Occupational risk factors for renal cell carcinoma: agent-specific results from a case-control study in Germany. MURC Study Group. Multicenter urothelial and renal cancer study

Our plain-English summary of Occupational risk factors for renal cell carcinoma: agent-specific results from a case-control study in Germany. MURC Study Group. Multicenter urothelial and renal cancer study, by B. Pesch, J. Haerting, U. Ranft, et al (International Journal of Epidemiology, 2000).

The study

• Authors: B. Pesch, J. Haerting, U. Ranft, A. Klimpel, B. Oelschlägel, W. Schill
• Journal: International Journal of Epidemiology
• Published: 2000;29(6):1014-24
• Cited by: 164 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: This case-control study was conducted to estimate the renal cell cancer (RCC) risk for exposure to occupation-related agents, besides other suspected risk factors.

Methods: In a population-based multicentre study, 935 incident RCC cases and 4298 controls matched for region, sex, and age were interviewed between 1991 and 1995 for their occupational history and lifestyle habits. Agent-specific exposure was expert-rated with two job-exposure matrices and a job task-exposure matrix. Conditional logistic regression was used to calculate smoking adjusted odds ratios (OR).

Results: Very long exposures in the chemical, rubber, and printing industries were associated with risk for RCC. Males considered as 'substantially exposed to organic solvents' showed a significant excess risk (OR = 1.6, 95% CI : 1.1-2.3). In females substantial exposure to solvents was also a significant risk factor (OR = 2.1, 95% CI : 1.0-4.4). Excess risks were shown for high exposure to cadmium (OR = 1.4, 95% CI : 1.1-1.8, in men, OR = 2.5, 95% CI : 1.2-5.3 in women), for substantial exposure to lead (OR = 1.5, 95% CI : 1.0-2.3, in men, OR = 2.6, 95% CI : 1.2-5.5, in women) and to solder fumes (OR = 1.5, 95% CI : 1.0-2.4, in men). In females, an excess risk for the task 'soldering, welding, milling' was found (OR = 3.0, 95% CI : 1.1-7.8). Exposure to paints, mineral oils, cutting fluids, benzene, polycyclic aromatic hydrocarbons, and asbestos showed an association with RCC development.

Conclusions: Our results indicate that substantial exposure to metals and solvents may be nephrocarcinogenic. There is evidence for a gender-specific susceptibility of the kidneys.

In plain English

This population-based case-control study, run from 1991 to 1995 in five German regions, compared 935 people with newly diagnosed renal cell cancer, a kidney cancer (570 men, 365 women), with 4298 population controls. Work histories were collected by interview. Expert job-exposure matrices were used to estimate lifetime exposure to metals, solvents, paints, mineral oils, polycyclic aromatic hydrocarbons and asbestos (fiber type not specified), with adjustment for smoking. Men rated as substantially exposed to organic solvents had an odds ratio of 1.6 (95% CI 1.1–2.3), and higher cadmium and lead exposure were linked to raised odds in both sexes. Men in the 'high' asbestos category of the British matrix had an odds ratio of 1.3 (95% CI 1.0–1.7, 103 cases). Asbestos estimates from the authors' job-task matrix were not raised in men (0.9 to 1.0), nor was 'use of asbestos for heat protection'. The authors listed asbestos among agents showing excess risk but cautioned that workplace heat could confound the asbestos results. They concluded that metal and chlorinated-solvent exposure were associated with excess risk.

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: population-based multicentre case-control study, analysed with conditional logistic regression adjusted for smoking
• Who was studied: 935 incident renal cell cancer cases (570 men, 365 women) and 4298 population controls (2650 men, 1648 women) from five German regions (West Berlin, Bremen, Leverkusen, Halle, Jena), interviewed 1991 to 1995
• Exposure: Lifetime occupational exposure estimated from job titles and job tasks using two job-exposure matrices (British and German) and a job task-exposure matrix. Agents included metals (cadmium, lead, solder fumes), solvents, paints, mineral oils, benzene, polycyclic aromatic hydrocarbons and asbestos (no fiber type given). A job task 'use of asbestos for heat protection' was also analysed.
• Main results:
  • Men rated as substantially exposed to organic solvents (British JEM) had an odds ratio of 1.6 (95% CI 1.1–2.3); women with substantial solvent exposure (job-task matrix) had an odds ratio of 2.1 (95% CI 1.0–4.4)
  • High cadmium exposure: odds ratio 1.4 (95% CI 1.1–1.8) in men and 2.5 (95% CI 1.2–5.3) in women
  • Substantial lead exposure: odds ratio 1.5 (95% CI 1.0–2.3) in men and 2.6 (95% CI 1.2–5.5) in women
  • Men with 'very long' employment as chemical workers (OR 3.1, 95% CI 1.2–7.9), rubber workers (OR 4.3, 95% CI 1.1–17.4) and printers (OR 3.5, 95% CI 1.1–11.2) had significantly elevated risks
  • Women in the task 'soldering, welding, milling' with very long duration had an odds ratio of 3.0 (95% CI 1.1–7.8)
  • Asbestos, British job-exposure matrix, men: medium exposure OR 0.9 (0.7–1.2, 64 cases), high OR 1.3 (1.0–1.7, 103 cases), substantial OR 1.3 (0.9–2.0, 32 cases). Women: high OR 1.5 (0.8–2.8, 15 cases), substantial OR 1.0 (0.3–3.5, 3 cases).
  • Asbestos, job task-exposure matrix, men: medium OR 1.0 (0.7–1.3, 66 cases), high OR 0.9 (0.6–1.2, 61 cases), substantial OR 0.9 (0.6–1.5, 20 cases)
  • Job task 'use of asbestos for heat protection', men: medium duration OR 0.6 (0.3–1.4, 7 cases), long OR 0.9 (0.5–1.8, 10 cases), very long OR 0.3 (0.04–2.4, 1 case)
  • The authors described a slightly increased risk among men for high and substantial polycyclic aromatic hydrocarbon exposure (British JEM) and said this corresponded to the asbestos estimates
• The authors' conclusion: The authors concluded that occupational heavy metal exposure and chlorinated solvent exposure were associated with a significant excess risk for renal cell cancer in men and women. They said petrochemicals, paints, polycyclic aromatic hydrocarbons and asbestos also showed excess risk, and that these results must be discussed in light of methodological limitations.
• Limitations the authors state:
  • The lower response rate among controls (71%) than cases (88%) means selection bias cannot be ruled out
  • Confounding by workplace heat has to be considered for both asbestos and polycyclic aromatic hydrocarbon exposure
  • Mutual confounding by other agents or occupations was not accounted for
  • The British job-exposure matrix did not take into account changes in exposure after 1950
  • The many job titles and low exposure prevalence reduce statistical power and increase chance findings
  • For chlorinated solvents, the increase in relative risk was low and no dose-response relation was shown

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Case-Control Study, Occupational History, Habit, Odds Ratio.

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