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Occupational exposure to arsenic, cadmium, chromium, lead and nickel, and renal cell carcinoma: a case–control study from Central and Eastern Europe
  1. Paolo Boffetta1,2,
  2. Luc Fontana3,
  3. Patricia Stewart4,5,
  4. David Zaridze6,
  5. Neonilia Szeszenia-Dabrowska7,
  6. Vladimir Janout8,
  7. Vladimir Bencko9,
  8. Lenka Foretova10,
  9. Viorel Jinga11,
  10. Vsevolod Matveev12,
  11. Helena Kollarova8,
  12. Gilles Ferro13,
  13. Wong-Ho Chow4,
  14. Nathaniel Rothman4,
  15. Dana van Bemmel4,
  16. Sara Karami4,
  17. Paul Brennan13,
  18. Lee E Moore4
  1. 1International Prevention Research Institute, Lyon, France
  2. 2The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
  3. 3Department of Occupational Health, University Hospital, Saint-Etienne, France
  4. 4Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
  5. 5Stewart Exposure Assessments, LLC, Arlington, Virginia, USA
  6. 6Institute of Carcinogenesis, Cancer Research Centre, Moscow, Russia
  7. 7Department of Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
  8. 8Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic
  9. 9Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
  10. 10Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
  11. 11Department of Urology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  12. 12Department of Urology, Russian Cancer Research Centre, Moscow, Russia
  13. 13International Agency for Research on Cancer, Lyon, France
  1. Correspondence to Dr Paolo Boffetta, International Prevention Research Institute, 95 cours Lafayette, Lyon 69006, France; paolo.boffetta{at}


Objectives To investigate the risk of renal cell carcinoma (RCC) in Central and Eastern Europe in relation to exposure to known and suspected carcinogenic metals.

Methods During 1999–2003, the authors conducted a hospital-based study in Czech Republic, Poland, Romania and Russia, including 1097 cases of RCC and 1476 controls. Occupational exposure to arsenic, cadmium, chromium(III), chromium(VI), lead and nickel was assessed by teams of local industrial hygiene experts, based on detailed occupational questionnaires.

Results The ORs for RCC were 1.55 (95% CI 1.09 to 2.21) for exposure to lead and 1.40 (95% CI 0.69 to 2.85) for exposure to cadmium. No clear monotonic exposure–response relation was apparent for either duration of exposure or cumulative exposure to either metal, although the OR for the highest category of cumulative exposure to lead was 2.25 (95% CI 1.21 to 4.19). Exposure to other metals did not entail an increased risk of RCC.

Conclusions For cadmium, the lack of statistical significance of most results, potential confounding and the absence of clear dose–response relations suggest that an association with RCC is unlikely to be causal. In the case of lead, however, the elevated risk in the category of highest cumulative exposure is noteworthy and justifies further investigation.

  • Arsenic
  • cadmium
  • chromium
  • kidney cancer
  • lead
  • nickel
  • occupation
  • renal cell carcinoma
  • epidemiology
  • cancer
  • metals

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  • Funding This study was supported by a grant from the European Commission's INCO-COPERNICUS Program (contract IC15-CT98-0332) and by the Intramural Research Program of the US National Cancer Institute.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the IARC and national collaborating centres.

  • Provenance and peer review Not commissioned; externally peer reviewed.