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Occupation and bladder cancer in a population-based case–control study in Northern New England
  1. Joanne S Colt1,
  2. Margaret R Karagas2,
  3. Molly Schwenn3,
  4. Dalsu Baris1,
  5. Alison Johnson4,
  6. Patricia Stewart5,
  7. Castine Verrill3,
  8. Lee E Moore1,
  9. Jay Lubin1,
  10. Mary H Ward1,
  11. Claudine Samanic1,
  12. Nathaniel Rothman1,
  13. Kenneth P Cantor6,
  14. Laura E Beane Freeman1,
  15. Alan Schned2,
  16. Sai Cherala7,
  17. Debra T Silverman1
  1. 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
  2. 2Dartmouth Medical School, Hanover, Lebanon, New Hampshire, USA
  3. 3Maine Cancer Registry, Augusta, Maine, USA
  4. 4Vermont Cancer Registry, Burlington, Vermont, USA
  5. 5Stewart Exposure Assessments, LLC, USA
  6. 6KP Cantor Environmental, LLC, Silver Spring, Maryland, USA
  7. 7New Hampshire Department of Health and Human Services, Concord, New Hampshire, USA
  1. Correspondence to Joanne S Colt, National Cancer Institute, Occupational and Environmental Epidemiology Branch, 6120 Executive Boulevard, Room 8002, Bethesda, MD 20892-7240, USA; coltj{at}


Objectives We used data from a large, population-based case–control study in Maine, New Hampshire, and Vermont to examine relationships between occupation, industry and bladder cancer risk.

Methods Lifetime occupational histories were obtained by personal interview from 1158 patients newly diagnosed with urothelial carcinoma of the bladder in 2001–2004, and from 1402 population controls. Unconditional logistic regression was used to calculate ORs and 95% CIs, adjusted for demographic factors, smoking and employment in other high-risk occupations.

Results Male precision metalworkers and metalworking/plasticworking machine operators had significantly elevated risks and significant trends in risk with duration of employment (precision metalworkers: OR 2.2, 95% CI 1.4 to 3.4, ptrend=0.0065; metalworking/plasticworking machine operators: OR 1.6, 95% CI 1.01 to 2.6, ptrend=0.047). Other occupations/industries for which risk increased significantly with duration of employment included: for men, textile machine operators, mechanics/repairers, automobile mechanics, plumbers, computer systems analysts, information clerks, and landscape industry workers; for women, service occupations, health services, cleaning and building services, management-related occupations, electronic components manufacturing and transportation equipment manufacturing. Men reporting use of metalworking fluids (MWF) had a significantly elevated bladder cancer risk (OR 1.7, 95% CI 1.1 to 2.5).

Conclusions Our findings support the hypothesis that some component(s) of MWF may be carcinogenic to the bladder. Our results also corroborate many other previously reported associations between bladder cancer risk and various occupations. More detailed analyses using information from the study's job-specific questionnaires may help to identify MWF components that may be carcinogenic, and other bladder carcinogens associated with a variety of occupations.

  • Bladder cancer
  • occupation
  • case-control study
  • epidemiology
  • cancer
  • urological

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  • Funding The NIH funded this study.

  • Competing interests None.

  • Ethics approval The study protocol was approved by the National Cancer Institute Special Studies Institutional Review Board, as well as the human subjects review boards of each participating institution.

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