Occupational Lead Exposure and Associations with Selected Cancers: The Shanghai Men’s and Women’s Health Study Cohorts

Liao, Linda M.; Friesen, Melissa C.; Xiang, Yong‐Bing; Cai, Hui; Koh, Dong-Hee; Ji, Bu‐Tian; Yang, Gong; Li, Honglan; Locke, Sarah J.; Rothman, Nathaniel; Zheng, Wei; Gao, Yu‐Tang; Shu, Xiao‐Ou; Purdue, Mark P.

doi:10.1289/ehp.1408171

Cited by 70 publications

(45 citation statements)

References 31 publications

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“…Hence, there is little information about specific cancer sites among men with high exposure in this cohort. Liao et al 30 studied cancer incidence among approximately 7000 lead-exposed men and women workers in two plants in Shanghai, comparing them with a large number of unexposed workers, and using a job-exposure matrix to classify workers into none, low, medium and high exposure to either lead dust or fumes. Overall, there were suggestions of an excess among exposed versus non-exposed workers for brain cancer (rate ratio (RR) 1.8, 0.704.28, 10 exposed cases) and kidney cancer (RR 1.4, (0.9–2.3), 17 exposed cases).…”

Section: Discussionmentioning

confidence: 99%

A cohort mortality study of lead-exposed workers in the USA, Finland and the UK

et al. 2017

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Objectives To investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study. Methods We conducted internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates. results The combined cohort had a median BL of 26 µg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p<0.05) positive trends, using the log of each worker's maximum BL, were found for lung cancer, chronic obstructive pulmonary disease (COPD), stroke and heart disease, while borderline significant trends (0.05≤p≤0.10) were found for bladder cancer, brain cancer and larynx cancer. Most results were consistent across all three cohorts. In external comparisons, we found significantly elevated SMRs for those with BLs>40 µg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL. conclusions We found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking.

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Section: Discussionmentioning

confidence: 99%

A cohort mortality study of lead-exposed workers in the USA, Finland and the UK

et al. 2017

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“…Lead is a highly prevalent and persistent environmental toxicant that is widely used in different industries . Because of its chemical properties, lead is used in a wide variety of industries and is the fifth most frequently used metal worldwide .…”

Section: Introductionmentioning

confidence: 99%

“…Lead's effect on the haematologic system is typically manifested by a mild hypochromic, microcytic, sometimes haemolytic, anaemia . Some studies have suggested carcinogenic effects of lead for stomach, lung, kidney, brain and meninges, though the evidence in this area has conflicting results . Overall, high BLLs have been associated with increased mortality from various causes …”

Section: Introductionmentioning

confidence: 99%

Impact of chronic lead exposure on liver and kidney function and haematologic parameters

Nakhaee

Amirabadizadeh

Brent

et al. 2018

Basic Clin Pharma Tox

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Background: Lead, one of the most widely used metals because of its beneficial physical properties, has been reported to adversely influence several different organs and organ systems. The aim of the present study was to examine the effect of lead exposure on liver and renal function and haematologic parameters. Methods: This was a case-cohort study comparing adults with occupational, environmental or opium-related lead exposure with blood lead levels [BLL] >10 μg/ dL (High blood lead level (HBLL) group and age-and gender-matched normal healthy individuals (Low blood lead level [LBLL] group with BLL <10 μg/dL). The complete blood count and concentrations of serum creatinine, urea, aspartate aminotransferase (AST), alanine aminotransferase (ALT) were recorded for subsequent investigation. Results: The mean BLL was significantly higher in the HBLL than in the LBLL groups (51.36 ± 44.72 vs 4.17 ± 1.97 µg/dL). The Spearman's rho revealed a significant association between BLL and urea (r = 0.25, P < 0.001), creatinine (r = 0.16, P = 0.02), AST (r = 0.42, P < 0.001) and ALT (r = 0.27, P < 0.001). The median [IQR] serum urea (34 mg/dL [27-221]) vs (30 [27-36]), creatinine (0.9 mg/dL [0.8-1]) vs (0.8 [0.7-0.9]), ALT (25 mg/dL [16-49]) vs (22 [16-30]) and AST concentrations (29 mg/dL [20-42]) vs (20 [18-24]) were all significantly higher (P < 0.05) in the HBLL group compared to the LBLL group.The median ]) vs (15.2 [14.6-16.3] and haematocrit (36.9% [31-44.8]) vs (45.6 [43.6-48.2]) were both significantly lower (P < 0.001) in the HBLL group than in the LBLL group. Conclusion: The results indicated that people with chronic lead exposure with BLLs greater than 10 μg/dL are at risk of renal, liver and haematologic impairments.

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“…Since smoking is a predictor of blood lead,25 the potential for residual confounding by other carcinogens in cigarette smoke cannot be ruled out as an explanation for these findings. Exposure to lead, as estimated by a job-exposure matrix, was associated with a non-significant increase in kidney cancer risk among participants in the Shanghai Men’s and Women’s Health Study cohorts 4. Kidney cancer has been assessed in two occupational cohort studies of lead-exposed workers that did not adjust for smoking.…”

Section: Discussionmentioning

confidence: 99%

Case-control investigation of occupational lead exposure and kidney cancer

Callahan¹,

Friesen²,

Locke³

et al. 2019

Occup Environ Med

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ObjectivesLead is a suspected carcinogen that has been inconsistently associated with kidney cancer. To clarify this relationship, we conducted an analysis of occupational lead exposure within a population-based study of kidney cancer using detailed exposure assessment methods.MethodsStudy participants (1217 cases and 1235 controls), enrolled between 2002 and 2007, provided information on their occupational histories and, for selected lead-related occupations, answered questions regarding workplace tasks, and use of protective equipment. Industrial hygienists used this information to develop several estimates of occupational lead exposure, including probability, duration and cumulative exposure. Unconditional logistic regression was used to compute ORs and 95% CIs for different exposure metrics, with unexposed subjects serving as the reference group. Analyses were also conducted stratifying on several factors, including for subjects of European ancestry only, single nucleotide polymorphisms in ALAD (rs1805313, rs1800435, rs8177796, rs2761016), a gene involved in lead toxicokinetics.ResultsIn our study, cumulative occupational lead exposure was not associated with kidney cancer (OR 0.9, 95% CI 0.7 to 1.3 for highest quartile vs unexposed; ptrend=0.80). Other lead exposure metrics were similarly null. We observed no evidence of effect modification for the evaluated ALAD variants (subjects of European ancestry only, 662 cases and 561 controls) and most stratifying factors, although lead exposure was associated with increased risk among never smokers.ConclusionsThe findings of this study do not offer clear support for an association between occupational lead exposure and kidney cancer.

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Occupational Lead Exposure and Associations with Selected Cancers: The Shanghai Men’s and Women’s Health Study Cohorts

Cited by 70 publications

References 31 publications

A cohort mortality study of lead-exposed workers in the USA, Finland and the UK

A cohort mortality study of lead-exposed workers in the USA, Finland and the UK

Impact of chronic lead exposure on liver and kidney function and haematologic parameters

Case-control investigation of occupational lead exposure and kidney cancer

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