title: Occupational risk factors for endometrial cancer among textile workers in Shanghai, China.
abstract: OBJECTIVE
  A case-cohort study was conducted to investigate associations between occupational exposures and endometrial cancer nested within a large cohort of textile workers in Shanghai, China.
  
  
  METHODS
  The study included 176 incident endometrial cancer cases diagnosed from 1989 to 1998 and a randomly-selected age-stratified reference subcohort (n = 3,061). Study subjects' complete work histories were linked to a job-exposure matrix developed specifically for the textile industry to assess occupational exposures. Hazard ratios (HR) and 95% confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design, adjusting for age at menarche and a composite variable of gravidity and parity.
  
  
  RESULTS
  An increased risk of endometrial cancer was detected among women who had worked for > or =10 years in silk production (HR = 3.8, 95% CI 1.2-11.8) and had exposure to silk dust (HR = 1.7, 95% CI 0.9-3.4). Albeit with few exposed women (two cases and eight subcohort women), there was a 7.4-fold increased risk associated with > or =10 years of silica dust exposure (95% CI 1.4-39.7).
  
  
  CONCLUSIONS
  The findings suggest that some textile industry exposures might play a role in endometrial carcinoma and should be further replicated in other occupational settings.
authors.affiliation: Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington 9810, USA. kwernli@fhcrc.org
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Wernli
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Ray
authors.forename: Dao Li
authors.initials: DL
authors.lastname: Gao
authors.forename: E Dawn
authors.initials: ED
authors.lastname: Fitzgibbons
authors.forename: Janice E
authors.initials: JE
authors.lastname: Camp
authors.forename: George
authors.initials: G
authors.lastname: Astrakianakis
authors.forename: Noah
authors.initials: N
authors.lastname: Seixas
authors.forename: Wenjin
authors.initials: W
authors.lastname: Li
authors.forename: Anneclaire J
authors.initials: AJ
authors.lastname: De Roos
authors.forename: Ziding
authors.initials: Z
authors.lastname: Feng
authors.forename: David B
authors.initials: DB
authors.lastname: Thomas
authors.forename: Harvey
authors.initials: H
authors.lastname: Checkoway
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D004391:Dust; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D047011:Silk; D013783:Textile Industry / Q000706:statistics & numerical data*
chemical_list: D004391:Dust; D047011:Silk