Occupational exposure to organic solvents and risk of bladder cancer

Authors

• CN Strain
• AN Murphy
• J Barchi Jr

Abstract

Background: Bladder cancer has been linked to several occupations that involve the use of solvents, including those used in the dry-cleaning industry.
Objectives: 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 21 specific 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 a novel 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 novel hybrid BTX metrics (OR_Q1 vs. Unexposed=1.26, 95% CI: 0.83-1.90; OR_Q2 vs. Unexposed=1.52, 95% CI: 1.00-2.31; OR_Q3 vs.Unexposed=1.88, 95% CI: 1.24- 2.85; and OR_Q4 vs. Unexposed=2.23, 95% CI: 1.35- 3.69) (p-trend=0.001) than using CANJEM-based metrics (p-trend=0.02).
Significance: The integration of occupational exposure data from personal interviews with the use of CANJEM likely decreased misclassification of exposure, improving our ability to identify an exposure-response between BTX and bladder cancer risk.

Scientific Focus Area: Epidemiology

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