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. 2001 Sep;58(9):590–596. doi: 10.1136/oem.58.9.590

Occupational risk factors for male bladder cancer: results from a population based case cohort study in the Netherlands

M Zeegers 1, G Swaen 1, I Kant 1, R Goldbohm 1, P A van den Brandt 1
PMCID: PMC1740187  PMID: 11511746

Abstract

OBJECTIVES—This study was conducted to estimate risk of bladder cancer associated with occupational exposures to paint components, polycyclic aromatic hydrocarbons (PAHs), diesel exhausts, and aromatic amines among the general population in The Netherlands.
METHODS—A prospective cohort study was conducted among 58 279 men. In September 1986, the cohort members (55-69 years) completed a self administered questionnaire on risk factors for cancer including job history. Follow up for incident bladder cancer was established by linkage to cancer registries until December 1992. A case-cohort approach was used based on 532 cases and 1630 subcohort members. A case by case expert assessment was carried out to assign to the cases and subcohort members a cumulative probability of occupational exposure for each carcinogenic exposure.
RESULTS—Men in the highest tertiles of occupational exposure to paint components, PAHs, aromatic amines, and diesel exhaust had non-significantly higher age and smoking adjusted incident rate ratios (RRs) of bladder cancer than men with no exposure: 1.29 (95% confidence interval (95% CI) 0.71 to 2.33), 1.24 (95% CI 0.68 to 2.27), 1.32 (95% CI 0.41 to 4.23) and 1.21 (95% CI 0.78 to 1.88), respectively. The associations between paint components and PAHs and risk of bladder cancer were most pronounced for current smokers. Among former smokers it seemed that for cumulative probability of exposure to paint components and PAHs, men who had smoked more than 15 cigarettes a day had RRs below unity compared with men who had smoked less than 15 cigarettes a day, whereas among current smokers the opposite was found. Exposure to diesel exhaust was positively associated with risk of bladder cancer among current and former smokers who had smoked more than 15 cigarettes a day.
CONCLUSIONS—This study provided only marginal evidence for an association between occupational exposure to paint components, PAHs, aromatic amines, and bladder cancer. Despite the small proportion of exposed subjects, an interaction with cigarette smoking was found, specifically for paint components, suggesting that the carcinogenic effect on the bladder might decrease after stopping smoking.


Keywords: bladder cancer; occupation; epidemiology

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Selected References

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  1. Barlow W. E. Robust variance estimation for the case-cohort design. Biometrics. 1994 Dec;50(4):1064–1072. [PubMed] [Google Scholar]
  2. Baxter P. J., McDowall M. E. Occupation and cancer in London: an investigation into nasal and bladder cancer using the Cancer Atlas. Br J Ind Med. 1986 Jan;43(1):44–49. doi: 10.1136/oem.43.1.44. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bethwaite P. B., Pearce N., Fraser J. Cancer risks in painters: study based on the New Zealand Cancer Registry. Br J Ind Med. 1990 Nov;47(11):742–746. doi: 10.1136/oem.47.11.742. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bonassi S., Merlo F., Pearce N., Puntoni R. Bladder cancer and occupational exposure to polycyclic aromatic hydrocarbons. Int J Cancer. 1989 Oct 15;44(4):648–651. doi: 10.1002/ijc.2910440415. [DOI] [PubMed] [Google Scholar]
  5. Bouyer J., Hémon D. Retrospective evaluation of occupational exposures in population-based case-control studies: general overview with special attention to job exposure matrices. Int J Epidemiol. 1993;22 (Suppl 2):S57–S64. doi: 10.1093/ije/22.supplement_2.s57. [DOI] [PubMed] [Google Scholar]
  6. Bouyer J., Hémon D. Studying the performance of a job exposure matrix. Int J Epidemiol. 1993;22 (Suppl 2):S65–S71. doi: 10.1093/ije/22.supplement_2.s65. [DOI] [PubMed] [Google Scholar]
  7. Burns P. B., Swanson G. M. Risk of urinary bladder cancer among blacks and whites: the role of cigarette use and occupation. Cancer Causes Control. 1991 Nov;2(6):371–379. doi: 10.1007/BF00054297. [DOI] [PubMed] [Google Scholar]
  8. 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]
  9. Claude J. C., Frentzel-Beyme R. R., Kunze E. Occupation and risk of cancer of the lower urinary tract among men. A case-control study. Int J Cancer. 1988 Mar 15;41(3):371–379. doi: 10.1002/ijc.2910410309. [DOI] [PubMed] [Google Scholar]
  10. Clavel J., Mandereau L., Limasset J. C., Hémon D., Cordier S. Occupational exposure to polycyclic aromatic hydrocarbons and the risk of bladder cancer: a French case-control study. Int J Epidemiol. 1994 Dec;23(6):1145–1153. doi: 10.1093/ije/23.6.1145. [DOI] [PubMed] [Google Scholar]
  11. Cordier S., Clavel J., Limasset J. C., Boccon-Gibod L., Le Moual N., Mandereau L., Hemon D. Occupational risks of bladder cancer in France: a multicentre case-control study. Int J Epidemiol. 1993 Jun;22(3):403–411. doi: 10.1093/ije/22.3.403. [DOI] [PubMed] [Google Scholar]
  12. Dosemeci M., Cocco P., Gómez M., Stewart P. A., Heineman E. F. Effects of three features of a job-exposure matrix on risk estimates. Epidemiology. 1994 Jan;5(1):124–127. doi: 10.1097/00001648-199401000-00019. [DOI] [PubMed] [Google Scholar]
  13. Englund A. Cancer incidence among painters and some allied trades. J Toxicol Environ Health. 1980 Sep-Nov;6(5-6):1267–1273. doi: 10.1080/15287398009529946. [DOI] [PubMed] [Google Scholar]
  14. Hours M., Dananche B., Fevotte J., Bergeret A., Ayzac L., Cardis E., Etard J. F., Pallen C., Roy P., Fabry J. Bladder cancer and occupational exposures. Scand J Work Environ Health. 1994 Oct;20(5):322–330. doi: 10.5271/sjweh.1390. [DOI] [PubMed] [Google Scholar]
  15. Jensen O. M., Wahrendorf J., Knudsen J. B., Sørensen B. L. The Copenhagen case-referent study on bladder cancer. Risks among drivers, painters and certain other occupations. Scand J Work Environ Health. 1987 Apr;13(2):129–134. doi: 10.5271/sjweh.2070. [DOI] [PubMed] [Google Scholar]
  16. Matanoski G. M., Stockwell H. G., Diamond E. L., Haring-Sweeney M., Joffe R. D., Mele L. M., Johnson M. L. A cohort mortality study of painters and allied tradesmen. Scand J Work Environ Health. 1986 Feb;12(1):16–21. doi: 10.5271/sjweh.2179. [DOI] [PubMed] [Google Scholar]
  17. Morrison A. S., Ahlbom A., Verhoek W. G., Aoki K., Leck I., Ohno Y., Obata K. Occupation and bladder cancer in Boston, USA, Manchester, UK, and Nagoya, Japan. J Epidemiol Community Health. 1985 Dec;39(4):294–300. doi: 10.1136/jech.39.4.294. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Parkin D. M., Vizcaino A. P., Skinner M. E., Ndhlovu A. Cancer patterns and risk factors in the African population of southwestern Zimbabwe, 1963-1977. Cancer Epidemiol Biomarkers Prev. 1994 Oct-Nov;3(7):537–547. [PubMed] [Google Scholar]
  19. Pesch B., Haerting J., Ranft U., Klimpel A., Oelschlägel B., Schill W. Occupational risk factors for urothelial carcinoma: agent-specific results from a case-control study in Germany. MURC Study Group. Multicenter Urothelial and Renal Cancer. Int J Epidemiol. 2000 Apr;29(2):238–247. doi: 10.1093/ije/29.2.238. [DOI] [PubMed] [Google Scholar]
  20. Porru S., Aulenti V., Donato F., Boffetta P., Fazioli R., Cosciani Cunico S., Alessio L. Bladder cancer and occupation: a case-control study in northern Italy. Occup Environ Med. 1996 Jan;53(1):6–10. doi: 10.1136/oem.53.1.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Schumacher M. C., Slattery M. L., West D. W. Occupation and bladder cancer in Utah. Am J Ind Med. 1989;16(1):89–102. doi: 10.1002/ajim.4700160110. [DOI] [PubMed] [Google Scholar]
  22. Siemiatycki J., Dewar R., Nadon L., Gérin M. Occupational risk factors for bladder cancer: results from a case-control study in Montreal, Quebec, Canada. Am J Epidemiol. 1994 Dec 15;140(12):1061–1080. doi: 10.1093/oxfordjournals.aje.a117207. [DOI] [PubMed] [Google Scholar]
  23. Silverman D. T., Levin L. I., Hoover R. N., Hartge P. Occupational risks of bladder cancer in the United States: I. White men. J Natl Cancer Inst. 1989 Oct 4;81(19):1472–1480. doi: 10.1093/jnci/81.19.1472. [DOI] [PubMed] [Google Scholar]
  24. Steenland K., Burnett C., Osorio A. M. A case-control study of bladder cancer using city directories as a source of occupational data. Am J Epidemiol. 1987 Aug;126(2):247–257. doi: 10.1093/aje/126.2.247. [DOI] [PubMed] [Google Scholar]
  25. Steinmaus C. M., Nuñez S., Smith A. H. Diet and bladder cancer: a meta-analysis of six dietary variables. Am J Epidemiol. 2000 Apr 1;151(7):693–702. doi: 10.1093/oxfordjournals.aje.a010264. [DOI] [PubMed] [Google Scholar]
  26. Terstegge CW, Swaen GM, Slangen JJ, Van Vliet C Mortality Patterns among Commercial Painters in The Netherlands. Int J Occup Environ Health. 1995 Oct;1(4):303–310. doi: 10.1179/oeh.1995.1.4.303. [DOI] [PubMed] [Google Scholar]
  27. Van den Brandt P. A., Schouten L. J., Goldbohm R. A., Dorant E., Hunen P. M. Development of a record linkage protocol for use in the Dutch Cancer Registry for Epidemiological Research. Int J Epidemiol. 1990 Sep;19(3):553–558. doi: 10.1093/ije/19.3.553. [DOI] [PubMed] [Google Scholar]
  28. Zeegers M. P., Tan F. E., Dorant E., van Den Brandt P. A. The impact of characteristics of cigarette smoking on urinary tract cancer risk: a meta-analysis of epidemiologic studies. Cancer. 2000 Aug 1;89(3):630–639. doi: 10.1002/1097-0142(20000801)89:3<630::aid-cncr19>3.3.co;2-h. [DOI] [PubMed] [Google Scholar]
  29. Zeegers M. P., Tan F. E., Verhagen A. P., Weijenberg M. P., van den Brandt P. A. Elevated risk of cancer of the urinary tract for alcohol drinkers: a meta-analysis. Cancer Causes Control. 1999 Oct;10(5):445–451. doi: 10.1023/a:1008938520686. [DOI] [PubMed] [Google Scholar]
  30. van Loon A. J., Kant I. J., Swaen G. M., Goldbohm R. A., Kremer A. M., van den Brandt P. A. Occupational exposure to carcinogens and risk of lung cancer: results from The Netherlands cohort study. Occup Environ Med. 1997 Nov;54(11):817–824. doi: 10.1136/oem.54.11.817. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. van den Brandt P. A., Goldbohm R. A., van 't Veer P., Volovics A., Hermus R. J., Sturmans F. A large-scale prospective cohort study on diet and cancer in The Netherlands. J Clin Epidemiol. 1990;43(3):285–295. doi: 10.1016/0895-4356(90)90009-e. [DOI] [PubMed] [Google Scholar]

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