title: Occupational Lead Exposure and Associations with Selected Cancers: The Shanghai Men's and Women's Health Study Cohorts.
abstract: BACKGROUND
  Epidemiologic studies of occupational lead exposure have suggested increased risks of cancers of the stomach, lung, kidney, brain, and meninges; however, the totality of the evidence is inconsistent.
  
  
  OBJECTIVE
  We investigated the relationship between occupational lead exposure and cancer incidence at the five abovementioned sites in two prospective cohorts in Shanghai, China.
  
  
  METHODS
  Annual job/industry-specific estimates of lead fume and lead dust exposure, derived from a statistical model combining expert lead intensity ratings with inspection measurements, were applied to the lifetime work histories of participants from the Shanghai Women's Health Study (SWHS; n = 73,363) and the Shanghai Men's Health Study (SMHS; n = 61,379) to estimate cumulative exposure to lead fume and lead dust. These metrics were then combined into an overall occupational lead exposure variable. Cohort-specific relative hazard rate ratios (RRs) and 95% confidence intervals (CIs) comparing exposed and unexposed participants were estimated using Cox proportional hazards regression and combined by meta-analysis.
  
  
  RESULTS
  The proportions of SWHS and SMHS participants with estimated occupational lead exposure were 8.9% and 6.9%, respectively. Lead exposure was positively associated with meningioma risk in women only (n = 38 unexposed and 9 exposed cases; RR = 2.4; 95% CI: 1.1, 5.0), particularly with above-median cumulative exposure (RR = 3.1; 95% CI: 1.3, 7.4). However, all 12 meningioma cases among men were classified as unexposed to lead. We also observed non-significant associations with lead exposure for cancers of the kidney (n = 157 unexposed and 17 ever exposed cases; RR = 1.4; 95% CI: 0.9, 2.3) and brain (n = 67 unexposed and 10 ever exposed cases; RR = 1.8; 95% CI: 0.7, 4.8) overall.
  
  
  CONCLUSIONS
  Our findings, though limited by small numbers of cases, suggest that lead is associated with the risk of several cancers in women and men.
  
  
  BACKGROUND
  Liao LM, Friesen MC, Xiang YB, Cai H, Koh DH, Ji BT, Yang G, Li HL, Locke SJ, Rothman N, Zheng W, Gao YT, Shu XO, Purdue MP. 2016. Occupational lead exposure and associations with selected cancers: the Shanghai Men's and Women's Health Study cohorts. Environ Health Perspect 124:97-103; http://dx.doi.org/10.1289/ehp.1408171.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Liao
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Friesen
authors.forename: Yong-Bing
authors.initials: YB
authors.lastname: Xiang
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.forename: Dong-Hee
authors.initials: DH
authors.lastname: Koh
authors.forename: Bu-Tian
authors.initials: BT
authors.lastname: Ji
authors.forename: Gong
authors.initials: G
authors.lastname: Yang
authors.forename: Hong-Lan
authors.initials: HL
authors.lastname: Li
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Locke
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Gao
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007854:Lead / Q000633:toxicity*; D008297:Male; D008579:Meningioma / Q000453:epidemiology; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D007854:Lead