PT  - JOURNAL ARTICLE
AU  - Neela Guha
AU  - Nelson Kyle Steenland
AU  - Franco Merletti
AU  - Andrea Altieri
AU  - Vincent Cogliano
AU  - Kurt Straif
TI  - Bladder cancer risk in painters: a meta-analysis
AID  - 10.1136/oem.2009.051565
DP  - 2010 Aug 01
TA  - Occupational and Environmental Medicine
PG  - 568--573
VI  - 67
IP  - 8
4099  - http://oem.bmj.com/content/67/8/568.short
4100  - http://oem.bmj.com/content/67/8/568.full
SO  - Occup Environ Med2010 Aug 01; 67
AB  - The International Agency for Research on Cancer has classified occupational exposure as a painter as ‘carcinogenic to humans’, largely based on increased risks of bladder and lung cancer. A meta-analysis, including more than 2900 incident cases or deaths from bladder cancer among painters reported in 41 cohort (n=2), record linkage (n=9) and case–control (n=30) studies, was conducted to quantitatively compare the results of the different study designs and the potential confounding effect of smoking as well as other occupational exposures. The summary relative risk (meta-RR, random effects) for bladder cancer in painters was 1.25 (95% CI 1.16 to 1.34; 41 studies) overall and 1.28 (95% CI 1.15 to 1.43; 27 studies) when including only smoking adjusted risk estimates. The elevated risk persisted when restricted to studies that adjusted for other occupational exposures (meta-RR 1.27; 95% CI 0.99 to 1.63; 4 studies). The results remained robust when stratified by study design, gender and study location. Furthermore, exposure–response analyses suggested that the risk increased with duration of employment. There was no evidence of publication bias. Taken together, these results support the conclusion that occupational exposures in painters are causally associated with the risk of bladder cancer.