Table 2

Risk of death from selected cancers by 15-year lagged cumulative exposure to nitrosamines sum score, NDMA and NMor in a cohort of rubber factory workers in the UK

MalignancyNCumulative nitrosamines sum score*
(year* μg/m3)
Cumulative NDMA
(year* μg/m3)
Cumulative NMor
(year* μg/m3)
Exposures†SHR‡95% CIExposures§SHR‡95% CIExposures¶SHR‡95% CI
All malignant neoplasms9101III
II1.471.39 to 1.56II1.321.25 to 1.40II1.221.15 to 1.29
III1.891.78 to 2.01III1.831.72 to 1.95III1.441.36 to 1.53
IV1.491.41 to 1.58IV2.081.96 to 2.21IV1.481.39 to 1.57
P for trend<0.01<0.01<0.01
Bladder417III
II1.411.06 to 1.89II1.571.19 to 2.07II1.310.97 to 1.76
III2.191.69 to 2.84III2.451.87 to 3.21III1.671.25 to 2.24
IV1.951.51 to 2.52IV2.822.16 to 3.67IV2.591.99 to 3.38
P for trend0.01<0.01<0.01
Lung3377III
II1.211.10 to 1.34II1.211.10 to 1.32II1.060.97 to 1.16
III1.61.45 to 1.76III1.541.39 to 1.70III1.191.09 to 1.31
IV1.361.25 to 1.49IV1.71.54 to 1.87IV1.191.08 to 1.31
P for trend0.030.36<0.01
Stomach768III
II1.611.32 to 1.95II1.321.10 to 1.57II1.281.06 to 1.55
III1.781.46 to 2.17III1.621.32 to 1.98III1.431.17 to 1.75
IV1.371.13 to 1.65IV1.721.41 to 2.10IV1.491.22 to 1.81
P for trend0.10.010.01
Leukaemia195III
II2.61.74 to 3.91II1.520.99 to 2.33II1.450.97 to 2.16
III3.082.02 to 4.71III3.272.20 to 4.86III1.460.95 to 2.23
IV2.081.38 to 3.14IV3.472.35 to 5.13IV1.961.32 to 2.91
P for trend0.02<0.01<0.01
Multiple myeloma462III
II2.091.61 to 2.71II1.591.22 to 2.08II1.481.15 to 1.91
III2.351.80 to 3.06III2.782.15 to 3.60III1.471.12 to 1.92
IV1.791.38 to 2.32IV2.812.17 to 3.64IV1.821.40 to 2.36
P for trend0.02<0.01<0.01
Non-Hodgkin’s lymphoma141III
II1.821.11 to 2.96II1.510.93 to 2.43II1.240.79 to 1.96
III2.241.42 to 3.53III2.171.35 to 3.47III1.581.01 to 2.46
IV1.540.95 to 2.48IV2.251.41 to 3.59IV1.360.83 to 2.24
P for trend0.550.110.23
Oesophagus333III
II2.141.56 to 2.93II1.71.24 to 2.33II1.741.28 to 2.37
III2.421.75 to 3.33III2.431.78 to 3.31III1.861.35 to 2.56
IV2.011.46 to 2.75IV3.042.26 to 4.09IV2.251.64 to 3.08
P for trend0.260.26<0.01
Prostate885III
II3.052.46 to 3.78II2.321.82 to 2.97II1.971.59 to 2.45
III3.753.02 to 4.64III4.873.89 to 6.11III2.572.08 to 3.18
IV2.492.00 to 3.11IV5.364.27 to 6.73IV2.712.20 to 3.34
P for trend0.02<0.01<0.01
Larynx62III
II1.320.67 to 2.58II1.710.93 to 3.14II1.780.93 to 3.39
III1.991.08 to 3.65III1.490.69 to 3.19III1.490.73 to 3.00
IV0.630.28 to 1.40IV1.390.67 to 2.90IV1.30.62 to 2.71
P for trend0.370.240.4
Brain106III
II1.160.65 to 2.08II1.30.76 to 2.25II2.161.21 to 3.87
III1.10.60 to 2.00III1.260.68 to 2.36III3.161.79 to 5.55
IV1.751.06 to 2.90IV2.51.53IV2.341.22 to 4.47
P for trend0.03<0.01<0.01
Pancreas328III
II2.21.63 to 2.97II1.591.18 to 2.15II1.320.98 to 1.78
III2.151.56 to 2.96III2.191.60 to 3.00III1.441.05 to 1.99
IV1.771.31 to 2.39IV2.61.94 to 3.49IV1.961.46 to 2.64
P for trend0.930.42<0.01
Liver122III
II2.161.28 to 3.66II1.530.93 to 2.50II1.170.68 to 2.00
III3.21.97 to 5.19III1.961.16 to 3.29III1.911.16 to 3.14
IV1.60.94 to 2.73IV2.861.78 to 4.59IV1.841.11 to 3.05
P for trend0.520.03<0.01
In situ, benign and tumours of unknown origin36III
II1.180.38 to 3.63II0.780.31 to 1.97II0.420.14 to 1.21
III1.050.36 to 3.07III0.460.06 to 3.67III00.00 to 0.00
IV0.270.06 to 1.13IV0.30.04 to 2.18IV0.530.18 to 1.53
P for trend0.360.40.07
Cancers associated with the rubber industry**6860III
II1.471.37 to 1.57II1.321.23 to 1.41II1.211.13 to 1.29
III1.851.73 to 1.98III1.821.70 to 1.95III1.391.29 to 1.48
IV1.491.40 to 1.59IV2.071.94 to 2.21IV1.491.39 to 1.59
P for trend<0.01<0.01<0.01
  • *Cumulative nitrosamines sum score is a sum of NDMA, NMor, NDBA, NDEA and NPIP.

  • †Exposure quartiles I: <10.03 year µg/m3 (384 893.5 person years); II: 10.03–21.38 year µg/m3 (165 784.3 person years); III: 21.38–442.93 year µg/m3 (142 507.6 person years); IV: >442.93 year µg/m3 (187 608.3 person years).

  • ‡SHRs from competing risk survival analysis adjusted for birth year.

  • §Exposure quartiles I: <3.12 year µg/m3 (407 378.9 person years); II: 3.12–5.96 year µg/m3 (210 818.3 person years); III: 5.96–9.67 year µg/m3 (133 681.9 person years); IV: >9.67 year µg/m3 (128 914.5 person years).

  • ¶Exposure quartiles I: <4.69 year µg/m3 (360 154.8 person years); II: 4.69–9.77 year µg/m3 (216 870.8 person years); III: 9.77–16.40 year µg/m3 (165 740.5 person years); IV: >16.40 year µg/m3 (138 027.5 person years).

  • **Cancers of the bladder, lung, stomach, oesophagus, prostate, larynx, brain, pancreas, liver, lymphatic and haematopoietic tissue.

  • NDBA, N-nitrosodibutylamine; NDEA, N-nitrosodiethylamine; NDMA, N-nitrosodimethylamine; NMor, N-nitrosomorpholine; NPIP, N-nitrosopiperidine; SHR, subdistribution HR.