title: Constitutional and occupational risk factors associated with bladder cancer.
abstract: OBJECTIVE
  Bladder carcinoma (BC) is the fourth most common type of cancer in males from Western countries, with primary prevention an important healthcare challenge. We review the associated constitutional and occupational risk factors (RF), with greater or lesser scientific evidence, in the aetiology of BC.
  
  
  METHODS
  Literature review of the last 25 years of the constitutional and occupational RF associated with BC, conducted on MedLine, CancerLit, Science Citation Index and Embase. The search profiles were Risk factors/Genetic factors/Genetic polymorphisms/Epidemiology/Occupational factors and Bladder cancer.
  
  
  RESULTS
  The main RF were a) age and gender (diagnosed at age 65 and over, with a 4:1 ratio of males to females); b) race, ethnicity and geographic location (predominantly in Caucasians and in Southern European countries); c) genetic (N-acetyltransferase-2 and glutathione s-transferase M1 gene mutations, which significantly increase the risk for BC); d) occupational, which represent 5%-10% of BC RF; and f) occupations with high BC risk, such as aluminium production, the manufacture of dyes, paints and colourings, the rubber industry and the extraction and industrial use of fossil fuels.
  
  
  CONCLUSIONS
  BC is the end result of the variable combination of constitutional and environmental RF, the majority of which are unknown. The most significant constitutional RF are related to age, gender, race, ethnicity geographic location and genetic polymorphisms. The main occupational RF are those related to aromatic amines and polycyclic aromatic hydrocarbons.
authors.affiliation: Unitat de Salut Mediambiental Pediàtrica, Unitat d'Oncologia Pediàtrica, Hospital Universitari i Politècnic La Fe, València, España. Electronic address: ferris_jos@gva.es.
authors.forename: J
authors.initials: J
authors.lastname: Ferrís
authors.forename: J
authors.initials: J
authors.lastname: Garcia
authors.forename: O
authors.initials: O
authors.lastname: Berbel
authors.forename: J A
authors.initials: JA
authors.lastname: Ortega
mesh_terms: D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D016273:Occupational Exposure / Q000009:adverse effects*; D011110:Polymorphism, Genetic; D012307:Risk Factors; D012737:Sex Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics
keywords: Aminas aromáticas; Aromatic amines; Bladder cancer; Cáncer vesical; Epidemiology; Epidemiología; Exposiciones ocupacionales; Factores de riesgo genéticos; Genetic risk factors; Hidrocarburos policíclicos aromáticos; Occupational exposure; Polycyclic aromatic hydrocarbons