title: Brain tumors and occupational exposures in a cohort of female textile workers in Shanghai, China.
abstract: OBJECTIVE
  This study assessed the associations between brain tumors and specific processes and exposures among female textile workers in Shanghai, China.
  
  
  METHODS
  A case-cohort study was conducted that was nested in a cohort of textile workers originally included in a randomized trial of breast self-examination. Incident brain tumor cases (N=114) were identified from 1989 to 1998 from a tumor and death registry operated by the Shanghai Textile Industry Bureau. A subcohort (N=3188), representing an age-stratified random sample of the entire cohort, was selected as a comparison group. Job-exposure matrices were created to assess historical exposures to specific agents, including quantitative assessments for cotton dust and endotoxin exposure. Cox proportional hazards modeling, modified according to a case-cohort design, was used to analyze associations between jobs and exposures and the risk of brain tumors.
  
  
  RESULTS
  Employment in maintenance workshops was associated with an increased brain tumor incidence (ever-never exposed hazard ratio 2.36, 95% confidence interval 1.12-4.97), with increasing hazard ratios by duration of employment in maintenance jobs. Handling or processing wool fibers was associated with an increased risk of brain tumors, as was specific exposure to wool fibers; however, estimates did not increase with duration of employment.
  
  
  CONCLUSIONS
  These results provide some preliminary suggestion that employment in textile industry maintenance jobs and exposure to wool products may be associated with an increased risk of brain tumors.
authors.affiliation: Program in Epidemiology, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N. PO Box 19024 Seattle, WA 98109, USA.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Gold
authors.forename: Anneclaire J
authors.initials: AJ
authors.lastname: De Roos
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Ray
authors.forename: Karen
authors.initials: K
authors.lastname: Wernli
authors.forename: E Dawn
authors.initials: ED
authors.lastname: Fitzgibbons
authors.forename: Dao-Li
authors.initials: DL
authors.lastname: Gao
authors.forename: George
authors.initials: G
authors.lastname: Astrakianakis
authors.forename: Ziding
authors.initials: Z
authors.lastname: Feng
authors.forename: David
authors.initials: D
authors.lastname: Thomas
authors.forename: Harvey
authors.initials: H
authors.lastname: Checkoway
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000209:etiology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016273:Occupational Exposure; D013783:Textile Industry; D000078329:Workforce