RT Journal Article
SR Electronic
T1 Bladder cancer risk in painters: a meta-analysis
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 568
OP 573
DO 10.1136/oem.2009.051565
VO 67
IS 8
A1 Guha, Neela
A1 Steenland, Nelson Kyle
A1 Merletti, Franco
A1 Altieri, Andrea
A1 Cogliano, Vincent
A1 Straif, Kurt
YR 2010
UL http://oem.bmj.com/content/67/8/568.abstract
AB The International Agency for Research on Cancer has classified occupational exposure as a painter as ‘carcinogenic to humans’, largely based on increased risks of bladder and lung cancer. A meta-analysis, including more than 2900 incident cases or deaths from bladder cancer among painters reported in 41 cohort (n=2), record linkage (n=9) and case–control (n=30) studies, was conducted to quantitatively compare the results of the different study designs and the potential confounding effect of smoking as well as other occupational exposures. The summary relative risk (meta-RR, random effects) for bladder cancer in painters was 1.25 (95% CI 1.16 to 1.34; 41 studies) overall and 1.28 (95% CI 1.15 to 1.43; 27 studies) when including only smoking adjusted risk estimates. The elevated risk persisted when restricted to studies that adjusted for other occupational exposures (meta-RR 1.27; 95% CI 0.99 to 1.63; 4 studies). The results remained robust when stratified by study design, gender and study location. Furthermore, exposure–response analyses suggested that the risk increased with duration of employment. There was no evidence of publication bias. Taken together, these results support the conclusion that occupational exposures in painters are causally associated with the risk of bladder cancer.