Article Text

Download PDFPDF
Original Article
The INTEROCC case-control study: risk of meningioma and occupational exposure to selected combustion products, dusts and other chemical agents
  1. Damien M McElvenny1,
  2. Martie van Tongeren1,2,
  3. Michelle C Turner3,4,5,6,
  4. Geza Benke7,
  5. Jordi Figuerola3,4,5,
  6. Sarah Fleming8,
  7. Martine Hours9,
  8. Laurel Kincl10,
  9. Daniel Krewski6,11,
  10. Dave McLean12,
  11. Marie-Élise Parent13,
  12. Lesley Richardson14,
  13. Brigitte Schlehofer15,
  14. Klaus Schlaefer15,
  15. Siegal Sadetzki16,17,
  16. Joachim Schüz18,
  17. Jack Siemiatycki14,
  18. Elisabeth Cardis3,4,5
  1. 1 Institute of Occupational Medicine, Edinburgh, UK
  2. 2 Centre for Occupational and Environmental Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Medicine, Biology and Health, University of Manchester, UK
  3. 3 Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
  4. 4 Universitat Pompeu Fabra (UPF), Barcelona, Spain
  5. 5 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  6. 6 McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
  7. 7 Monash University, Melbourne, Australia
  8. 8 Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
  9. 9 Unité Mixte de Recherche Epidémiologique Transport Travail Environnement Université Lyon 1/IFSTTAR, Université de Lyon, Lyon, France
  10. 10 College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
  11. 11 Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
  12. 12 Centre for Public Health Research, Massey University, Wellington, New Zealand
  13. 13 INRS-Institut Armand-Frappier, Université du Québec, Laval, Canada
  14. 14 University of Montreal Hospital Research Centre, Montreal, Canada
  15. 15 Unit of Environmental Epidemiology, German Cancer Research Center, Heidelberg, Germany
  16. 16 The Cancer & Radiation Epidemiology Unit, The Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel
  17. 17 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  18. 18 International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France
  1. Correspondence to Dr Martie van Tongeren, Centre for Occupational and Environmental Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Medicine, Biology and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK; martie.j.van-tongeren{at}


Background Little is known about occupational risk factors for meningioma.

Objectives To study whether risk of meningioma is associated with several occupational exposures, including selected combustion products, dusts and other chemical agents.

Methods The INTEROCC study was an international case-control study of brain cancer conducted in seven countries. Data collection by interview included lifetime occupational histories. A job exposure matrix was used to derive estimates of exposure for the 12 agents. ORs for ever versus never exposed and for exposure-response using duration of exposure and cumulative exposure were derived using conditional logistic regression stratified by sex, age group, country/region, adjusted for education.

Results These analyses included 1906 cases and 5565 controls. For 11 of the 12 agents, no excess risk was found for ever exposed. For ever exposure to oil mists, an elevated OR of 1.57 (95% CI 1.10 to 2.22, 51 exposed cases) was found. Statistically significant exposure-response relationships were observed with cumulative exposure (p=0.01) and duration of exposure (p=0.04). Among women, there were also significant trends for cumulative and duration of exposure to asbestos and excesses in the highest exposure categories for formaldehyde.

Conclusions Most agents examined did not provoke excess risks of meningioma. The main finding from this study is that it is the first study to identify a statistical association between exposure to oil mists and meningioma. This may be a chance finding or could be due to confounding with iron exposure and further research is required to understand whether the relationship is causal.

  • meningioma
  • occupational exposure
  • combustion products
  • dusts

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors Study conception and design: MvT, EC; acquisition of data: GB, SF, MH, DK, DMcL, MEP, LR, SS, KS, BS, JS, JS; exposure assessment: MvT, GB, JF, LK, DMcL; statistical analysis: MCT, JF; drafting of manuscript: DMMcE; all authors participated in the interpretation of data and revision and approval of the manuscript.

  • Funding MCT was funded by a Government of Canada Banting Postdoctoral Fellowship. The INTEROCC study was funded by the National Institutes for Health (NIH) Grant No. 1R01CA124759 (PI E Cardis). Coding of the French occupational data was in part funded by AFSSET (Convention N° ST-2005-004). The INTERPHONE study was supported by funding from the European Fifth Framework Programme, ‘Quality of Life and Management of Living Resources’ (contract 100 QLK4-CT-1999901563) and the International Union against Cancer (UICC). The UICC received funds for this purpose from the Mobile Manufacturers’ Forum and GSM Association. In Australia, funding was received from the Australian National Health and Medical Research Council (EME Grant 219129) with funds originally derived from mobile phone service license fees; the University of Sydney Medical Foundation Programme; the Cancer Council NSW and the Cancer Council Victoria. In Canada, funding was received from the Canadian Institutes of Health Research (project MOP-42525); the Canada Research Chair programme; the Guzzo-CRS Chair in Environment and Cancer; the Fonds de la recherche en santé duQuébec; the Canadian Institutes of Health Research (CIHR), the latter including partial support from the Canadian Wireless Telecommunications Association; the NSERC Chair in Risk Science at the University of Ottawa. In France, funding was received by l’Association pour la Recherche sur le Cancer (ARC) (Contrat N85142) and three network operators (Orange, SFR, Bouygues Telecom). In Germany, funding was received from the German Mobile Phone Research Programme (Deutsches Mobilfunkforschungsprogramm) of the German Federal Ministry for the Environment, Nuclear Safety, and Nature Protection; the Ministry for the Environment and Traffic of the state of Baden-Wuerttemberg; the Ministry for the Environment of the state of North Rhine-Westphalia; the MAIFOR Programme (Mainzer Forschungsforderungsprogramm) of the University of Mainz. In New Zealand, funding was provided by the Health Research Council, Hawke’s Bay Medical Research Foundation, the Wellington Medical Research Foundation, the Waikato Medical Research Foundation and the Cancer Society of New Zealand. Additional funding for the UK study was received from the Mobile Telecommunications, Health and Research (MTHR) programme, funding from the Health and Safety Executive, the Department of Health, the UK Network Operators (O2, Orange, T-Mobile, Vodafone, ‘3’) and the Scottish Executive. All industry funding was governed by contracts guaranteeing the complete scientific independence of the investigators.

  • Competing interests MCT reports personal fees from ICF, outside this work. DK reports to serving as Chief Risk Scientist and CEO at Risk Sciences International (, a Canadian company established in 2006 in partnership with the University of Ottawa conducting work in risk assessment, management and communication of health and environmental risks and their broader impacts on both public and private interests. He also holds an Industrial Research Chair in Risk Science under a peer-reviewed university-industry partnership programme administered by the Natural Sciences and Engineering Research Council of Canada.

  • Patient consent Obtained.

  • Ethics approval Ethics approval from all appropriate national and regional research ethics boards was obtained including the Ethical Review Board of the International Agency for Research on Cancer for INTERPHONE and the Municipal Institute for Medical Investigation Barcelona for INTEROCC.

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

  • Correction notice This article has been corrected since it first published online. Some values in tables 2, 4 and 5 have been corrected.