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Occupational risk factors for nasopharyngeal cancer among female textile workers in Shanghai, China
  1. W Li1,
  2. R M Ray1,
  3. D L Gao2,
  4. E D Fitzgibbons1,
  5. N S Seixas3,
  6. J E Camp3,
  7. K J Wernli3,
  8. G Astrakianakis3,
  9. Z Feng1,3,
  10. D B Thomas1,3,
  11. H Checkoway1,3
  1. 1Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
  2. 2Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai, China
  3. 3School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
  1. 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}


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 × 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.

  • 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
  • nasopharyngeal carcinoma
  • cotton dust
  • textile exposures

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