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Original article
Lifetime exposure to rubber dusts, fumes and N-nitrosamines and cancer mortality in a cohort of British rubber workers with 49 years follow-up
  1. Mira Hidajat1,
  2. Damien Martin McElvenny2,
  3. Peter Ritchie2,
  4. Andrew Darnton3,
  5. William Mueller2,
  6. Martie van Tongeren4,
  7. Raymond M Agius4,
  8. John W Cherrie2,5,
  9. Frank de Vocht1
  1. 1 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  2. 2 Research Division, Institute of Occupational Medicine, Edinburgh, UK
  3. 3 Statistics and Epidemiology Unit, Health and Safety Executive, Bootle, UK
  4. 4 Centre for Occupational and Environmental Health, Centre for Epidemiology, School of Health Sciences, The University of Manchester, Manchester, UK
  5. 5 Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh, UK
  1. Correspondence to Dr Frank de Vocht, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK; frank.devocht{at}bristol.ac.uk

Abstract

Objectives To quantitatively evaluate exposure-response associations between occupational exposures to rubber dust, fumes and N-nitrosamines and cancer mortality in the UK rubber industry.

Methods Competing risk survival analyses were used to examine cancer mortality risk in a cohort of 36 441 males aged 35+ years employed in the British rubber industry in 1967, followed up to 2015 (94% mortality). Exposure measurements are based on a population-specific quantitative job-exposure matrix for rubber dust, rubber fumes and N-nitrosamines from the EU-EXASRUB project.

Results Exposure (lifetime cumulative (LCE))-response associations were found for N-nitrosomorphiline and all cancers (subdistribution HR (SHR) 1.48, 95% CI 1.39 to 1.57) and cancers of the bladder, stomach, multiple myeloma, oesophagus, prostate and pancreas, as well as for N-nitrosodimethylamine and all cancers (SHR 2.08, 95% CI 1.96 to 2.21) and cancers of the bladder, stomach, leukaemia, multiple myeloma, prostate and liver. LCE to the N-nitrosamines sum were associated with increased risks from all cancers (SHR 1.89, 95% CI 1.78 to 2.01) and cancers of the lung, non-Hodgkin’s lymphoma and brain. LCE to rubber dust and fumes are associated with increased mortality from all cancers (rubber dust SHR 1.67, 95% CI 1.58 to 1.78; rubber fumes SHR 1.91, 95% CI 1.80 to 2.03) and cancers of the bladder, lung, stomach, leukaemia, multiple myeloma, non-Hodgkin’s lymphoma, oesophagus, prostate, pancreas and liver.

Conclusions Consistent with previous studies, N-nitrosamines exposures are associated with mortality from cancers of the bladder, lung, stomach, leukaemia, multiple myeloma, oesophagus, prostate, pancreas and liver. The long follow-up with nearly complete mortality enabled estimations of lifetime cancer mortality risk from occupational exposures in the rubber industry.

  • rubber
  • occupational exposures
  • cohort
  • exposure-response
  • cancer

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/oemed-2018-105181

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    Footnotes

    • Contributors FdV and DMMcE conceived of the study. FdV, DMMcE, AD, RMA and JWC obtained funding. FdV, DMMcE, PR, AD and WM worked on coding of data not in digital format. MH conducted the statistical analyses and wrote the first draft version of the manuscript. All authors contributed to interpretation of the results and commented on the various iterations of the manuscript. All authors approved the final version.

    • Funding This study was funded by Cancer Research UK (C29425/A16521). Additional funding for tracing of the cohort was provided by the UK Health and Safety Executive (PRJ787).

    • Disclaimer The views expressed are those of the author(s) and not necessarily those of the Cancer Research UK or UK Health and Safety Executive.

    • Competing interests None declared.

    • Ethics approval The study obtained clearances from an NHS ethics committee (Ref: 13/NW/0543), the Health Research Authority’s Confidentiality Advisory Group (Ref: CAG 5-08(d)/2013), the Office for National Statistics and NHS Digital’s Data Access Advisory Group (now Independent Group Advising on the Release of Data, Ref: NIC-323309-L2G9T).

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

    • Data sharing statement Use of these data was granted by the NHS ethics committee, the Health Research Authority’s Confidentiality Advisory Group, the Office for National Statistics and NHS Digital’s Data Access Advisory Group (now Independent Group Advising on the Release of Data) for the specific purpose of this study only.

    • Patient consent for publication Not required.

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