OCCUPATION AND THE RISK OF BLADDER-CANCER

La Vecchia C (Mario Negri Institute for Pharmacological Research, Via Eritrea 62, 20157 Milan, Italy), Negri E, D'Avanzo B and Franceschi S. Occupation and the risk of bladder cancer. International Journal of Epidemiology 1990; 19: 264-268.The relationship between bladder cancer, occupation and exposure to a number of occupational agents was assessed in a case-control study conducted in the greater Milan area, Northern Italy. The case series consisted of 263 cases (219 males, 44 females) with histologically confirmed invasive bladder cancer, admitted to a network including major teaching and general hospitals in the area under surveillance. The controls were 287 patients (210 males, 77 females), admitted for acute, non-neoplastic or urinary tract diseases to the same network of hospitals. Cases more frequently reported occupation in dyestuff production (relative risk (RR) = 4.6), painting/spraying work (RR = 1.8), chemicalindustry (RR = 1.7), pharmaceuticals (RR = 1.7) and coal/gas production (RR = 3.1). Only for dyestuff production however, was the excess statistically significant. There was no association with agriculture or related activities, rubber manufacturing, printing, the petroleum industry, food processing and mechanics. In relation to exposure to occupational agents, significant positive trends in risk were observed for dyes/paints (RR = 4.8 for > ten years of exposure), herbicides (RR = 4.1), chemicals (RR = 2.4) and gases/fumes (RR = 4.8). No association was found with metals or metal dusts, plastic resins or glues, oil, wood dust, solvents or benzene, asbestos, electricity or radar and coal tar. Besides confirming the well known association between bladder cancer risk and dyestuff production and, to a lesser extent, a wide spectrum of chemical-related activities, this study provides statistically significant evidence of an independent role of herbicides on the risk of bladder cancer. Some of the negative results, such as the absence of association with printing, furniture manufacturing, plastic resins or glues and mechanics (whose 90% upper confidence limit was 1.4) are of interest, too, and probably indicate that these occupations are not per se strongly related with bladder cancer risk, although contamination with bladder carcinogens may occur in specific situations, and hence explain the elevated risk found in other studies. © 1990 International Epidemiological Association.