title: Relationship between cumulative exposure to 1,2-dichloropropane and incidence risk of cholangiocarcinoma among offset printing workers.
abstract: This study aimed to evaluate the relationship between cumulative exposure to 1,2-dichloropropane (1,2-DCP) and incidence risk of cholangiocarcinoma among workers in the offset proof-printing section of a small printing company in Osaka, Japan.
  
  
  
  We identified 95 workers of a printing company (78 men and 17 women) who had been exposed to 1,2-DCP between 1987 and 2006, and calculated the standardised incidence ratio (SIR) of cholangiocarcinoma from 1987 to 2012. We estimated cumulative exposure to 1,2-DCP and calculated SIRs in four exposure categories. We also calculated incidence rate ratios (RRs) adjusted by sex, age, calendar year and dichloromethane (DCM) exposure for three exposure categories using Poisson regression analysis.
  
  
  
  Cumulative exposures to 1,2-DCP ranged from 32 to 3433 ppm-years (mean, 851 ppm-years) and the SIR was 1171 (95% CI 682 to 1875). In the analysis of the four exposure categories, SIRs increased significantly in the three highest exposure categories, but not in the lowest category. Adjusted RRs in the middle and high exposure categories were 14.9 (95% CI 4.1 to 54.3) and 17.1 (95% CI 3.8 to 76.2), respectively, in the analysis without lag time, and were 11.4 (95% CI 3.3 to 39.6) and 32.4 (95% CI 6.4 to 163.9), respectively, in the analysis with a 5-year lag. The trend analysis revealed a significant increase in RR in association with increasing cumulative exposure to 1,2-DCP. DCM exposure was not significantly associated with the development of cholangiocarcinoma.
  
  
  
  The present study demonstrated an exposure-response relationship between exposure to 1,2-DCP and the development of cholangiocarcinoma.
authors.affiliation: Department of Occupational and Environmental Management, University of Occupational and Environmental Health, Kitakyusyu, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kumagai
authors.affiliation: Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Sobue
authors.affiliation: Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Makiuchi
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.affiliation: Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Uehara
authors.affiliation: Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kyoko Kogawa
authors.initials: KK
authors.lastname: Sato
authors.affiliation: Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan Ohara Memorial Institute for Science of Labor, Tokyo, Japan.
authors.forename: Ginji
authors.initials: G
authors.lastname: Endo
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000139:chemically induced*; D018281:Cholangiocarcinoma / Q000139:chemically induced*; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000009:adverse effects*; D015994:Incidence; D007221:Industry; D007564:Japan; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects*; D011327:Printing; D011407:Propane / Q000009:adverse effects / Q000031:analogs & derivatives*; D012307:Risk Factors
chemical_list: D006843:Hydrocarbons, Chlorinated; C004765:propylene dichloride; D011407:Propane
keywords: 1,2-dichloropropane; Bile duct cancer; Printing workers