A meta-analysis on the association between bladder cancer and occupation

Reulen, Raoul C.; Kellen, Eliane; Buntinx, Frank; Brinkman, Maree; Zeegers, Maurice P.

doi:10.1080/03008880802325192

Cited by 110 publications

(106 citation statements)

References 122 publications

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“…3 The second commonest exposure to carcinogens is through occupational tasks. 4 This route has been known for many years, includes a genetic interaction with detoxification enzymes 5,6 and has been reduced through workplace health and safety regulations in most countries. Examples include European Union directives (eg, Council Directives 90/394/EEC 7 and 98/24/EC 8 ) and the 2002 Control of Substances Hazardous to Health Regulations in the United Kingdom.…”

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confidence: 99%

Contemporary Occupational Carcinogen Exposure and Bladder Cancer

et al. 2015

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IMPORTANCEBladder cancer (BC) is a common disease. Despite manufacturing and legislative changes to workplace hygiene, many BCs still arise through occupational carcinogen exposure.OBJECTIVE To profile contemporary risks of occupational BC.DATA SOURCES A systematic review using PubMed, Medline, Embase, and Web of Science was performed in October 2012 (initial review) and May 2014 (final review) and was updated in June 2015.STUDY SELECTION We identified 263 eligible articles. We excluded reports in which BC or occupation were not the main focus, and those with insufficient case, risk, or confidence interval data. We selected the most recent data from populations with multiple reports.DATA EXTRACTION AND SYNTHESIS Reports were selected by 2 of us independently. We combined odds ratios and risk ratios (RRs) to provide pooled RRs, using maximally adjusted RRs in a random effects model. Heterogeneity and publication bias were assessed using I 2 and Begg and Egger tests. Risk estimates were annotated by occupational class using Nordisk Yrkesklassificering, or Nordic Occupational Classification, and International Standard Classifications of Occupations (NYK and ISCO-1958) Codes. MAIN OUTCOMES AND MEASURESOccupations were profiled by BC incidence and mortality risk over time. After data collection, we detected a sex difference in these profiles and recorded this as a secondary outcome.RESULTS Meta-analysis revealed increased BC incidence in 42 of 61 occupational classes and increased BC-specific mortality in 16 of 40 occupational classes. Reduced incidence and mortality were seen in 6 of 61 and 2 of 40 classes, respectively. Risk varied with sex and was greatest in men (standardized incidence ratio, 1.03 [95% CI, 1.02-1.03]; P < .001]). From the 1960s to the 1980s, there was a steady decline in standarized incidence ratio (SIR) for both sexes. This trend reversed from the 1980s, as in the decade 2000 to 2010 the SIR increased to 1.13 (95% CI, 1.07-1.19) for men and 1.27 (95% CI, 1.12-1.43) for women. In contrast, mortality risk declined for both sexes from the 1960s to the 1990s. The overall risk of BC mortality was also greater for men (standardized mortality ratio [SMR], 1.32 [95% CI, 1.18-1.48]) than for women (SMR, 1.14 [95% CI,). Limitations include possible publication bias, that reports stratify workers mostly by job title not task, that not all studies adjusted for smoking, and that the population was mostly derived from Western nations.CONCLUSIONS AND RELEVANCE The profile of contemporary occupations with increased BC risk is broad and differs for incidence and mortality. Currently the incidence seems to be increasing, and this increase is occurring faster in women than men. Improved detection mechanisms and screening are possible reasons for this. Workers with aromatic amine exposure have the highest incidence, while those exposed to polycyclic aromatic hydrocarbons and heavy metals have the greatest mortality.

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confidence: 99%

Contemporary Occupational Carcinogen Exposure and Bladder Cancer

et al. 2015

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“…The summary relative risk conferred by occupational exposures range from 1.2 to 1.4. 47 Aromatic amines, to which exposure occurs in the chemical and rubber industries, are major occupational carcinogens. Dyestuff workers exposed to one or more substances including benzidine, beta-naphthylamine, alpha-naphthylamine and dianisidine were followed completely, and the incidence of urothelial carcinoma was determined by periodic urological screenings.…”

Section: Occupational Carcinogen Exposurementioning

confidence: 99%

Epidemiology of urothelial carcinoma

2017

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The epithelium lining is defined as the mucosal surfaces of the renal collecting tubules, calyces and pelvis, as well as the ureter, bladder and urethra. The term "urothelium" is used to refer to these surfaces. Upper tract urothelial carcinoma is a rare subset of urothelial cancers with a poor prognosis. Urinary bladder cancer is the most common malignancy involving the urinary system. Upper tract urothelial carcinoma is more common in men than in women, with a male-to-female ratio of 2:1. The incidence of urinary bladder cancer is also higher in men. Cigarette smoking and occupational exposure are the main upper tract urothelial carcinoma and urinary bladder cancer risk factors, while other factors are more specific to the carcinogenesis of upper tract urothelial carcinoma (i.e. Balkan endemic nephropathy, Chinese herb nephropathy). In Egypt until recent years, urinary bladder cancer was the most frequently diagnosed cancer due to Schistosoma haematobium. Substantial knowledge exists regarding the causes of upper tract urothelial carcinoma and urinary bladder cancer, and epidemiological studies have identified various chemical carcinogens that are believed to be responsible for most cases of urothelial carcinoma. In the era of precision medicine, genetic effects might play a direct role in the initiation and progression of urothelial carcinoma.

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“…Particularly, over 40 different occupations and more than 200 chemicals, mainly represented by PAHs, have been identified as risk factors for UC [5] . To date, the surveillance of risk populations has become an appreciable part of the urological workload and many authors published their data concerning the screening for UC in high risk population groups, reporting positive effects on patients' morbidity and mortality and on the costs of the healthcare system [9][10][11][14][15] . In the present study, we report our early experience concerning the development of UC in a risk group of workers, employed in a Ligurian coke plant, who were exposed to the products formed during coke production for a mean period of 16 years.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, we report our early experience concerning the development of UC in a risk group of workers, employed in a Ligurian coke plant, who were exposed to the products formed during coke production for a mean period of 16 years. In accordance with other authors, our screening protocol also included an extensive history and physical examination, in order to identify possible associated risk factors or suspect lesions for UC, followed by non-invasive urinary tests which could help to distinguish healthy individuals from those who required further examination such as cystoscopy, urography or CT scan [9][10][11][16][17] . Particularly, we decided to combine the execution of urine analysis with urinary cytology and the uCyt+ assay in order to produce a high detection rate for all forms of UC, limiting the need for cystoscopy only in the event of a positive urine analysis [18][19][20][21][22] .…”

Section: Discussionmentioning

confidence: 99%