Smoking as a confounder in case-control studies of occupational bladder cancer in women

被引:0
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作者
t'Mannetje, A
Kogevinas, M
Chang-Claude, J
Cordier, S
González, CA
Hours, M
Jöckel, KH
Bolm-Audorff, U
Lynge, E
Porru, S
Donato, F
Ranft, U
Serra, C
Tzonou, A
Vineis, P
Wahrendorf, J
Boffetta, P
机构
[1] Inst Municipal Invest Med, Resp & Environm Hlth Res Unit, E-08003 Barcelona, Spain
[2] Deutsch Krebsforschungszentrum, Abt Epidemiol, D-6900 Heidelberg, Germany
[3] INSERM, Villejuif, France
[4] Inst Recerca Epidemiol Clin, Mataro, Spain
[5] Univ Lyon 1, Inst Epidemiol, F-69365 Lyon, France
[6] Inst Med Informat Biometrie & Epidemiol, Essen, Germany
[7] Hess Minist Frauen Arbeit & Sozialordnung, Wiesbaden, Germany
[8] Univ Copenhagen, Inst Publ Hlth, Kobenhavn, Denmark
[9] Univ Brescia, Inst Occupat Hlth, I-25121 Brescia, Italy
[10] Univ Dusseldorf, Med Inst Environm Hyg, D-4000 Dusseldorf, Germany
[11] Ctr Estudis, Programe Sanitaris, Sabadell, Spain
[12] Ctr Estudis, Serv Sanitaris, Sabadell, Spain
[13] Med Sch Athens, Dept Hyg & Epidemiol, Athens, Greece
[14] Canc Epidemiol Unit, Turin, Italy
[15] Int Agcy Res Canc, Unit Environm Canc Epidemiol, F-69372 Lyon, France
关键词
confounding factors; smoking; occupational exposure; bladder neoplasms; women;
D O I
暂无
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: In studies in men, risk estimates on occupation and bladder cancer are distorted by about 10% when not adjusting for smoking. We examined the degree to which occupational risk estimates for bladder cancer in women are confounded by smoking, and the degree of residual confounding by inadequate control of this effect. Methods: Primary data of 11 case-control studies on occupation and bladder cancer from Denmark, France, Germany, Greece, Italy, and Spain were pooled. Information for smoking and lifetime occupational history for 700 female cases and 2,425 female controls ages 30-79 was abstracted and recoded. Logistic regression was used to calculate odds ratios (OR) by occupation, applying five models which differed in their degree of adjustment for smoking. Results: In major occupational groups risk estimates were distorted by less than 10% when not adjusting for smoking. A statistically significant excess risk for bladder cancer was found in 13 specific occupations and industries. In most occupations, adjustment for smoking led the ORs towards the null value, but all statistically significant associations were maintained after adjustment. In three occupations (lathe operators, field crop workers, and wood manufacturers), a statistically significant excess risk was masked when not adjusting for smoking. In six occupations, estimates were distorted by more than 10% (-22% up to +40%). In occupations where smoking acted as a positive confounder, the proportion of confounding removed using a dichotomous smoking variable (ever/never) was around 60%. In one occupation (buyers), controlling for smoking status (ever, never) led to over-adjustment, because the percentage of smokers was high but the quantity smoked was low. Conclusions: Tobacco smoking was not found to be a major confounder for the association between occupation and bladder cancer in women Most of this confounding effect could be removed by adjustment by smoking status (ever/never),. without consideration of amount or duration of smoking. Am.. Ind. Med. 36:75-82, 1999. (C) 1999 Wiley-Liss, Inc.
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收藏
页码:75 / 82
页数:8
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