PDF(Pubmed)
Abstract：
BACKGROUND: Bladder cancer has been linked to several occupations that involve the use of solvents, including those used in the dry-cleaning industry.
OBJECTIVE: We evaluated exposure to solvents and risk of bladder cancer in 1182 incident cases and 1408 controls from a population-based study.
METHODS: Exposure to solvents was quantitatively assessed using a job-exposure matrix (CANJEM). Exposure to benzene, toluene and xylene often co-occur. Therefore, we created two additional sets of metrics for combined benzene, toluene and xylene (BTX) exposure: (1) CANJEM-based BTX metrics and (2) hybrid BTX metrics, using an approach that integrates the CANJEM-based BTX metrics together with lifetime occupational histories and exposure-oriented modules that captured within-job, respondent-specific details about tasks and chemicals. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) were estimated using logistic regression.
RESULTS: Bladder cancer risks were increased among those ever exposed to benzene (OR = 1.63, 95% CI: 1.14-2.32), toluene (OR = 1.60, 95% CI: 1.06-2.43), and xylene (OR = 1.67, 95% CI: 1.13-2.48) individually. We further observed a statistically significant exposure-response relationship for cumulative BTX exposure, with a stronger association using the hybrid BTX metrics (ORQ1vsUnexposed = 1.26, 95% CI: 0.83-1.90; ORQ2vsUnexposed = 1.52, 95% CI: 1.00-2.31; ORQ3vsUnexposed = 1.88, 95% CI: 1.24-2.85; and ORQ4vsUnexposed = 2.23, 95% CI: 1.35-3.69) (p-trend=0.001) than using CANJEM-based metrics (p-trend=0.02).
CONCLUSIONS: There is limited evidence about the role of exposure to specific organic solvents, alone or in combination on the risk of developing bladder cancer. In this study, workers with increasing exposure to benzene, toluene, and xylene as a group (BTX) had a statistically significant exposure-response relationship with bladder cancer. Future evaluation of the carcinogenicity of BTX and other organic solvents, particularly concurrent exposure, on bladder cancer development is needed.
OBJECTIVE: We evaluated exposure to solvents and risk of bladder cancer in 1182 incident cases and 1408 controls from a population-based study.
METHODS: Exposure to solvents was quantitatively assessed using a job-exposure matrix (CANJEM). Exposure to benzene, toluene and xylene often co-occur. Therefore, we created two additional sets of metrics for combined benzene, toluene and xylene (BTX) exposure: (1) CANJEM-based BTX metrics and (2) hybrid BTX metrics, using an approach that integrates the CANJEM-based BTX metrics together with lifetime occupational histories and exposure-oriented modules that captured within-job, respondent-specific details about tasks and chemicals. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) were estimated using logistic regression.
RESULTS: Bladder cancer risks were increased among those ever exposed to benzene (OR = 1.63, 95% CI: 1.14-2.32), toluene (OR = 1.60, 95% CI: 1.06-2.43), and xylene (OR = 1.67, 95% CI: 1.13-2.48) individually. We further observed a statistically significant exposure-response relationship for cumulative BTX exposure, with a stronger association using the hybrid BTX metrics (ORQ1vsUnexposed = 1.26, 95% CI: 0.83-1.90; ORQ2vsUnexposed = 1.52, 95% CI: 1.00-2.31; ORQ3vsUnexposed = 1.88, 95% CI: 1.24-2.85; and ORQ4vsUnexposed = 2.23, 95% CI: 1.35-3.69) (p-trend=0.001) than using CANJEM-based metrics (p-trend=0.02).
CONCLUSIONS: There is limited evidence about the role of exposure to specific organic solvents, alone or in combination on the risk of developing bladder cancer. In this study, workers with increasing exposure to benzene, toluene, and xylene as a group (BTX) had a statistically significant exposure-response relationship with bladder cancer. Future evaluation of the carcinogenicity of BTX and other organic solvents, particularly concurrent exposure, on bladder cancer development is needed.
摘要：
背景：膀胱癌与涉及使用溶剂的几种职业有关，包括干洗行业中使用的那些。
目的：我们从一项基于人群的研究中评估了1182例事件病例和1408例对照患者的溶剂暴露和膀胱癌风险。
方法：使用工作暴露矩阵（CANJEM）定量评估对溶剂的暴露。接触苯,甲苯和二甲苯经常共存。因此,我们为组合苯创建了另外两组指标，甲苯和二甲苯（BTX）暴露：（1）基于CANJEM的BTX指标和（2）混合BTX指标，使用一种方法，将基于CANJEM的BTX指标与终身职业历史和面向暴露的模块集成在一起，这些模块在工作中捕获，特定于受访者的任务和化学品详细信息。使用逻辑回归估计调整后的比值比（OR）和95％置信区间（95％CI）。
结果：曾接触过苯的人患膀胱癌的风险增加（OR=1.63，95%CI：1.14-2.32），甲苯（OR=1.60，95%CI：1.06-2.43），和二甲苯(OR=1.67，95%CI：1.13-2.48)单独。我们进一步观察到累积BTX暴露的统计学上显著的暴露-反应关系，使用混合BTX指标具有更强的关联(ORQ1vsUnexposed=1.26,95%CI:0.83-1.90;ORQ2vsUnexposed=1.52,95%CI:1.00-2.31;ORQ3vsUnexposed=1.88,95%CI:1.24-2.85;ORQ4vsUnexposed=2.23,95%CI:1.35-3.69
结论：关于暴露于特定有机溶剂的作用的证据有限，单独或联合对发展膀胱癌的风险。在这项研究中,越来越多接触苯的工人，甲苯,和二甲苯组（BTX）与膀胱癌的暴露-反应关系具有统计学意义。BTX和其他有机溶剂的致癌性的未来评估，特别是同时暴露，对膀胱癌的发展是需要的。
目的：我们从一项基于人群的研究中评估了1182例事件病例和1408例对照患者的溶剂暴露和膀胱癌风险。
方法：使用工作暴露矩阵（CANJEM）定量评估对溶剂的暴露。接触苯,甲苯和二甲苯经常共存。因此,我们为组合苯创建了另外两组指标，甲苯和二甲苯（BTX）暴露：（1）基于CANJEM的BTX指标和（2）混合BTX指标，使用一种方法，将基于CANJEM的BTX指标与终身职业历史和面向暴露的模块集成在一起，这些模块在工作中捕获，特定于受访者的任务和化学品详细信息。使用逻辑回归估计调整后的比值比（OR）和95％置信区间（95％CI）。
结果：曾接触过苯的人患膀胱癌的风险增加（OR=1.63，95%CI：1.14-2.32），甲苯（OR=1.60，95%CI：1.06-2.43），和二甲苯(OR=1.67，95%CI：1.13-2.48)单独。我们进一步观察到累积BTX暴露的统计学上显著的暴露-反应关系，使用混合BTX指标具有更强的关联(ORQ1vsUnexposed=1.26,95%CI:0.83-1.90;ORQ2vsUnexposed=1.52,95%CI:1.00-2.31;ORQ3vsUnexposed=1.88,95%CI:1.24-2.85;ORQ4vsUnexposed=2.23,95%CI:1.35-3.69
结论：关于暴露于特定有机溶剂的作用的证据有限，单独或联合对发展膀胱癌的风险。在这项研究中,越来越多接触苯的工人，甲苯,和二甲苯组（BTX）与膀胱癌的暴露-反应关系具有统计学意义。BTX和其他有机溶剂的致癌性的未来评估，特别是同时暴露，对膀胱癌的发展是需要的。
