OCCUPATIONAL RISKS OF BLADDER-CANCER IN FRANCE - A MULTICENTER CASE-CONTROL STUDY

The relationships between occupational risk factors in France and bladder cancer were assessed from a hospital-based case-control study conducted between 1984 and 1987 in five regions representing various industries, including mining, textile manufacture, metallurgy and the production of rubber and chemicals. The study concerned 765 cases (658 men and 107 women) and the same number of controls. Odds ratios (OR) adjusted for matching variables (age, place of residence and hospital), and tobacco smoking were estimated by unconditional logistic regression. A significantly increased risk of bladder cancer was observed among men employed in coal mining (OR = 2.42; 95% confidence interval (CI) : 1.25-4.67) and the chemicals industry (OR = 2.36; 95% CI : 1.23-4.53). Aircraft and ship's officers (OR = 11.8; 95% CI : 1.46-95.7), managers (OR = 1.64; 95% CI : 1.11-2.43) and street vendors (OR = 3.60; 95% CI : 1.15-11.3) also had an increased risk. Among women, employment in the clothing industry was associated with a high OR (= 3.21; 95% CI : 1.34-7.71). Assessment of individual exposures by a panel of industrial hygiene experts showed that significantly more cases than controls had been exposed to the following substances: chlorinated solvents (OR = 1.86; 95% CI : 1.19-2.90), industrial oils and greases (OR = 1.44; 95% CI : 1.10-1.89), welding fumes (OR = 1.40; 95% CI : 0.98-2.01), coal dust (OR = 1.71; 95% CI : 1.02-2.89) and metallic oxide dust (OR = 2.99; 95% CI : 1.12-8.01). The high risks observed for coal mining, petroleum refining, the tool and die, glass and chemicals industries, steel foundries, car manufacture and car repair are consistent with the possibility that exposure to polycyclic aromatic hydrocarbons is a risk factor for bladder cancer.