title: Occupational exposure to arsenic, cadmium, chromium, lead and nickel, and renal cell carcinoma: a case-control study from Central and Eastern Europe.
abstract: OBJECTIVE
  To investigate the risk of renal cell carcinoma (RCC) in Central and Eastern Europe in relation to exposure to known and suspected carcinogenic metals.
  
  
  METHODS
  During 1999-2003, the authors conducted a hospital-based study in Czech Republic, Poland, Romania and Russia, including 1097 cases of RCC and 1476 controls. Occupational exposure to arsenic, cadmium, chromium(III), chromium(VI), lead and nickel was assessed by teams of local industrial hygiene experts, based on detailed occupational questionnaires.
  
  
  RESULTS
  The ORs for RCC were 1.55 (95% CI 1.09 to 2.21) for exposure to lead and 1.40 (95% CI 0.69 to 2.85) for exposure to cadmium. No clear monotonic exposure-response relation was apparent for either duration of exposure or cumulative exposure to either metal, although the OR for the highest category of cumulative exposure to lead was 2.25 (95% CI 1.21 to 4.19). Exposure to other metals did not entail an increased risk of RCC.
  
  
  CONCLUSIONS
  For cadmium, the lack of statistical significance of most results, potential confounding and the absence of clear dose-response relations suggest that an association with RCC is unlikely to be causal. In the case of lead, however, the elevated risk in the category of highest cumulative exposure is noteworthy and justifies further investigation.
authors.affiliation: International Prevention Research Institute, 95 cours Lafayette, Lyon 69006, France. paolo.boffetta@i-pri.org
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Luc
authors.initials: L
authors.lastname: Fontana
authors.forename: Patricia
authors.initials: P
authors.lastname: Stewart
authors.forename: David
authors.initials: D
authors.lastname: Zaridze
authors.forename: Neonilia
authors.initials: N
authors.lastname: Szeszenia-Dabrowska
authors.forename: Vladimir
authors.initials: V
authors.lastname: Janout
authors.forename: Vladimir
authors.initials: V
authors.lastname: Bencko
authors.forename: Lenka
authors.initials: L
authors.lastname: Foretova
authors.forename: Viorel
authors.initials: V
authors.lastname: Jinga
authors.forename: Vsevolod
authors.initials: V
authors.lastname: Matveev
authors.forename: Helena
authors.initials: H
authors.lastname: Kollarova
authors.forename: Gilles
authors.initials: G
authors.lastname: Ferro
authors.forename: Wong-Ho
authors.initials: WH
authors.lastname: Chow
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
authors.forename: Dana
authors.initials: D
authors.lastname: van Bemmel
authors.forename: Sara
authors.initials: S
authors.lastname: Karami
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.forename: Lee E
authors.initials: LE
authors.lastname: Moore
mesh_terms: D000328:Adult; D000368:Aged; D001151:Arsenic / Q000633:toxicity*; D002104:Cadmium / Q000633:toxicity; D002292:Carcinoma, Renal Cell / Q000139:chemically induced / Q000453:epidemiology*; D016022:Case-Control Studies; D002857:Chromium / Q000633:toxicity; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D007854:Lead / Q000633:toxicity; D008297:Male; D019216:Metals, Heavy / Q000633:toxicity*; D008875:Middle Aged; D009532:Nickel / Q000633:toxicity; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D019216:Metals, Heavy; D002104:Cadmium; D002857:Chromium; D007854:Lead; D009532:Nickel; D001151:Arsenic