Journal Article

Occupational exposure to arsenic, cadmium, chromium, lead and nickel, and renal cell carcinoma: a case–control study from Central and Eastern Europe

van Bemmel, Dana, Jinga, Viorel, Zaridze, David, Ferro, Gilles, Stewart, Patricia, Szeszenia-Dabrowska, Neonilia, Fontana, Luc, Bencko, Vladimir, Foretova, Lenka, Brennan, Paul, Karami, Sara, Moore, Lee E, Kollarova, Helena, Chow, Wong-Ho, Boffetta, Paolo, Matveev, Vsevolod, Janout, Vladimir, Rothman, Nathaniel

2011

Overview

ObjectivesTo investigate the risk of renal cell carcinoma (RCC) in Central and Eastern Europe in relation to exposure to known and suspected carcinogenic metals.MethodsDuring 1999–2003, the authors conducted a hospital-based study in Czech Republic, Poland, Romania and Russia, including 1097 cases of RCC and 1476 controls. Occupational exposure to arsenic, cadmium, chromium(III), chromium(VI), lead and nickel was assessed by teams of local industrial hygiene experts, based on detailed occupational questionnaires.ResultsThe ORs for RCC were 1.55 (95% CI 1.09 to 2.21) for exposure to lead and 1.40 (95% CI 0.69 to 2.85) for exposure to cadmium. No clear monotonic exposure–response relation was apparent for either duration of exposure or cumulative exposure to either metal, although the OR for the highest category of cumulative exposure to lead was 2.25 (95% CI 1.21 to 4.19). Exposure to other metals did not entail an increased risk of RCC.ConclusionsFor cadmium, the lack of statistical significance of most results, potential confounding and the absence of clear dose–response relations suggest that an association with RCC is unlikely to be causal. In the case of lead, however, the elevated risk in the category of highest cumulative exposure is noteworthy and justifies further investigation.

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group,BMJ Publishing Group LTD
• Subject: Adult / Aged / Apoptosis / Arsenic / Arsenic - toxicity / Cadmium / Cadmium - toxicity / cancer / Carcinogens / Carcinoma, Renal Cell - chemically induced / Carcinoma, Renal Cell - epidemiology / Case-Control Studies / Chromium / Chromium - toxicity / Employment / epidemiology / Europe, Eastern - epidemiology / Family medical history / Female / Gangrene / Heavy metals / Hospitals / Humans / Kidney cancer / Kidney Neoplasms - chemically induced / Kidney Neoplasms - epidemiology / Kidneys / Lead / Lead - toxicity / Lead acid batteries / Lead compounds / Lead industry / Male / Metals / Metals, Heavy - toxicity / Middle Aged / Mortality / Nickel / Nickel - toxicity / occupation / Occupational Diseases - chemically induced / Occupational Diseases - epidemiology / Occupational Exposure - adverse effects / Oxidative stress / Questionnaires / Recruitment / Renal cell carcinoma / Risk Factors / Studies / Tobacco smoking / Workplace