Journal Article

Occupational bladder cancer: A cross section survey of previous employments, tasks and exposures matched to cancer phenotypes

Goodwin, Louise, Catto, James W. F., Griffin, Jon, Cumberbatch, Marcus G., Jubber, Ibrahim, Hussain, Syed, Noon, Aidan P., Reed, Oliver

2020

Overview

Up to 10% of Bladder Cancers may arise following occupational exposure to carcinogens. We hypothesised that different cancer phenotypes reflected different patterns of occupational exposure. Consecutive participants, with bladder cancer, self-completed a structured questionnaire detailing employment, tasks, exposures, smoking, lifestyle and family history. Our primary outcome was association between cancer phenotype and occupational details. We collected questionnaires from 536 patients, of whom 454 (85%) participants (352 men and 102 women) were included. Women were less likely to be smokers (68% vs. 81% Chi sq. p<0.001), but more likely than men to inhale environmental tobacco smoke at home (82% vs. 74% p = 0.08) and use hair dye (56% vs. 3%, p<0.001). Contact with potential carcinogens occurred in 282 (62%) participants (mean 3.1 per worker (range 0-14)). High-grade cancer was more common than low-grade disease in workers from the steel, foundry, metal, engineering and transport industries (p<0.05), and in workers exposed to crack detection dyes, chromium, coal/oil/gas by-products, diesel fumes/fuel/aircraft fuel and solvents (such as trichloroethylene). Higher staged cancers were frequent in workers exposed to Chromium, coal products and diesel exhaust fumes/fuel (p<0.05). Various workers (e.g. exposed to diesel fuels or fumes (Cox, HR 1.97 (95% CI 1.31-2.98) p = 0.001), employed in a garage (HR 2.19 (95% CI 1.31-3.63) p = 0.001), undertaking plumbing/gas fitting/ventilation (HR 2.15 (95% CI 1.15-4.01) p = 0.017), undertaking welding (HR 1.85 (95% CI 1.24-2.77) p = 0.003) and exposed to welding materials (HR 1.92 (95% CI 1.27-2.91) p = 0.002)) were more likely to have disease progression and receive radical treatment than others. Fewer than expected deaths were seen in healthcare workers (HR 0.17 (95% CI 0.04-0.70) p = 0.014). We identified multiple occupational tasks and contacts associated with bladder cancer. There were some associations with phenotype, although our study design precludes robust assessment.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Air Pollutants, Occupational - toxicity / Aircraft fuels / Authorship / Aviation fuel / Biology and Life Sciences / Bladder / Bladder cancer / Cancer / Carcinogens / Carcinogens - toxicity / Chromium / Contact potentials / Cross-Sectional Studies / Diagnosis / Diesel engines / Diesel fuels / Distribution / Dyes / Employers / Employment / Engineering and Technology / Exposure / Female / Fumes / Genetics / Hair dyes / Humans / Male / Medical personnel / Medical treatment / Medicine and Health Sciences / Middle Aged / Mortality / Mutation / Neoplasm Staging / Occupational diseases / Occupational Diseases - mortality / Occupational Diseases - pathology / Occupational exposure / Occupational Exposure - analysis / Occupational health / Occupations / Passive smoking / Patients / Phenotype / Phenotypes / Physical Sciences / Progression-Free Survival / Proportional Hazards Models / Questionnaires / Risk factors / Self completed questionnaires / Smoke / Smoking / Social Sciences / Solvents / Supervision / Surveys and Questionnaires / Survival Rate / Teaching hospitals / Tobacco / Tobacco smoke / Transportation industry / Trichloroethylene / Tumors / Urinary Bladder Neoplasms - mortality / Urinary Bladder Neoplasms - pathology / Urology / Vehicle Emissions - toxicity / Ventilation / Welding / Womens health