Environmental Tobacco Smoke and Bladder Cancer Risk in Never Smokers of Los Angeles County

Abstract

Cigarette smoking is a major risk factor for bladder cancer and a prominent point source of 4-aminobiphenyl (4-ABP), a recognized human bladder carcinogen. 4-ABP-hemoglobin (Hb) adducts are established biomarkers of 4-ABP exposure in humans. The role of environmental tobacco smoke (ETS) in the etiology of bladder cancer is largely unknown. As part of a large population-based bladder cancer study in Los Angeles County, California, lifetime exposure to ETS was ascertained for 148 cases and 292 control subjects who had never used any tobacco products over their lifetime. 4-ABP-Hb adducts were quantitatively measured on 230 control subjects. Female lifelong nonsmokers living with two or more smokers during childhood were significantly related to risk of bladder cancer [odds ratio (OR), 3.08; 95% confidence interval (95% CI), 1.16-8.22]. During adulthood, f2-fold risks were seen among women living with a spouse/domestic partner who smoked for z10 years or having a coworker who smoked in an indoor environment for z10 years. When all sources of ETS exposure were combined, a statistically significant, dose-dependent association (P for trend = 0.03) was noted in women, with the OR for the highest category of ETS exposure being 5.48 (95% CI, 1.06-28.36). Levels of 4-ABP-Hb adducts varied by ETS exposure status among female control subjects. Mean level was lowest in women never exposed to ETS (16.4 pg/g Hb) and highest in those with current ETS exposure (23.6 pg/g Hb). ETS exposure was associated with neither bladder cancer risk nor 4-ABP-Hb adduct levels in male lifelong nonsmokers. In conclusion, ETS is a risk factor for bladder cancer in women who were lifelong nonusers of any tobacco products. [Cancer Res 2007;67(15):7540-5]

Secondhand Smoking, 4-Aminobiphenyl, and Bladder Cancer: Two Meta-analyses

“…The finding of a positive statistically significant SMD suggests a higher level of 4-ABP among nonsmokers exposed to SHS (16,18) and thus suggests an association between SHS and 4-ABP. Nevertheless, we did not find an effect of SHS on bladder cancer risk, despite the robust plausibility for such an association, given the underlying biological mechanisms.…”

“…Six studies reported 4-ABP Hb adduct levels (pg/ng Hb; refs. [16][17][18][19][20][21], whereas one study reported 4-ABP levels in 24-hour urine samples (ng/24 hours; ref. 22).…”

Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden—before and after the implementation of a smoke-free law

“…It has Legislation, environmental tobacco smoke and health effects been shown that environmental tobacco smoke may be a risk for diseases such as bladder cancer among women who have never used tobacco products (22,35). The cutoff level for nicotine related to environmental tobacco smoke (<0.5 µg/m 3 ) was chosen for use in this study because, above this level, the associated 4-ABP exposure may notably increase cancer risk (22).…”

Secondhand Tobacco Smoke

“…iarc.fr/ENG/Monographs/vol100E/100E-02-Table2.9.pdf), four case-control studies (Burch et al, 1989;Chen et al, 2005a;Samanic et al, 2006;Jiang et al, 2007; Table 2.10 available at http://monographs.iarc.fr/ENG/Monographs/ vol100E/100E-02-Table2.10.pdf), and one metaanalysis (Van Hemelrijck et al, 2009). Table. The Working Group noted the marked variation in risk in the analyses by sex and by timing of exposure to second-hand tobacco smoke during adulthood or childhood].…”

“…Jiang et al (2007) used variation in 4-ABP-haemoglobin adducts levels to assess exposure to second-hand tobacco smoke and reported a significantly increased risk with increasing lifetime exposure among never-smoking women exposed in adulthood or childhood. Chen et al (2005a) hypothesized that the ability to detoxify arsenic (a risk factor urinary bladder cancer) through methylation may modify risk related to second-hand tobacco smoke exposure.…”