ORIGINAL ARTICLE

Occupational risk factors for nasopharyngeal cancer among female textile workers in Shanghai, China

W Li¹, R M Ray¹, D L Gao², E D Fitzgibbons¹, N S Seixas³, J E Camp³, K J Wernli³, G Astrakianakis³, Z Feng^1,3, D B Thomas^1,3, H Checkoway^1,3

¹ Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
² Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai, China
³ School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA

Correspondence to:
Correspondence to:
Dr H Checkoway
Department of Environmental and Occupational, Health Sciences, School of Public Health and Community Medicine, University of Washington, Box 357234, Seattle, WA 98195-7234, USA; checko{at}u.washington.edu

Aims: To investigate whether occupational exposure to dusts and chemicals in the Chinese textile industry are associated with risk of nasopharyngeal cancer.

Methods: Sixty seven nasopharyngeal carcinoma (NPC) cases identified during 1989–98 and a random sample (n = 3188) of women were included in a case cohort study nested in a cohort of 267 400 women textile workers in Shanghai, China. A complete occupational history of work in the textile industry was obtained for each woman. A job exposure matrix developed by experienced industrial hygienists was used to assess exposures to specific dusts and chemicals.

Results: Risk of NPC is associated with cumulative exposure to cotton dust. The hazard ratio for women cumulatively exposed to >143.4 mg/m³ x years of cotton dust was 3.6 (95% CI 1.8 to 7.2) compared with unexposed women. Trends of increasing risk were also found with increasing duration of exposure to acids and caustics (p = 0.05), and with years worked in dyeing processes (p = 0.06). Women who worked at least 10 years in dyeing processes had a 3.6-fold excess risk of NPC (95% CI 1.0 to 12.1).

Conclusions: Occupational exposure to cotton dust, acids, and caustics, and work in dyeing and printing jobs in the textile industry may have increased risk of NPC in this cohort.

Abbreviations: BSE, breast self examination; EBV, Epstein-Barr virus; JEM, job exposure matrix; NPC, nasopharyngeal carcinoma; OHRP, Office for Human Research Protections; STIB, Shanghai Textile Industry Bureau

Keywords: nasopharyngeal carcinoma; cotton dust; textile exposures

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