| Petralia et al. [13] |
USA
(1986–1991) |
Benzene and PAHs
PAH exposure (no benzene): traffic, shipping and receiving clerks, inspectors, testers, graders in motor vehicles industry
Benzene exposure (no PAH): laboratory technologists and technicians, painters, sculptors, artists, assemblers in motor vehicle industry
PAH and benzene: bus truck and stationary engine mechanics, molding and casting machine operators, garage, and service station occupation |
Women with premenopausal breast cancer (age: ≥40 years) (n.301)
Referents matched by age and country of residence (n.316) |
-
✓
Tumors with ER >10 fmol/mg or cells with ER > 10% classified as ER-positive.
-
✓
Personal, medical, and occupational histories obtained by interviews.
-
✓
Exposure assessed by job-exposure matrices
|
-
✓
Overall breast cancer risk increased with ever being exposed to chemicals. Benzene (possible PAH co-exposure) (OR: 1.91; 95%CI 1.18–3.08); PAH (possible benzene co-exposure) (OR: 1.82; 95%CI 1.02–3.16); PAH and benzene -all exposed groups (OR: 2.01; 95%CI 1.08–3.75); exclusively benzene (OR: 1.70; 95%CI 1.17–2.92)
-
✓
No increased overall breast cancer risk following exposure to PAH alone (OR: 1.01; 95%CI 0.55–3.45)
-
✓
Increased risk of ER-positive cases in all exposure, except benzene alone: PAH (possible benzene co-exposure) (OR: 2.27; 95%CI 1.14–4.54); Benzene (possible PAH co-exposure) (OR: 2.29; 95%CI 1.27–4.13), PAH and benzene (OR: 2.54; 95%CI 1.28–5.04); Exclusively benzene (OR: 1.74; 95%CI 0.72–4.21).
-
✓
No increased risk for ER-positive tumors for PAH exposure alone (OR: 0.78; 95%CI 0.12–5.03)
-
✓
ER-negative cases: PAH (possible benzene co-exposure) (OR: 1.12; 95%CI 0.47–2.64); Benzene (possible PAH co-exposure) (OR: 1.49; 95%CI 0.74–3.02), exclusively PAH (OR: 1.79; 0.46–8.52); PAH and benzene (OR: 1.28; 95%CI 0.52–3.15); Exclusively benzene (OR: 2.10; 95%CI 0.87–5.53).
|
| Labreche et al. [14] |
Canada
(1996–1997) |
Organic solvents in broad categories
Organic solvents: gasoline, diesel, jet fuel engine emissions and mineral spirits
Monoaromatic hydrocarbons: benzene, toluene, xylene, and styrene
Compounds containing PAH from petroleum: carbon black, petroleum soot, jet fuel engine emissions, oil-based cutting fluids and more
Other chemicals: wool, acrylic and rayon fibers |
Women with postmenopausal primary breast (n.556; 50–75 years old)
Women with other cancers matched by age (n.613) |
-
✓
Personal, medical, and occupational histories obtained by interviews.
-
✓
Exposure assessed translating all jobs into a set of exposure indices by a team of experienced industrial hygienists and chemists
-
✓
Hormonal receptor status categorized as positive or negative for ER and/or PR, as provided in the pathology reports.
|
-
✓
No significant alterations in risk of postmenopausal breast cancer with lifetime (OR: 1.14; 95%CI 0.80–1.62), or early (<36 years) exposure to organic solvents (OR: 1.30; 95%CI 0.65–2.60).
-
✓
Organic solvents increased the risk for ER-positive/PR-negative tumors in early exposures (<36 years) (OR: 3.31; 95%CI 1.07–10.20)
-
✓
PAHs from petroleum associated with increased risk of ER-positive/PR-positive tumors for both lifetime (OR: 1.65; 95%CI 0.97–2.83) and early (OR: 3.00; 95%CI 1.10–8.13) exposure.
-
✓
Acrylic fibers: For ER-positive/PR-negative tumors the risk tripled for each 10-year increase in duration on exposure to organic solvents and more than doubled for each 10-year increase in duration of exposure to monoaromatic hydrocarbons. Exposure to PAHs from petroleum tripled the risk for ER-positive/PR-positive tumors.
|
| Peplonska et al. [15] |
Poland
(2000–2003) |
Organic solvents and benzene
“Organic solvents” include aromatic, aliphatic, chlorinated hydrocarbons, ketones, organic acid esters, petroleum distillates. |
Female newly diagnosed with in situ or invasive breast cancer (n.2383; age: 20–74 years)
Controls matched to the cases by city of residence and age (n.2502). |
-
✓
Personal, medical, and occupational histories obtained by questionnaires, medical records, and pathology forms.
-
✓
Occupational exposure scored as intensity, probability, and duration.
-
✓
ER and PR status determined by immunohistochemistry or biochemical methods.
|
-
✓
Non-significant increase in breast cancer risk in women ever exposed to organic solvents (OR: 1.16; 95%CI 0.99–1.4). No significant changes for benzene exposure alone (OR: 1.00; 95%CI 0.8–1.3)
-
✓
None of the exposure metrics showed evidence for a exposure-response risk of breast cancer.
-
✓
Exposure to organic solvents significantly associated with an increased risk for negative ER and PR tumors (OR 1.40; 95%CI 1.1–1.8).
|
| Ekenga et al. [16] |
USA and Puerto Rico
(2003–2009) |
Solvent exposed occupations
Building and grounds cleaning and maintenance; education, training, and library; food preparation and serving related; healthcare practitioner and technical; management; office administrative and support; production occupations. |
Women enrolled in the Sister Study (n. 47,661 sisters of women with breast cancer) occupationally exposed to solvents
Women diagnosed with breast cancer during follow-up (n. 1798) |
-
✓
Personal, medical, and occupational histories obtained by interviews and questionnaires.
-
✓
Most commonly reported solvent-exposed occupations classified into major categories.
-
✓
Data on receptor status obtained by medical record, pathology report data or self-reported.
|
-
✓
No increased risk of invasive breast cancer among women occupationally exposed to solvents (HR: 1.04; 95%CI 0.88–1.24).
-
✓
Non-significant increase for ER-positive tumors in exposed women (HR: 1.15; 95%CI 0.95–1.39)
-
✓
ER-positive tumors significantly associated with exposure before the birth of their first child (HR 1.39; 95% CI 1.03–1.86) and first exposure to solvents occurred before 1980 (HR: 1.28; 95%CI 1.01–1.62).
-
✓
Significantly elevated risk for ER-positive cancers associated in clinical laboratory technologists and technicians who worked with solvents (HR: 2.00, 95%CI: 1.07–3.73)
|
| Glass et al. [17] |
Australia
(2009–2011) |
Solvents
Benzene, other aromatic, aliphatic, chlorinated solvents, and alcohol |
Women with first incident invasive primary breast cancer (n.1205; aged 18–80 years)
Randomly selected age-matched controls (n.1789) |
-
✓
Personal, medical, and occupational histories obtained by interviews and questionnaires.
-
✓
Occupational solvents exposure assessed using telephone interview and the web-based application OccIDEAS.
-
✓
Information on ER status obtained by interviews and questionnaires.
|
-
✓
Non-significant increase in the risk of breast cancer among women professionally exposed to aliphatic (OR 1.21; 95% CI 0.99-1.48) and aromatic (OR 1.21; 95% CI 0.97–1.52) solvents
-
✓
No differences detected for hormonal receptor status.
|
| Lee et al. [18] |
Canada
(2005–2010) |
Polycyclic aromatic hydrocarbons
Food-service industry (>20%) |
Women aged 40–80 years diagnosed with in situ or invasive breast cancer (n.1130).
Women recruited from the Breast Screening Programme as age-matched controls (n.1169) |
-
✓
Personal, medical, and occupational histories obtained with questionnaires
-
✓
Exposure to PAHs assessed by a job exposure matrix based on a statistical model
|
-
✓
Exposure to any level of PAHs associated with a significantly increased risk of breast cancer (OR: 1.32, 95%CI 1.10–1.59)
-
✓
Evidence of increased risk with duration of exposure apparent for medium or high exposure levels (the longest duration: OR: 1.41, 95%CI: 1.10–1.81) and high exposure levels (the longest duration: OR: 1.45, 95%CI: 1.10–1.91).
-
✓
No difference in breast cancer risk observed by receptor status
|
| Lerro et al. [19] |
USA
(Enrollment: 1993–1997; Follow-up: until 2010–2011) |
Organophosphate (OP) insecticides
OP insecticides: chlorpyrifos, coumaphos, diazinon, dichlorvos, fonofos, malathion, parathion, phorate, terbufos, trichlorfon |
Spouses of private pesticide applicators (n. 30,003)
Women with diagnosed breast cancer during the follow up period (n. 718) |
-
✓
Personal, medical, and occupational histories obtained by questionnaires.
-
✓
Pesticides exposure assessed by questionnaires
-
✓
Incident breast cancer cases ascertained through population-based cancer registries.
|
-
✓
Any OP use associated with an elevated risk of breast cancer (RR: 1.20, 95%CI 1.01–1.43)
-
✓
Chlorpyrifos use (RR: 1.41, 95% CI: 1.00–1.99) and terbufos use (RR: 1.52; 95% CI 0.97–2.36) associated with non-significantly elevated risk of breast cancer
-
✓
Among post-menopausal women, significantly elevated risk of breast cancer associated with use of any OP (RR: 1.27, 95%CI 1.00–1.62), and non-significantly elevated breast cancer risk associated with chlorpyrifos (RR: 1.53, 95%CI 0.96–2.44) and terbufos (RR: 1.73; 95%CI 0.93–3.21).
-
✓
Chlorpyrifos was associated with a significantly increased risk of ER-negative/PR-negative breast cancer (RR: 2.26, 95% CI: 1.07–4.75)
|
| Engel et al. [20] |
USA
(Enrollment: 1993–1997; Follow-up: until 2010–2011) |
OP insecticides |
Spouses of private pesticide applicators (n.30594)
Women with diagnosed incident breast cancer during follow-up period (n.1081) |
-
✓
Personal, medical, and occupational histories obtained by questionnaires and interviews.
-
✓
Pesticides exposure assessed by questionnaires
-
✓
Incident breast cancer cases ascertained through population-based cancer registries.
|
-
✓
Ever personal use of any insecticide associated with risk of breast cancer (HR: 1.0; 95%CI 0.7–2.9)
-
✓
Significant association between breast cancer risk and ever use of chlorpyrifos (HR: 1.4, 95%CI: 1.0–2.0) and terbufos (HR: 1.5, 95% CI: 1.0–2.1).
-
✓
No significant differences in risk related to the woman’s use of insecticides according to ER tumoral status.
|
| Rabstein et al. [21] |
Germany
(2000–2004) |
Aromatic and heterocyclic amines (AHA)
Job activities: developing of films, rubber industry, using dyes, painting, working with tar. |
Incident breast cancer cases from the GENICA study, a German population-based case-control study (n.1155)
Age-matched controls (n.1143) |
-
✓
Data on breast cancer risk factors obtained with interviews.
-
✓
Expert rating applied to assess possible occupational exposure based on self-assessed tasks.
-
✓
Immunohistochemical staining of breast-cancer tissues: ER+ and PR+ when ≥10% cells showed nuclear staining.
|
-
✓
No significant association for occupational AHA exposure and risk of overall breast cancer (OR: 1.05; 95%CI 0.70–1.56 for >1-year exposure vs. none or < 1 year).
-
✓
No significant association for occupational AHA exposure and risk of ER-positive (OR: 1.26; 95%CI 0.81–1.95 for >1 year exposure vs. none or < 1 year) or ER-negative cancers (OR: 0.81; 95%CI 0.36–1.82 for >1 year exposure vs. none or < 1 year)
-
✓
No significant association for occupational AHA exposure and risk of PR-positive (OR: 1.24; 95%CI 0.79–1.94 for >1 year exposure vs. none or < 1 year) or PR-negative cancers (OR: 0.82; 95%CI 0.38–1.76 for >1 year exposure vs. none or < 1 year)
|
| Ekenga et al. [22] |
USA and Puerto Rico
(2003–2009) |
Different chemical substances
Acids, dyes or inks, gasoline or other petroleum products, glues, or adhesives, lubricating oils, metals, paints, pesticides, soldering materials, solvents and stains or varnishes. |
Women enrolled in the Sister Study (n. 45,674 sisters of women with breast cancer) occupationally exposed to different chemicals
Women diagnosed with breast cancer during follow-up (n. 1966) |
-
✓
Personal, medical, and occupational histories obtained by interviews and questionnaires.
-
✓
Cumulative exposure to each agent estimated as a function of frequency and duration of use; quartile cut points were used to assign participants to exposure categories
-
✓
Data on receptor status obtained by medical record, pathology report data, or self-reported.
|
-
✓
No significant associations between ever use of chemical agents and breast cancer risk.
-
✓
Significant association between occupational exposure to soldering materials and premenopausal breast cancer (HR: 1.8, 95%CI = 1.1–3.0).
-
✓
Women with cumulative exposure to gasoline or petroleum products ≥ the highest quartile cutoff had an elevated risk of total (HR: 2.3, 95% CI: 1.1–4.9) and invasive (HR: 2.5, 95% CI: 1.1–5.9) breast cancer compared with women in the lowest quartile.
-
✓
Risk estimates did not differ significantly by hormone receptor status.
-
✓
Exposure to gasoline or other petroleum products in the highest quartile associated with a non-significant increased risk of hormone-receptor positive breast cancer (Q4 vs. never used: HR: 1.4, 95% CI: 0.9–2.3; Q4 vs. Q1: HR: 2.5, 95% CI: 1.0–5.8).
-
✓
Borderline increased risk of hormone receptor-positive cancer observed for women in the highest quartile of exposure to paints (Q4 vs. never used: HR: 1.4, 95% CI: 1.0–2.0).
|
