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Diseases of the kidney and the urinary system - 286 entries found

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  • Diseases of the kidney and the urinary system


CIS 93-231 Mutti A., Alinovi R., Bergamaschi E., Biagini C., Cavazzini S., Franchini I., Lauwerys R.R., Bernard A.M., Roels H., Gelpi E., Rosello J., Ramis I., Price R.G., Taylor S.A., De Broe M., Nuyts G.D., Stolte H., Fels L.M., Herbort C.
Nephropathies and exposure to perchloroethylene in dry-cleaners
In a collaborative European study, the renal effects of occupational exposure to perchloroethylene (PCE) were assessed by comparing markers of nephrotoxic effects in dry-cleaners and matched controls. Exposure was evaluated by measuring the solvent concentration in blood specimens and in air samples; urinary samples were also collected. Several renal disturbances were found among PCE-exposed workers compared with the controls. The findings indicate that solvent-exposed subjects, especially dry-cleaners, need to be monitored for the possible development of chronic renal diseases.
Lancet, 25 July 1992, Vol.340, No.8813, p.189-193. 29 ref.

CIS 92-1983 Indulski J.A., Lutz W.
Biological monitoring of risk of bladder cancer in persons occupationally exposed to aromatic amines
Recent advances in molecular biology and toxicology have greatly contributed to the early detection of biological changes associated with neoplasms. This paper reviews the issues regarding the screening of persons occupationally exposed to carcinogenic aromatic amines. The screening was designed for an early detection of bladder cancer by means of biochemical tests. The tests applied facilitated the estimation of the level of aromatic amines penetrating an organism (biomarkers of exposure), early diagnosis of the biochemical disorders which may influence cancer development (biomarkers of early effects) and the detection of genetic predispositions which enhance the risk of such disorders (biomarkers of susceptibility).
Polish Journal of Occupational Medicine and Environmental Health, 1992, Vol.5, No.2, p.143-151. 51 ref.

CIS 92-1334 Pin N.T., Ling N.Y., Siang L.H.
Dehydration from outdoor work and urinary stones in a tropical environment
A questionnaire survey was carried out to determine the prevalence of urinary stone disease among 406 male workers in several occupations in Singapore: quarry drilling and crusher workers, quarry truck and loader drivers, postal delivery men and hospital maintenance workers. The prevalence of urinary stone disease was found to be 5 times higher in outdoor workers compared to indoor workers, and contrary to expectation, no increased risk of urolithiasis was apparent in physically inactive workers. Chronic dehydration is likely to be the most important factor for increased risk of urolithiasis in outdoor workers in the tropics, and should be easily prevented by increased water intake.
Occupational Medicine, Feb. 1992, Vol.42, No.1, p.30-32. 9 ref.


CIS 95-86 Marqués Marqués F.
Toxic nephropathies - Aetiology and preclinical markers for epidemiological surveillance
Nefropatías tóxicas - Etiología y marcadores preclínicos para la vigilancia epidemiológica [in Spanish]
Manual and technical information note on nephropathies caused by toxic substances and their epidemiological monitoring. Topics covered: economic impact; renal physiopathology and aetiological classification of nephropathies; renal dysfunction caused by metals and solvents; renal function assessment; biological monitoring of toxic nephropathies and epidemiological surveillance.
Instituto Nacional de Seguridad e Higiene en el Trabajo, Ediciones y Publicaciones, c/Torrelaguna 73, 28027 Madrid, Spain, Sep. 1991. 94p. Illus. Bibl.ref.

CIS 94-871 Sherson D., Svane O., Lynge E.
Cancer incidence among foundry workers in Denmark
Cancer incidence was studied among 6,144 male foundry workers who participated in either of two Danish national silicosis surveys conducted during 1967-1969 and 1972-1974. Cancer incidence was followed through to the end of 1985 by computerized linkage to the Danish Cancer Registry, and standardized morbidity ratios (SMRs) were calculated based on incidence rates for the Danish population. For the entire cohort, significantly elevated SMRs were seen for all cancers (SMR, 1.09; 95% CI, 1.01-1.18) and lung cancer (SMR, 1.30; 95% CI, 1.12-1.51) and SMRs were at the borderline of statistical significance for bladder cancer (SMR, 1.24; 95% CI, 0.97-1.59). Excess lung and bladder cancer risk was confined to workers who had worked in foundries for at least 20yrs. There was a positive correlation between silicosis prevalence in employees at the foundries at the time of the X-ray examinations and lung cancer incidence during the follow-up period. Squamous cell carcinomas, anaplastic carcinomas, and other lung cancers accounted for the excess lung cancer risk, whereas there was not an excess risk among the foundry workers for adenocarcinomas of the lung.
Archives of Environmental Health, Mar.-Apr. 1991, Vol.46, No.2, p.75-81. 34 ref.

CIS 94-558 Vineis P., Simonato L.
Proportion of lung and bladder cancers in males resulting from occupation: A systematic approach
Studies conducted in several countries that investigated the relationship of occupation and cancer in men were reviewed and compared. Estimates of the proportion of cancers due to occupational exposure that occurred in the general population were analyzed, and sources of variation were explored. A systematic and standardized evaluation of studies on lung and bladder cancer were undertaken, and only investigations that allowed for confounding from tobacco smoking were included. The proportion of lung cancers attributable to occupation ranged between 1 and 5% (when considering only exposure to asbestos) and 40% (in a study with a high proportion of subjects exposed to ionizing radiation); for bladder cancer, estimates were between 0 and 3% in a few studies and between 16 and 24% in several investigations. No similar attempt at systematic comparison was possible for other cancers.
Archives of Environmental Health, Jan.-Feb. 1991, Vol.46, No.1, p.6-15. 68 ref.

CIS 93-1545 Marsh G.M., Leviton L.C., Talbott E.O., Callahan C., Pavlock D., Hemstreet G., Logue J.N., Fox J., Schulte P.
Drake Chemical Workers' Health Registry Study: I. Notification and medical surveillance of a group of Workers at high risk of developing bladder cancer
A medical surveillance programme and epidemiologic study of 408 former workers of the Drake Chemical Company was established in 1986. The Drake Health Registry Study was initiated because these workers had probable past exposures to beta-naphthylamine (BNA), a potent bladder carcinogen. The registry is widely viewed as a model for notification of workers at high risk of bladder cancer. 40 months later, out of the 366 living workers 262 were enrolled in the annual screening for bladder cancer. Among these, 27 persons have had abnormal screening results indicating moderate to high risk of bladder cancer and were made eligible for further diagnostic tests. While no invasive bladder tumors were found among 18 persons completing the extended diagnostic evaluation, two diagnoses of moderate to severe dysplasia were made. The registry has also identified three living and three deceased cases of bladder cancer in the cohort; a mortality analysis showed a 20- to 30-fold excess of bladder cancer. An incidence projection has revealed that between six and ten new bladder cancer cases are likely to occur among the Drake cohort over the next year period.
American Journal of Industrial Medicine, Mar. 1991, Vol.19, No.3, p.291-301. 18 ref.

CIS 93-174 Becherini R., Seniori Costantini A., Benelli R., Calistri S., Gasperini M.M., Gavazzi M., Masala G., Merler E., Monechi V., Nannini R., Paci E., Zappa M., Kriebel D.
Urinary tract tumours in textile workers in the Prato area
Tumori delle vie urinarie escretrici negli addetti all'industria tessile nell'area pratese [in Italian]
A hospital-based case control study on bladder and lower urinary tract cancers was conducted in the Prato area, Italy, where the textile industry is the main manufacturing sector (about 50,000 employees). 'Cases' were male subjects, aged over 15yrs in whom urothelial cancer had been diagnosed during the period 1980-1985; control (two for each case) were subjects of the same sex and age with other urological diseases or cancer of the prostate or testis. Cases and controls were interviewed via a questionnaire on occupational history and personal habits. A positive association was found for subjects who had worked in the textile industry (OR=1.42). Analysis by job title showed a positive association for "rag selectors" (OR=4.09), whereas no association was found for dyers (OR=0.74).
Medicina del lavoro, Nov.-Dec. 1991, Vol.82, No.6, p.492-503. 31 ref.

CIS 93-253 Hashimoto D.M., Kelsey K.T., Seitz T., Feldman H.A., Yakes B., Christiani D.C.
The presence of urinary cellular sediment and albuminuria in newspaper pressworkers exposed to solvents
A cross-sectional study of 215 newspaper pressroom workers (76% of the total eligigle) was conducted to investigate the relationship between organic solvent exposure and increased urinary cellular sediment. Thirty-two compositors were surveyed as referents. Industrial hygiene measurements showed low-level airborne exposure to organic solvents and minimal airborne exposure to glycol ethers. There was a high prevalence of solvent-related dermatitis, indicating significant dermal exposure to these substances. Pressworkers were exposed to solvent mixtures associated with dose-related increases in leukocyturia alone or in urinary cellular sediment. The presence of urinary cellular sediment was associated with increasing frequency of use of five organic solvent mixtures. The increase in urinary cellular sediment may be due to the effects of solvents on the kidney. Sixteen percent of pressmen and no compositors were found to have primarily low-grade albuminuria. Workers with urinary cellular sediment were significantly more likely to have detectable albuminuria, which was more likely to occur with increased frequency of use of four solvent mixtures.
Journal of Occupational Medicine, Apr. 1991, Vol.33, No.4, p.516-526. Illus. 49 ref.

CIS 92-1910 Serre C.
The bladder: target organ of tobacco - Prevention and detection of cancer
La vessie, organe cible du tabac - Prévention et dépistage du cancer [in French]
Summary of papers presented at a Colloquium organised in Paris on 24 May 1991 concerning the prevention and detection of bladder cancer and the role of tobacco smoking on its development. Main topics discussed: classification and evolution of bladder cancers; risk factors (results of an epidemiological survey of 700 cases; risk factors recognised today; role of tobacco; case-control study of environmental factors); detection, diagnosis and prognosis; role of endoscopy; anti-smoking campaings; role of the occupational physician in preventive efforts. It was recommended that in a case of bladder cancer all possible (present or past) occupational factors should be investigated, even in heavy smokers, so that the disease can be declared as an occupational disease or as being of an occupational nature.
Documents pour le médecin du travail, 4th Quarter 1991, No.48, p.377-381.

CIS 92-1535 Partanen T., Heikkilä P., Hernberg S., Kauppinen T., Moneta G., Ojajärvi A.
Renal cell cancer and occupational exposure to chemical agents
A case-referent study of occupational risk indicators of renal cell adenocarcinoma was conducted. Each incident case in Finland in 1977-1978 was matched with two population referents. Lifelong job histories were collected and translated into indicators of industry, occupation, and occupational exposures. The analyses of 338 sets of cases and referents revealed elevated risks for a history of employment in: white-collar occupations; the printing industry; the chemical industry; the manufacture of metal products; mail, telephone, and telegraph services; metalworking. A decreased risk was observed for male farmers. An elevated risk and an exposure-response relationship were found for gasoline exposure. The excess risk was highest at a latency period of approximately 30 years. The findings support the hypothesis that exposure to some constituent(s) of gasoline increases the incidence of renal adenocarcinoma in humans. Suggestions of elevated risks appeared for exposures to inorganic lead, cadmium, and nonchlorinated solvents.
Scandinavian Journal of Work, Environment and Health, Aug. 1991, Vol.17, No.4, p.231-239. 47 ref.

CIS 92-878 Spinelli J.J., Band P.R., Svirchev L.M., Gallagher R.P.
Mortality and cancer incidence in aluminum reduction plant workers
An historical cohort study was conducted among 4,213 men who worked for 5 or more years at an aluminium reduction plant. Standardised mortality and incidence ratios were used to compare the mortality and cancer incidence of the cohort with that of the population (British Columbia, Canada) and to examine risk by cumulative exposure to coal-tar pitch volatiles (CTPV) and electromagnetic fields. Significantly elevated rates were observed for bladder cancer incidence and brain cancer mortality. The risk of bladder cancer was strongly related to cumulative exposure to CTPV (p<.01). The risk for non-Hodgkin's lymphoma also increased with increasing exposure (p<.05), although the overall rate was similar to that of the general population. The lung cancer rate was as expected, but showed a weak association with CTPV exposure that was not statistically significant. No individual cause of death or incident cancer site was related to exposure to electromagnetic fields.
Journal of Occupational Medicine, Nov. 1991, Vol.33, No.11, p.1150-1155. 10 ref.

CIS 92-464 Matsuoka K., Etoh K., Yoshitake N.
Clinical analysis of patients with occupational urothelial tumours
Shokugyōsei nyōro jōhi shuyō no kaiseki [in Japanese]
The incidence of occupational urothelial carcinoma and the accompanying problems were studied in workers who had manufactured or handled dyestuffs at a chemical factory. 25 cases of urothelial carcinomas, mainly consisting of urinary bladder carcinoma, occurred among 398 men who were examined at regular intervals; the incidence rate was 6.3%. The mean age at onset, mean period of exposure to aromatic compounds and mean latent period were 61 years, 7.2 years and 30 years, respectively. The highest incidences were associated with prolonged exposure and smoking. As the age at entry in the workforce advanced, the latent period became shorter. The incidence was highest in workers exposed to 2 or 3 aromatics, followed by those exposure to benzidine and alpha-naphthylamine. No urothelial carcinoma occured in those who worked with beta-naphthylamine. 94% of the carcinomas were superficial and transurethral resections were performed for bladder carcinomas. The recurrence rate in the bladder cavity after surgery was 39%, which is almost the same as for non-occupational bladder carcinomas; however, the recurrence rate in the upper urinary tract was relatively high (26%). The 5, 10, 20 year survival rates were 92%, 72% and 47%, respectively. Three of the 8 patients dying of cancer died of double cancer. The incidence rate for non-urothelial cancer was 5.7%.
Japanese Journal of Urology, 20 July, 1991, Vol.82, No.7, p.1118-1124. 28 ref.

CIS 92-126 Myslak Z.W., Bolt H.M., Brockmann W.
Tumors of the urinary bladder in painters: A case-control study
In a case-control study, 403 male patients with a diagnosis of "bladder tumour" and (as controls) 426 patients suffering from prostate disease were investigated. Past employment as a painter was associated with an excess risk of bladder tumour. The relative risk of bladder tumour estimated for painters was 2.76. The possible role of benzidine-based azo dyes (or azo dyes based on substituted benzidines) as a carcinogenic risk factor for painters is discussed.
American Journal of Industrial Medicine, June 1991, Vol.19, No.6, p.705-713. 57 ref.


CIS 91-1293 NIOSH Alert - Request for assistance in preventing bladder cancer from exposure to o-toluidine and aniline
On the basis of reviews of human and animal data in the literature and significant new epidemiological evidence of increased bladder cancer presented in this report, NIOSH concludes that o-toluidine and aniline are potential occupational carcinogens and recommends that exposures be reduced to the lowest feasible concentration. Recommended measures include: information and training of personnel; engineering controls (enclosed systems, back-up leak protection); correct work practices; use of chemical protective clothing and respiratory protection; environmental and biological monitoring; medical screening.
National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226, USA, Dec. 1990. 13p. 31 ref.

CIS 91-460 Skov T., Andersen A., Malker H., Pukkala E., Weiner J., Lynge E.
Risk of cancer of the urinary bladder among hairdressers in the Nordic Countries
There is evidence of an increased risk for cancer of the urinary bladder among hairdressers. In a Danish linkage between census data and cancer register data both male and female hairdressers have an elevated risk for bladder cancer. The risk for lung cancer is close to unity, indicating that occupational factors, rather than smoking, may be responsible for the increased risk for bladder cancer among hairdressers. To evaluate this hypothesis a collaborative analysis of data from similar linkages in Finland, Norway, and Sweden was carried out. The combination of high risk for bladder cancer and low or no risk for lung cancer was not found in the other Nordic countries: however, statistically significant increased risks for both bladder and lung cancer were found among male hairdressers in both Norway and Sweden. The relative risks for bladder cancer were of the same magnitude as the relative risks for lung cancer.
American Journal of Industrial Medicine, 1990, Vol.17, No.2, p.217-223. Bibl.ref.

CIS 91-457 Steineck G., Plato N., Norell S.E., Hogstedt C.
Urothelial cancer and some industry-related chemicals: an evaluation of the epidemiologic literature
The authors add combustion gases / soot from coal to the list of substances considered as increasing the risk of urothelial cancer. It is however uncertain whether this risk is due to contaminants of aromatic amines in tar volatiles or whether it depends on other agents, such as nitroarenes or polycyclic aromatic hydrocarbons. The authors find some support for the hypothesis that exposure to chlorinated aliphatic hydrocarbons increases the risk of urothelial cancer. For creosote, cutting fluids and cutting oils, hair dyes, and polychlorinated biphenyls, data are scarce. Available data do not support the hypothesis that asbestos is associated with urothelial cancer.
American Journal of Industrial Medicine, 1990, Vol.17, No.3, p.371-391. Illus. Bibl.ref.

CIS 91-479 Steineck G.
Epidemiological studies on urothelial cancer
The purpose of this thesis was to identify the risk factors for urothelial cancer. Two cohorts were followed up and a case-referent study was made in the county of Stockholm in 1985-87. Pipe smoking increased and intake of supplements (mainly containing vitamin A) decreased the risks. The hypothesis that intake of browned material formed during cooking is an important risk factor was supported in a case-referent study. A dose-response relationship was also seen with an increasing average daily intake of fat. One cohort study gave some support for combustion gases from coal, creosote and polychlorinated biphenyls being associated with urothelial cancer. In the case-referent study, benzene was identified as a possible risk factor. In the epidemiological literature, among industry-related chemicals, only certain combustion gases from coal, besides aromatic amines, have convincingly been linked to urothelial cancer.
Arbetsmiljöinstitutet, Förlagstjänst, 171 84 Solna, Sweden, 1990. 76p. 146 ref.

CIS 91-543 Schulte P.A., Halperin W.E., Ward E.M., Ruder M.A.
Bladder cancer screening in high-risk groups
Proceedings of the international conference on bladder cancer screening in high-risk groups, held in Cincinnati, Ohio, USA, 13-14 September 1989. Papers are grouped under the following headings: general introduction (the role of medical screening; pathology of bladder cancer); detection techniques (including urine cytology, fluorescence image analysis, cystoscopy and bladder mucosal biopsy, hematuria screening); critical review of some screening programmes (workers exposed to 4,4'-methylenebis(2-chloroaniline), β-naphthylamine and benzidine; aluminium production workers; textile dyeing and printing workers); research on detection methods; therapeutic potential (current therapy of bladder cancer; survival statistics; advances in screening protocols for early detection).
Journal of Occupational Medicine, Sep. 1990, Vol.32, No.9, p.787-949. Illus. Bibl.ref.

CIS 91-448 Choi B.C.K., Farmilo J.A.
Microscopic haematuria as a predictor of urological diseases among steel workers
A cohort of 501 workers in a steel mill in Ontario, Canada was followed up from 1974 to 1986. The 13-year cumulative incidence of urological diseases among workers who were positive for microscopic haematuria in 1974 was 1.3 times that of those who had a negative result. This relative risk remained the same after adjusting for age and smoking. Thus, urinary screening for microscopic haematuria could be a useful predictor of urological disease.
Journal of the Society of Occupational Medicine, Summer 1990, Vol.40, No.2, p.47-52. Illus. 23 ref.

CIS 91-221
International Programme on Chemical Safety (IPCS)
Selected mycotoxins: Ochratoxins, trichothecenes, ergot
Human exposure to mycotoxins has been documented mainly through food contamination. Information on adverse health effects is, however, scarce. Epidemiological data indicate that Balkan nephropahty may be associated with food contamination by ochratoxin A and a significant relationship has been observed between Balkan nephropathy and tumours of the urinary tract. Reported cases of illness associated with exposure to trichothecenes are scarce and none has been established as being due to trichothecenes, although two disease outbreaks associated with the consumption of contaminated wheat suggest a causative role. Claviceps-infected grain is a source of human exposure to ergolines, and several outbreaks of ergotism have been reported. Detailed summaries in French and Spanish.
World Health Organization, Distribution and Sales Service, 1211 Genčve 27, Switzerland, 1990. 263p. Bibl.ref. Price: CHF 29.00; Price in developing countries: CHF 20.30.

CIS 91-126 Neumann H.G.
Arylamine induced systematic carcinogenesis
Systemische Kanzerogenese durch Arylamine [in German]
This review of metabolic and cytological processes induced by occupational exposure to arylamines shows that these compounds are activated mainly in the liver. The blood stream distributes the activated metabolites throughout the body and ultimate carcinogens are very likely formed in the target organ. Reactive metabolites initiate cellular susceptibility to tumour promotion. The role of specific enzymes in all of these steps is described. It differs widely among various species.
Arbeitsmedizin - Sozialmedizin - Präventivmedizin, Apr. 1990, Vol.25, No.4, p.154-157. Illus. Bibl.ref.


CIS 90-1907 Osterloh J.D., Selby J.V., Bernard B.P., Becker C.E., Menke D.J., Tepper E., Ordonez J.D., Behrens B.
Body burdens of lead in hypertensive nephropathy
Chronic human lead intoxication has long been associated with the development of renal failure. To determine the role of chelatable urinary lead, blood lead or the haematologic effect of lead in hypertensive nephropathy, a study was carried out on 40 subjects with hypertensive nephropathy and on 24 controls having a similar degree of renal dysfunction due to causes other than hypertension. The results show that subjects from the general population with hypertensive nephropathy do not have greater body burdens of lead than do renal failure controls without hypertension.
Archives of Environmental Health, Sep.-Oct. 1989, Vol.44, No.5, p.304-310. 62 ref.

CIS 90-1905 Piikivi L., Ruokonen A.
Renal function and long-term low mercury vapor exposure
Renal function indicated by urinary albumin and N-acetyl-β-glucosaminidase was studied among a group of 60 chlorine-alkali workers and 60 controls. Exposure to mercury (Hg) vapour had occurred for at least 5 years (mean exposure: 13.7 years). The estimated long-term exposure level, calculated from TWA blood concentrations of Hg, had been ca. 25µg/m3 of air. Neither glomerular nor tubular effects were shown in the exposed workers.
Archives of Environmental Health, May-June 1989, Vol.44, No.3, p.146-149. 24 ref.

CIS 90-1562 Smith A.H., Shearn V.I., Wood R.
Asbestos and kidney cancer: The evidence supports a causal association
This paper is concerned specifically with a possible causal association between asbestos and human kidney cancer. A review of the evidence to date indicates that only three human studies have sufficient statistical power to detect an excess mortality from kidney cancer among workers exposed to asbestos. All three were occupational cohort studies, and two of these gave strong direct evidence for such an excess; a study of U.S. insulators (kidney cancer SMR = 2.22) and a study of U.S. asbestos products company workers (kidney cancer SMR = 2.76). The third study, of Italian shipyard workers, reported excess mortality from "cancers of the kidney, urinary bladder, and other urinary organs" (SMR = 1.98). Further support for a causal association includes studies finding asbestos fibers in human kidneys and urine. It is concluded that asbestos should be regarded as a probable cause of human kidney cancer.
American Journal of Industrial Medicine, Aug. 1989, Vol.16, No.2, p.159-166. 18 ref.

CIS 90-1273 Andreou H.L.
Aromatic amines and cancer of the urinary bladder
Paragōga arōmatikōn aminōn kai karkinos tēs ourodohou kusteōs [in Greek]
This review article discusses the carcinogenicity of aromatic amines (β-naphthylamine, benzidine) used in azo dyes. Though these substances are normally considered to be biologically inert, there is some epidemiologic and metabolic evidence that they can cause cancer of the urinary bladder. Even cessation of azo dye production would not entirely eliminate the risk of exposure, as these substances are in widespread use in manufactured products. Appropriate protective measures are suggested.
Iatrikē tēs Ergasias, Apr.-June 1989, Vol.1, No.2, p.76-84. Illus. 26 ref.

CIS 90-1220 Schumacher M.C., Slattery M.L., West D.W.
Occupation and bladder cancer in Utah
The relationship between bladder cancer and occupation, industries, and occupational exposures in Utah were examined in a population-based, case-control study conducted between 1977 and 1983. Life-long occupational histories were obtained for 417 cases (332 men and 85 women) and 877 controls (685 men and 192 women). Increased risks were detected among men for employment in the leather and textile industries which increased with duration of employment. Among men and women, increased risk was detected among clerical workers. A protective effect was seen among men and women for 10 or more years employment in professional, managerial, and technical occupations. Increased risk for bladder cancer was detected among carpenters who smoked but not among carpenters who never smoked. Interactions between smoking and other industrial or occupational exposures were not demonstrated, and for the most part, smoking did not confound the estimates of the bladder cancer-occupation relationships.
American Journal of Industrial Medicine, July 1989, Vol.16, No.1, p.89-102. Bibl.

CIS 90-839 Kadamani S., Asal N.R., Nelson R.Y.
Occupational hydrocarbon exposure and risk of renal cell carcinoma
A population-based case-control study (210 cases and 210 age- sex- and frequency-matched population controls) was conducted to evaluate the association between occupational hydrocarbon exposure and risk of renal cell carcinoma. Retrospective estimates of lifetime occupational hydrocarbon exposure were made and an exposure index was calculated based on time and score combinations. A weak positive association was found for hydrocarbon exposure in males only (odds ratio = 1.6). For those under the age of 60, exposure to moderate levels of hydrocarbons produced the highest risk, while for those over the age of 70 a dose-response relationship was found. Those overweight were at high risk for renal cell carcinoma, and there was positive interaction between hydrocarbon exposure and overweight. Alcohol use alone or in the presence of hydrocarbon exposure decreased the risk significantly.
American Journal of Industrial Medicine, 1989, Vol.15, No.2, p.131-141. Bibl.

CIS 90-565 Harrington J.M., Whitby H., Gray C.N., Reid F.J., Caw T., Waterhouse J.A.
Renal disease and occupational exposure to organic solvents: a case referent approach
Several recent studies have suggested that a relation may exist between exposure to occupational organic solvents and diseases of the kidney - particularly malignancy and glomerulonephritis. Two case-referent studies were undertaken in the West Midlands (England) to investigate these possibilities. 54 live cases of biopsy-proved adenocarcinoma of the kidney were compared with an equal number of referents. For glomerulonephritis, 50 biopsy-proved cases were matched in the same manner with 50 referents. For both sets of cases and their referents, each individual was interviewed and a detailed account obtained of medical history and environmental exposures. Exposure to solvents was assessed independently and "blind" in a semiquantitative way by an experienced occupational hygienist. Past exposure was estimated for 10 different solvent types and 17 material types. No relation was found between exposure to solvents and renal cancer or glomerulonephritis.
British Journal of Industrial Medicine, Sep. 1989, Vol.46, No.9, p.643-650. 28 ref.

CIS 90-217 Roels H.A., Lauwerys R.R., Buchet J.P., Bernard A.M., Vos A., Oversteyns M.
Health significance of cadmium induced renal dysfunction: A five year follow up
To assess the health significance of early renal changes after chronic exposure to cadmium, 23 workers removed from exposure because of the discovery of an increased urinary excretion of β2-microglobulin or retinol binding protein, or both, have been examined once a year for five years. Eight of these workers had also an increased level of albuminuria. These workers had been exposed to cadmium for 6-41.7 years (mean 25 years). It was confirmed that proteinuria induced by cadmium is irreversible. The most important finding, however, is a significant increase of creatinine and β2-microglobulin concentrations in serum with time, indicating a progressive reduction of the glomerular filtration rate despite removal from exposure. Serum alkaline phosphatase activity also increases significantly with time. In conclusion, the present study indicates that early renal changes induced by cadmium should be regarded as adverse effects; they are predictive of an exacerbation of the age related decline in the glomerular filtration rate.
British Journal of Industrial Medicine, Nov. 1989, Vol.46, No.11, p.755-764. Illus. 41 ref.

CIS 90-210 Thun M.J., Osorio A.M., Schober S., Hannon W.H., Lewis B., Halperin W.
Nephropathy in cadmium workers: Assessment of risk from airborne occupational exposure to cadmium
To assess the quantitative relation between exposure to airborne cadmium (Cd) and various markers of renal tubular and glomerular function, 45 male workers employed at a plant that recovers Cd from industrial waste and 32 controls were examined. Cumulative external exposure to airborne Cd was estimated from historical air sampling data, adjusted for respirator use. Increasing Cd dose was associated with multiple renal tubular functional abnormalities, including reduced reabsorption of β-2-microglobulin, retinol binding protein (RBP), calcium, and phosphate. Serum creatinine concentration also increased with Cd dose, suggesting impaired glomerular function. Mean systolic and diastolic blood pressures were higher in the Cd workers than in the unexposed, but only systolic blood pressure was significantly associated with Cd dose in multivariate analyses. Cd dose remained the most important predictor of serum creatinine concentration after controlling for age, blood pressure, body size, and other extraneous factors. Logistic regression to model the probability (prevalence) of various renal abnormalities with increasing dose of Cd was used. The probability of multiple tubular abnormalities and raised serum creatinine concentration increased sharply at cumulative exceeding 300mg/m3 days, corresponding to working for 4.3 years at the current US exposure limit for Cd dust.
British Journal of Industrial Medicine, Oct. 1989, Vol.46, No.10, p.689-697. Illus. 27 ref.

CIS 89-1262 Chia K.S., Ong C.N., Ong H.Y., Endo G.
Renal tubular function of workers exposed to low levels of cadmium
Cadmium induced renal tubular effects were examined in 65 female workers in a factory manufacturing nickel cadmium batteries. Urinary β2-microglobulin (β2m), urinary N-acetyl-D-glucosaminidase activity (NAG), and serum creatinine and serum urea concentrations were used to assess the renal effects. Only urinary NAG showed a significant deterioration in renal function among the exposed group. NAG detects the largest proportion of abnormalities among the exposed group. Abnormal urinary β2m is detected in only 15.4% of the workers, half of whom have blood cadmium above 10µg/L. The proportion of abnormalities detected by urinary NAG differs significantly from the proportion of abnormalities detected by urinary β2m (p<0.01). The age adjusted mean urinary NAG excretion showed a significant rise with urinary cadmium of above 3µg/g creatinine. Urinary β2m failed to show any significant rise. With blood cadmium concentrations, the age adjusted mean urinary NAG excretion showed a rise from 1µg/L of blood cadmium followed by a plateau between blood cadmium concentrations of 3-10µg/L. No significant rise in mean urinary excretion of β2m was seen until blood cadmium concentrations exceeded 10µg/L.
British Journal of Industrial Medicine, Mar. 1989, Vol.46, No.3, p.165-170. Illus. 26 ref.


CIS 91-199 Teichman R.F., Fallon L.F., Brandt-Rauf P.W.
Health effects on workers in the pharmaceutical industry: a review
Until now little has been published about the known or suspected health risks of people employed in the manufacture and formulation of pharmaceutical products. Physicians are the only segment of the health care industry that have been studied extensively. Although pharmaceutical workers experience a potential risk from carcinogenic agents, the evidence for or against a real threat to their health remains both meagre and speculative. This paper reviews the available literature concerning occupational exposure to pharmaceutical agents.
Journal of the Society of Occupational Medicine, Autumn 1988, Vol.38, No.3, p.55-57. 19 ref.

CIS 90-893 Ward E., Halperin W., Thun M., Grossman H.B., Fink B., Kross L., Osorio A.M., Schulte P.
Bladder tumors in two young males occupationally exposed to MBOCA
MBOCA (4,4' methylenebis (2-chloroaniline)) is a structural analogue of benzidine and is carcinogenic in mice, rats, and dogs. MBOCA has not yet been demonstrated to be carcinogenic in humans and is not regulated as an occupational carcinogen in the United States. Two noninvasive papillary tumours of the bladder are reported, identified in a screening study of 540 workers exposed to MBOCA during its production at a Michigan chemical plant from 1968 to 1979. Both tumours occurred in men under 30yrs old who had never smoked. Although the prevalence of grade 1-2 tumours among asymptomatic males in this age group is unknown, the incidence of clinically apparent tumours on U.S. males aged 25-29 is only 1 per 100,000 per year. The detection of the 2 tumours in young, non-smoking males is consistent with the hypothesis that MBOCA induces bladder neoplasms in humans.
American Journal of Industrial Medicine, 1988, Vol.14, No.3, p.267-272. Illus. 19 ref.

CIS 89-1867 Risch H.A., Burch J.D., Miller A.B., Hill G.B., Steele R., Howe G.R.
Occupational factors and the incidence of cancer of the bladder in Canada
During 1979-82, a case-control study of occupational factors and urinary bladder cancer was conducted in various Canadian cities. 826 cases of cancer were individually matched with 792 controls. Subjects were specifically asked about employment in several industries thought relevant to risk of bladder cancer. Information was also obtained on lifelong occupational history, with special attention given to exposures to fumes, dusts, smoke, and chemicals. Subjects also provided data on past medical and residential history, intake of certain dietary items, and exposure to tobacco and other lifestyle factors. Conditional logistic regression methods were used for the analysis. Under adjustment for cumulative lifetime cigarette consumption, it appeared that for both men and women, most of the occupational factors examined were not associated with significant alteration in risk of bladder cancer. For exposures during the period eight to 28 years before diagnosis, raised risk was suggested for men employed at least six months in the chemical industry, in dye manufacturing or the dyeing of cloth, as tailors or in jobs in which contact with diesel or traffic fumes occurred. Increased risk was also seen for men occupationally exposed to tars or asphalt. This study supports the relationship between certain industries and the risk of bladder cancer for men.
British Journal of Industrial Medicine, June 1988, Vol.45, No.6, p.361-367. 27 ref.

CIS 89-1888 Gustavsson P., Gustavsson A., Hogstedt C.
Excess cancer morbidity in Swedish chimney sweeps
Canceröversjuklighet bland svenska skorstensfejare [in Swedish]
The incidence of cancer was investigated among 5,266 Swedish chimney sweeps employed at some time from 1918 to 1980 and information on cases of cancer from 1958 to 1981 was collected from the Swedish cancer registry. National cancer rates were used as a reference. A total of 214 cancers were found, compared to 162 expected. An increased risk of developing bladder cancer (23 observed vs. 9.8 expected) was a new finding. Risk excesses were also found for cancer of the lung, oesophagus and haematopoietic organs. Exposure to polycyclic aromatic hydrocarbons, dust, sulfur dioxide, asbestos and metals have probably contributed to the excess risks in varying degrees.
Arbetarskyddsstyrelsen, Publikationsservice, 171 84 Solna, Sweden, 1988. 21p. 24 ref.

CIS 89-1178 Armstrong B., Tremblay C., Theriault G.
Compensating bladder cancer victims employed in aluminium reduction plants
A criterion for eligibility to compensation is sought for bladder cancer cases among workers in the aluminium smelting industry. Probability that a case of bladder cancer was caused by occupational exposure can be estimated from a relationship derived from results of epidemiologic studies. Because the effects of occupational exposure and smoking apparently combine multiplicatively, this probability is independent of whether a case patient smoked. Estimated probabilities of causation have been used in a criterion for eligibility to compensation by the Quebec workers' compensation board. Workers with cancer for whom the upper 95% confidence limit of the probability of causation is at least 50% are compensated. This implies a minimum cumulative exposure to benzo(a)pyrene of 19µg/m3/year. Possible alternative approaches to compensation are discussed.
Journal of Occupational Medicine, Oct. 1988, Vol.30, No.10, p.771-775. Illus. 14 ref.

CIS 89-894 Bladder cancer and asbestos in Spain
Questionnaire study of the relation between occupational exposure to asbestos and bladder cancer in 406 bladder-cancer patients and equal number of controls. Coffee drinking and smoking were also considered. A relationship between bladder cancer and exposure to asbestos was demonstrated in the cases of the construction, automobile, plastics and thermal electric power industries.
Revue d'épidémiologie et de santé publique, 1988, Vol.36, p.10-14. 30 ref.

CIS 89-487 Brownson R.C.
A case-control study of renal cell carcinoma in relation to occupation, smoking, and alcohol consumption
A case control study based on data from a cancer registry was conducted to evaluate the effects of smoking, alcohol use, and occupation on renal cell cancer risk. Information was obtained for 326 male and female cases and 978 age- and sex-matched controls. Elevated risks were identified for cigarette smokers and for men employed as truck drivers. No relationship between alcohol consumption and renal cancer was observed.
Archives of Environmental Health, May-June 1988, Vol.43, No.3, p.238-241. 27 ref.


CIS 89-1274 Verschoor M., Wibowo A., Herber R., Van Hemmen J.
Influence of occupational low-level lead exposure on renal parameters
The influence of lead exposure on renal function was examined. In 155 lead workers and 126 control workers, lead in blood (PbB) and zinc protoporphyrin in blood (ZPP) were measured as indicators of exposure to lead; various proteins in urine were measured as parameters of renal functions. Regression and matched-pair analyses suggest that tubular parameters may be more influenced by lead exposure than glomerular parameters. Changes in renal function parameters may already occur at PbB levels below 3µgmol/L (600µg/L). The excretion of N-acetyl-α-D-glucosaminidase appears to be the most consistent and sensitive parameter of an early effect on the tubular function.
American Journal of Industrial Medicine, 1987, Vol.12, No.4, p.341-351. Illus. 21 ref.

CIS 88-1962 Koleva M., Ivanova-Čemišanska L., Burkova T.
Study on renal function in chronic peroral propineb intoxication
Proučvane na băbrečnata funkcija pri hronična oralna intoksikacija s propineb [in Bulgarian]
Rats were perorally treated with propineb in doses of 425 and 34mg/kg body mass (1/20 and 1/125 LD50), two times weekly for 4.5 months. Renal function was evaluated in terms of: clearance of endogenous creatinine, urea, sodium and potassium, chlorides in serum, serum osmolarity, clearance of free water and percentage of excreted versus filtered sodium. Decreased glomerular filtration and free water clearance, and increased sodium excretion were observed. Morphological studies established that functional changes precede morphological ones, and should be given consideration in the evaluation of pesticide residues in foods and in hygienic standard-setting.
Higiena i zdraveopazvane, 1987, Vol.30, No.4, p.34-37. 8 ref.

CIS 87-491 McLaughlin J.K., Malker H.S.R., Stone B.J., Weiner J.A., Malker B.K., Ericsson J.L.E., Blot W.J., Fraument J.F.
Occupational risks for renal cancer in Sweden
A systematic assessment was made of the occurrence of renal cancer among men by industrial and occupational classification using the Cancer-Environment Registry, which links cancer incidence (1961-79) and census data (1960) with industry and occupation for all employed individuals in Sweden. Data were analysed separately for cancers of the renal parenchyma and pelvis. Significantly increased risks for renal cell cancer were observed for several professional and white-collar occupations, including physicians and others in the health care industry. By contrast, the risks for renal pelvis cancer tended to be higher among blue-collar workers, especially in the machine industry. Deficits of both cancers occurred among farmers. The findings are considered as aetiological clues that may deserve further study, although some associations support observations in other countries.
British Journal of Industrial Medicine, Feb. 1987, Vol.44, No.2, p.119-123. 21 ref.


CIS 86-1987 Thun M.J., Clarkson T.W.
Spectrum of tests available to evaluate occupationally induced renal disease
The traditional tests used to screen workers for renal disease are inadequate to detect early or moderate loss of renal function. More sensitive tests are seldom measured reliably in the occupational setting. Several non-invasive tests of kidney function have proven useful in monitoring the effects of special toxins. The advantages and disadvantages of various tests of renal function that may be used to detect nephrotoxicity in workers are discussed. The tissue types that can be injured by toxic agents and the specific tests that may be used for each are reviewed briefly. Special research projects are needed to validate the clinical significance of these and other medical tests through careful study in a controlled clinical setting.
Journal of Occupational Medicine, Oct. 1986, Vol.28, No.10, p.1026-1033. Illus. 30 ref.

CIS 86-1985 Cartwright R.A.
Screening workers exposed to suspect bladder carcinogens
In England, screening programmes for detecting workers at increased risk for bladder cancer have helped identify the following issues: (1) early treatment should be considered part of the "screen"; (2) the early natural history of the disease is of some importance in conceptualising the problems and results of screening; (3) the epidemiology of high-risk groups might prove invaluable in extending screening to other groups. Of particular use might be aspects of genetic susceptibility. To address these points, an observational study has begun in Huddersfield to set up a trial of very early disease, contrasting therapy for early lesions with the long-term aim of altering the occurrence of invasive bladder lesions in the group of interest.
Journal of Occupational Medicine, Oct. 1986, Vol.28, No.10, p.1017-1019. 18 ref.

CIS 86-2051 Mason T.J., Prorok P.C., Neeld W.E., Vogler W.J.
Screening for bladder cancer at the DuPont Chambers Works: Initial findings
The following data have been abstracted on all persons ever screened for bladder cancer and on all persons known to have developed bladder cancer among the Chambers Works employees, regardless of whether they had been screened: complete work histories, including dates of employment by job title and location for the duration of employment by DuPont; medical histories, including the dates and results of every urinary cytological reading and urinary blood test, and the dates and type of every physical examination; and vital status information, including data from death certificates. For each bladder cancer case, detailed clinical histories were abstracted to provide information concerning signs or symptoms of bladder cancer, procedures performed, findings, and recommendations. Data are being edited and subjected to preliminary analysis.
Journal of Occupational Medicine, Oct. 1986, Vol.28, No.10, p.1011-1016. 8 ref.

CIS 86-1984 Hemstreet G.P., West S.S., Cook M.S.
Improved nuclear fluorescence screening technique
Three separate screening studies in the USA have tested the sensitivity and specificity of quantitative fluorescence image analysis for detecting bladder cancer. Nuclear intensity (NI) measurements of fluorescent dye-stained epithelial cells from voided urine and bladder washings were compared with routine Papanicolaou (Pap) cytology results, and findings were verified against pathological biopsy diagnoses. The NI cytology method detected the pathologically confirmed tumours earlier and with greater specificity than did conventional cytology. In the study of 140 clinically symptomatic patients in Oklahoma, the NI method detected 91.1% (3 of 34) of the pathologically confirmed grades 1 and 2 tumours and 100% of 18 grades 3 and 4 tumours. Pap cytology detected only 47% (16 of 34) of low-grade and 78% (14 of 18) of high-grade tumours. Comparable results were obtained in a study of symptomatic patients in Mississipi and the method has been employed in the screening of a high-risk occupationally exposed cohort in Georgia.
Journal of Occupational Medicine, Oct. 1986, Vol.28, No.10, p.1004-1010. Illus. 29 ref.

CIS 86-1933 Conso F.
Toxicity of organic solvents in the industrial environment
Toxicité des solvants organiques en milieu industriel [in French]
Analysis of the risks common to all solvents: biotransformation (metabolic activation, enzyme induction, toxic potentiation of solvent mixtures, urinary metabolites used as biological markers of exposure), liver and kidney damage (clinical, epidemiological and experimental studies), teratogenicity and carcinogenicity of organic solvents.
Documents pour le médecin du travail, Apr. 1986, No.25, p.3-10. 33 ref.

CIS 86-1956 Viau C., Lauwerys R., Bernard A.
The early detection of occupational nephropathies
Le rein et le dépistage précoce des néphropathies en milieu de travail [in French]
Although chronic renal insufficiency has a low incidence, the severity and social cost of this disease warrant its detection at the earliest possible stage. The measurement of specific proteins and enzymes in urine represents the most sensitive tests for that purpose. For example, retinol binding protein, of low molecular weight, freely crosses the glomerular filter and is reabsorbed by the proximal tubular cells. An increased urinary excretion of this protein therefore indicates a tubular disorder. On the other hand, the size and charge of albumen almost excludes it from the glomerular ultrafiltrate. Consequently, an increased albuminuria usually indicates a glomerular lesion. The availability of good analytical methods and their proven usefulness are the bases for the recommendation of the measurement of specific proteins in urine for the routine screening of the renal status of workers exposed to potential industrial nephrotoxins, such as heavy metals or solvents.
Travail et santé, Spring 1986, Vol.2, No.1, p.30-35. Illus. 38 ref.

CIS 86-1862 Skipper P.L., Bryant M.S., Tannenbaum S.R., Groopman J.D.
Analytical methods for assessing exposure to 4-aminobiphenyl based on protein adduct formation
Past studies with animals have demonstrated that 4-aminobiphenyl (ABP) administration results in the formation of appreciable amounts of adducts between the carcinogen and both serum albumin and haemoglobin. The haemoglobin adduct is relatively stable in vivo, but may be readily hydrolysed in vitro to regenerate ABP. The formation of this adduct reflects a mixed-function-oxidase-mediated metabolic pathway operating directly on the amine. The predominant albumin adduct, 3-(tryptophan-N1-yl)-4-acetylaminobiphenyl, reflects the contribution of N-acetyltransferase activity as well as mixed-function-oxidase activity to the overall metabolism. The simultaneous measurement of these 2 different adducts thus offers an opportunity to investigate the role of both ABP and acetylator phenotype in bladder carcinogenesis. An analytical method, using gas chromatography coupled with electron capture detection, was developed to quantitate ABP adducted to haemoglobin.
Journal of Occupational Medicine, Aug. 1986, Vol.28, No.8, p.643-646. Illus. 8 ref.

CIS 86-1072 Marrett L.D., Hartge P., Meigs J.W.
Bladder cancer and occupational exposure to leather
A case-control study of 2982 cases of bladder cancer and 5782 controls in the USA showed an odds ratio of 1.4 (95% confidence limits: 1.0, 1.9) after adjustment for sex, age and cigarette smoking. The risk was highest among those first employed in a job involving exposure to leather before 1945. No dose-response relationship was found. Those employed in "dusty" leather jobs had a slightly higher risk of bladder cancer than those with other types of exposure to leather.
British Journal of Industrial Medicine, Feb. 1986, Vol.43, No.2, p.96-100. 17 ref.

CIS 86-763 Matanoski G.M., Stockwell H.G., Diamond E.L., Sweeney M.H., Joffe R.D., Mele L.M., Johnson M.L.
A cohort mortality study of painters and allied tradesmen
The mortality experience of 57.175 workers in 4 states in the USA, from 1975 to 1979 was examined. No excess mortality was observed for the total union membership when compared to that of all US white males. When the study population was subdivided by the trade affiliation, members of locals comprised primarily of painters exhibited a significant elevation in mortality from all malignant neoplasms, lung and stomac cancer, compared to all US white males. This observation still remained after the data was treated to reduce the effect of non occupational activities. In addition, there was a statistically significant difference in mortality from leukemia and cancer of the bladder observed between the groups.
Scandinavian Journal of Work, Environment and Health, Feb. 1986, Vol.12, No.1, p.16-21. 21 ref.

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