Risks of biliary tract cancer and occupational exposures among Shanghai women textile workers: a case-cohort study.
BACKGROUND
Biliary tract cancer (BTC) is a relatively rare malignancy worldwide. Little is known about potential etiologic contributions of occupational exposures.


METHODS
The associations between occupational exposures to textile dusts and chemicals and BTC are investigated in a cohort of 267,400 women textile workers in Shanghai, China. A nested case-cohort analysis of 162 BTC cases diagnosed during 1989-1998 was conducted with a reference subcohort of 3,188 workers. Exposures to workplace dusts and chemicals were reconstructed by linking complete work history data with a job-exposure matrix (JEM). Hazard ratios (HR) and dose-response trends were estimated by Cox proportional hazards modeling modified for case-cohort design.


RESULTS
An elevated risk of > or = 1-year employment in maintenance jobs (HR 2.92, 95% CI: 1.48, 5.73) with a significant trend by duration is observed. Excess risk was also found for > or = 20 years exposure to metals (HR 2.50, 95% CI: 1.09, 5.72).


CONCLUSIONS
Long-term exposure to maintenance work and metals in the textile industry may have increased BTC risk in this population.
Chang
Chin-Kuo
CK
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA. ckchang@cuhk.edu.hk
Astrakianakis
George
G
Thomas
David B
DB
Seixas
Noah S
NS
Camp
Janice E
JE
Ray
Roberta M
RM
Gao
Dao Li
DL
Wernli
Karen J
KJ
Li
Wenjin
W
Fitzgibbons
E Dawn
ED
Vaughan
Thomas L
TL
Checkoway
Harvey
H
D000328:Adult; D001661:Biliary Tract Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D004391:Dust; D005260:Female; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013783:Textile Industry; D013784:Textiles / Q000633:toxicity*
D004391:Dust