Workplace risk factors for cancer in the German rubber industry: Part 2. Mortality from non-respiratory cancers. Occup Environ Med. 1998 May;55(5):325–332. doi: 10.1136/oem.55.5.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  85. Straughan J. K. Cancer risk in the rubber industry: a review of recent epidemiological evidence. Occup Environ Med. 1998 Sep;55(9):646–647. doi: 10.1136/oem.55.9.646. [DOI] [PMC free article] [PubMed] [Google Scholar]
  86. Sullivan P. A., Eisen E. A., Woskie S. R., Kriebel D., Wegman D. H., Hallock M. F., Hammond S. K., Tolbert P. E., Smith T. J., Monson R. R. Mortality studies of metalworking fluid exposure in the automobile industry: VI. A case-control study of esophageal cancer. Am J Ind Med. 1998 Jul;34(1):36–48. doi: 10.1002/(sici)1097-0274(199807)34:1<36::aid-ajim6>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  87. Swann P. F. Effect of ethanol on nitrosamine metabolism and distribution. Implications for the role of nitrosamines in human cancer and for the influence of alcohol consumption on cancer incidence. IARC Sci Publ. 1984;(57):501–512. [PubMed] [Google Scholar]
  88. Symons M. J., Andjelkovich D. A., Spirtas R., Herman D. R. Brain and central nervous system cancer mortality in U. S. rubber workers. Ann N Y Acad Sci. 1982;381:146–159. doi: 10.1111/j.1749-6632.1982.tb50379.x. [DOI] [PubMed] [Google Scholar]
  89. Szeszenia-Dabrowska N., Wilczyńska U., Kaczmarek T., Szymczak W. Cancer mortality among male workers in the Polish rubber industry. Pol J Occup Med Environ Health. 1991;4(2):149–157. [PubMed] [Google Scholar]
  90. Thun M. J., Peto R., Lopez A. D., Monaco J. H., Henley S. J., Heath C. W., Jr, Doll R. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med. 1997 Dec 11;337(24):1705–1714. doi: 10.1056/NEJM199712113372401. [DOI] [PubMed] [Google Scholar]
  91. Tolbert P. E., Eisen E. A., Pothier L. J., Monson R. R., Hallock M. F., Smith T. J. Mortality studies of machining-fluid exposure in the automobile industry. II. Risks associated with specific fluid types. Scand J Work Environ Health. 1992 Dec;18(6):351–360. doi: 10.5271/sjweh.1562. [DOI] [PubMed] [Google Scholar]
  92. Umbenhauer D., Wild C. P., Montesano R., Saffhill R., Boyle J. M., Huh N., Kirstein U., Thomale J., Rajewsky M. F., Lu S. H. O(6)-methyldeoxyguanosine in oesophageal DNA among individuals at high risk of oesophageal cancer. Int J Cancer. 1985 Dec 15;36(6):661–665. doi: 10.1002/ijc.2910360607. [DOI] [PubMed] [Google Scholar]
  93. Wacholder S., Hartge P., Lubin J. H., Dosemeci M. Non-differential misclassification and bias towards the null: a clarification. Occup Environ Med. 1995 Aug;52(8):557–558. doi: 10.1136/oem.52.8.557. [DOI] [PMC free article] [PubMed] [Google Scholar]
  94. Weiland S. K., Mundt K. A., Keil U., Kraemer B., Birk T., Person M., Bucher A. M., Straif K., Schumann J., Chambless L. Cancer mortality among workers in the German rubber industry: 1981-91. Occup Environ Med. 1996 May;53(5):289–298. doi: 10.1136/oem.53.5.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  95. Weiland S. K., Straif K., Chambless L., Werner B., Mundt K. A., Bucher A., Birk T., Keil U. Workplace risk factors for cancer in the German rubber industry: Part 1. Mortality from respiratory cancers. Occup Environ Med. 1998 May;55(5):317–324. doi: 10.1136/oem.55.5.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  96. Wu Y., Chen J., Ohshima H., Pignatelli B., Boreham J., Li J., Campbell T. C., Peto R., Bartsch H. Geographic association between urinary excretion of N-nitroso compounds and oesophageal cancer mortality in China. Int J Cancer. 1993 Jul 9;54(5):713–719. doi: 10.1002/ijc.2910540502. [DOI] [PubMed] [Google Scholar]
  97. Zheng W., Blot W. J., Shu X. O., Diamond E. L., Gao Y. T., Ji B. T., Fraumeni J. F., Jr Risk factors for oral and pharyngeal cancer in Shanghai, with emphasis on diet. Cancer Epidemiol Biomarkers Prev. 1992 Sep-Oct;1(6):441–448. [PubMed] [Google Scholar]
  98. Zou X. N., Lu S. H., Liu B. Volatile N-nitrosamines and their precursors in Chinese salted fish--a possible etological factor for NPC in china. Int J Cancer. 1994 Oct 15;59(2):155–158. doi: 10.1002/ijc.2910590202. [DOI] [PubMed] [Google Scholar]

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