Risk of bladder cancer in foundry workers: a meta-analysis

Abstract

To clarify the inconsistent reports of bladder cancer risk in foundry workers, a meta-analytic review of epidemiological studies was undertaken. Summary risk estimates (SRE) were calculated from 40 systematically extracted results. Weakly increased risks were observed overall, with an SRE of 1.11. Twenty three selected study results with better exposure information yielded an SRE of 1.16. This weak increase in risk is consistent with estimates obtained from dose-response trends of PAH exposures in aluminium smelter workers. Summary estimates did not vary substantially with exposure quality, study design, control for smoking, or when limiting the meta-analysis to large study results. Exposure-response findings showed significantly increased risks of about 1.6 to 1.7 after 20 or more years of employment, but this was based on few studies. Occupation specific SREs showed a 40–50% increased risk among moulders, casters, and unskilled foundry labourers. There was limited evidence that bladder cancer risk correlated with lung cancer risk, which is a more established risk among foundry workers. The small increased risk observed is prone to bias and confounding. Further studies of dose-response trends would greatly aid in determining whether this observed association is causal.

Contemporary Occupational Carcinogen Exposure and Bladder Cancer

“…42 High PAH exposure occurs during aluminum manufacture when coal tar and/or pitch anodes evaporate during electrolysis to produce benzo[a]pyrene vapor (IARC 1). 41 Our findings (SIR, 1.40) support previous metaanalysis indicating sustained elevated BC risk, 43 despite changes to anode manufacture. Drivers, miners, marine workers, and seamen partly derive their BC risk from the inhalation of diesel exhaust fumes.…”

Early Results of Urothelial Carcinoma Screening in a Risk Population of Coke Workers: Urothelial Carcinoma among Coke Workers

“…Particularly, over 40 different occupations and more than 200 chemicals, mainly represented by PAHs, have been identified as risk factors for UC [5] . To date, the surveillance of risk populations has become an appreciable part of the urological workload and many authors published their data concerning the screening for UC in high risk population groups, reporting positive effects on patients' morbidity and mortality and on the costs of the healthcare system [9][10][11][14][15] . In the present study, we report our early experience concerning the development of UC in a risk group of workers, employed in a Ligurian coke plant, who were exposed to the products formed during coke production for a mean period of 16 years.…”

“…In the present study, we report our early experience concerning the development of UC in a risk group of workers, employed in a Ligurian coke plant, who were exposed to the products formed during coke production for a mean period of 16 years. In accordance with other authors, our screening protocol also included an extensive history and physical examination, in order to identify possible associated risk factors or suspect lesions for UC, followed by non-invasive urinary tests which could help to distinguish healthy individuals from those who required further examination such as cystoscopy, urography or CT scan [9][10][11][16][17] . Particularly, we decided to combine the execution of urine analysis with urinary cytology and the uCyt+ assay in order to produce a high detection rate for all forms of UC, limiting the need for cystoscopy only in the event of a positive urine analysis [18][19][20][21][22] .…”

“…Based on these aspects, in the last few years, the detection of people at risk of UC has been taken into particular consideration by urologists and many screening protocols have been performed producing lots of papers addressing the association between occupational factors and UC [7][8][9][10][11] .…”

Urinary Thrombomodulin Levels Were Significantly Higher Following Occupational Exposure to Chemicals, In The Presence of Dipstick Protein, But Not in the Presence of Dipstick Blood

“…Chemical exposure remains a significant risk factor for urothelial cancer (UC) in developed countries despite the laws which limit occupational exposure to harmful chemicals. This is attributable to both the latency periods that often exceed 20 years [1][2][3], and the significant range of chemical agents associated with increased risk of bladder cancer [3][4][5][6][7]. Recent evidence suggests that metal workers, car mechanics, plumbers [8], those exposed to intermediates in rubber and plastics manufacture [9], and those working in occupations allied to agriculture or medicine and health [10] could be at risk of developing UC.…”