title: Risk of upper aerodigestive tract cancers in a case-cohort study of autoworkers exposed to metalworking fluids.
abstract: OBJECTIVE
  To re-examine aerodigestive cancer risk in a cohort of autoworkers exposed to metal working fluids (MWF), using improved case definition and more recently diagnosed cases.
  
  
  METHODS
  The autoworker cohort included 31 100 hourly workers alive on 1 January 1985 who worked at three automobile plants in Michigan. A case-cohort design was carried out that included incident cases of cancers of the larynx, oesophagus, and stomach, and a 10% sample of the cohort. A Cox proportional hazards model was used to estimate MWF exposure effects. The smoothing method of penalised splines was used to explore the shape of the underlying exposure-response curves.
  
  
  RESULTS
  The most important finding was the association between larynx cancer incidence and cumulative straight MWF exposure. The results for oesophageal cancer were less consistent. For stomach cancer there was no evidence of excess risk.
  
  
  CONCLUSIONS
  This association between larynx cancer and straight MWF exposures was consistent with a previous finding in this cohort, providing further support for a causal relation.
authors.affiliation: Work Environment Department, University of Massachusetts Lowell, Lowell, MA 01854, USA.
authors.forename: A
authors.initials: A
authors.lastname: Zeka
authors.forename: E A
authors.initials: EA
authors.lastname: Eisen
authors.forename: D
authors.initials: D
authors.lastname: Kriebel
authors.forename: R
authors.initials: R
authors.lastname: Gore
authors.forename: D H
authors.initials: DH
authors.lastname: Wegman
mesh_terms: D000368:Aged; D001336:Automobiles; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007219:Industrial Oils / Q000009:adverse effects*; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000209:etiology