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Occupation in relation to cancers of the bladder and renal pelvis in Sweden

Robin Taylor Wilson, MA, PhD1, Mark Donahue, BA1, Gloria Gridley, MS2, Laure El Ghormli, MPH3, Mustafa Dosemeci, PhD1, and Debra Silverman, PhD1. (1) Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, 6120 Executive Blvd., Bethesda, MD 20892, 301-451-5032, donahuma@mail.nih.gov, (2) Biometry Branch, Division of Cancer Epidemiology and Genetics, 6120 Executive Blvd., Bethesda, MD 20892, (3) Department of Epidemiology and Biostatistics, George Washington University, 2300 Eye Street NW, Washington, DC 20052

Background: Approximately one quarter of bladder cancers among men are considered occupationally related. Much less is known regarding risks for cancers of the renal pelvis. Purpose: Identify occupational factors associated with cancers of the bladder and renal pelvis. Methods: Cancer incidence and mortality during 1971-1989 among over 4 million employed Swedish residents was determined by linking the Swedish National Population and Housing Censuses with the Swedish Cancer Registry. Occupation and industry codes were used to create a job-exposure matrix (JEM) which estimated occupational physical activity (four levels) and outdoor exposure. Urban residence was defined according to the population size of the county of residence. Standardized Incidence Ratios were calculated for each occupation/industry. Relative risks (RR) for JEM variables were calculated using Poisson regression with sex-, and cancer site-stratified analyses adjusted for age. Results: Among both sexes, sedentary occupations were associated with higher risk for cancers of the bladder (RR=1.2, 95% CI: 1.1-1.4, women; RR=1.5, 95% CI: 1.4-1.6, men) and renal pelvis (RR=1.9, 95% CI: 1.2-2.8, men; RR=1.6, 95% CI:1.3-2.1, women). Risks increased monotonically with decreasing physical activity level. Indoor work and urban residence were also associated with an increased risk for both cancer sites. Occupational exposure to ionizing radiation was associated with increased risk for bladder cancer mortality (RR=2.4, 95% CI: 1.3-4.4) but not incidence. Discussion: Our results with respect to ionizing radiation and excess bladder cancer risk for occupations in the machine and rubber industries are consistent with previous research. Findings regarding physical activity and outdoor work require further investigation.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Epidemiology of Chronic Disease, STDs and TB

The 132nd Annual Meeting (November 6-10, 2004) of APHA