International renal-cell cancer study. IV. Occupation

Our plain-English summary of International renal-cell cancer study. IV. Occupation, by J.S. Mandel, J.K. McLaughlin, B. Schlehofer, et al (International Journal of Cancer, 1995).

The study

• Authors: J.S. Mandel, J.K. McLaughlin, B. Schlehofer, A. Mellemgaard, U. Helmert, P. Lindblad, M. McCredie, H.O. Adami
• Journal: International Journal of Cancer
• Published: 1995;61(5):601-5
• Cited by: 138 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The relationship between renal-cell cancer (RCC) and occupation was investigated in an international multicenter population-based case-control study. Study centers in Australia, Denmark, Germany, Sweden and the United States interviewed 1732 incident RCC cases and 2309 controls. Significant associations were found with employment in the blast-furnace or the coke-oven industry [relative risk (RR), 1.7; 95% confidence interval (CI), 1.1-2.7], the iron and steel industry (RR, 1.6; 95% CI, 1.2-2.2) and exposure to asbestos (RR, 1.4; 95% CI, 1.1-1.8), cadmium (RR, 2.0; 95% CI, 1.0-3.9), dry-cleaning solvents (RR, 1.4; 95% CI, 1.1-1.7), gasoline (RR, 1.6; 95% CI, 1.2-2.0) and other petroleum products (RR, 1.6; 95% CI, 1.3-2.1). Asbestos, petroleum products and dry-cleaning solvents appear to merit further investigation, in view of the relationship between risk and duration of employment or exposure and after adjustment for confounding. There was a negative association between RCC and education, but it was not consistent across all centers. Overall, the results of our multicenter case-control study suggest that occupation may be more important in the etiology of RCC than indicated by earlier studies.

In plain English

This international population-based case-control study looked at whether jobs and workplace exposures were linked to renal-cell cancer, a kidney cancer. Centers in Australia, Denmark, Germany, Sweden and the United States interviewed 1732 people diagnosed between 1989 and 1991 and 2309 comparison people (controls). People counted as exposed if they reported at least one year of exposure. The study did not report which asbestos fiber types participants were exposed to. Among men, 19.1% of cases and 13.1% of controls reported asbestos exposure. For men, asbestos was associated with renal-cell cancer (relative risk 1.4; 95% confidence interval 1.1 to 1.8). Men also showed associations with blast-furnace or coke-oven work, iron and steel work, cadmium, dry-cleaning solvents, gasoline and other petroleum products. Among women, the only significant association was with dry-cleaning solvents. Risk did not clearly rise with longer exposure, except for other petroleum products. The authors concluded that their asbestos finding supported earlier studies and suggested a relation. They added that more research on duration or amount of exposure was needed before a causal link could be confidently concluded. They also noted that this kind of study relies on participants' recall.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: multicenter international population-based case-control study (6 centers in 5 countries)
• Who was studied: 1732 incident renal-cell cancer cases and 2309 frequency-matched controls, men and women aged 20 to 79 (20 to 75 in Heidelberg), diagnosed 1989 to 1991, from Sydney (Australia), Denmark, Berlin and Heidelberg (Germany), Uppsala (Sweden) and Minnesota (USA); about 60% male
• Exposure: Self-reported work in specific industries and occupations and exposure to agents including asbestos, cadmium, dry-cleaning solvents, gasoline, other petroleum products (jet fuel, heating oil, kerosene, diesel fuel), cutting oils, radiation and pesticides; exposed meant at least one year of work or exposure; the fiber types of participants' asbestos exposure were not reported
• Main results:
  • Among men, asbestos exposure was reported by 19.1% of cases and 13.1% of controls (200 exposed male cases, 187 exposed male controls)
  • Among men, asbestos exposure was significantly associated with renal-cell cancer: RR 1.4 (95% CI 1.1 to 1.8), adjusted for age, center, body-mass index and smoking
  • Among men, employment in blast furnaces or coke ovens (RR 1.7; 95% CI 1.1 to 2.7) and the iron and steel industry (RR 1.6; 95% CI 1.2 to 2.2) was significantly associated with renal-cell cancer
  • Among men, cadmium (RR 2.0; 95% CI 1.0 to 3.9), dry-cleaning solvents (RR 1.4; 95% CI 1.1 to 1.7), gasoline (RR 1.6; 95% CI 1.2 to 2.0) and other petroleum products (RR 1.6; 95% CI 1.3 to 2.1) were significantly associated
  • Among women, the only statistically significant association was with dry-cleaning solvents (RR 1.6; 95% CI 1.0 to 2.7)
  • There was no clear pattern of increasing risk with increasing duration, except for other petroleum products, which showed an increasing risk with duration
  • For cadmium, risk declined with duration, from RR 4.3 for 1 to 10 years of exposure to 1.0 for 31 to 41 years
  • Men and women with college or university education had a 30% lower risk, but this was not consistent across centers
• The authors' conclusion: The authors concluded that their asbestos finding supported earlier studies and suggested a relation with renal-cell cancer. They added that further research showing a relationship with duration of employment or amount of exposure is needed before a causal association can be confidently concluded. They judged that occupation may play a larger role in renal-cell cancer than previously thought.
• Limitations the authors state:
  • Population-based case-control studies rely on participants' recall and are not the most accurate method for identifying specific occupational risks
  • Centers collected occupational information differently, so only occupations and exposures common to all centers were analyzed
  • There were relatively few physicians and dentists in the study
  • The various other petroleum products could not be told apart because they were asked about as a group

Topics

Medical terms in this study, explained in our Lexicon: Case-Control Study, Relative Risk, confidence interval, Confounding, Etiology.

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