Cancer Risks among Textile Workers in China

产品说明：在最初的资助周期中，我们对267，400名上海纺织女工进行了与职业暴露相关的癌症风险的全面调查。该队列先前已组装的乳房自我检查的疗效的干预试验，在最初的调查中，我们确定了癌症发病率（1989-1998年），开发了一个全面的工作/暴露矩阵重建历史暴露，并进行了嵌套的病例队列研究，以调查15个特定部位的癌症的关联。最强有力的先前假设是内毒素，一种棉尘污染物，会降低肺癌的风险。与这一假设相一致，我们观察到肺癌风险与内毒素累积暴露存在非常强的反向剂量反应梯度，这在职业生涯早期暴露（滞后20年）中最为明显。没有预料到内毒素对肝癌、食道癌、胃癌、直肠癌、胰腺癌和乳腺癌具有非常相似的反向剂量反应梯度。我们还观察到特定部位的癌症风险与暴露于其他药物（如二氧化硅和肺癌、卵巢癌和子宫内膜癌）的相关性。在这项竞争性的更新申请中，我们建议将队列随访延长8年至2006年，从而提供了确定我们关于内毒素的初步观察结果的一致性的机会，并大大增加了检查其他相关性（例如，膀胱癌和染料）。我们正在进行的一项关于电磁场、轮班工作和乳腺癌的研究将为这些暴露提供定量数据。一些相关的非职业性潜在混杂因素的数据（例如，配偶吸烟史）将补充目前可用的吸烟、饮酒和生育史协变量数据。拟议研究的结果将为内毒素的潜在抗癌作用以及其他职业暴露对多种不同癌症风险的影响提供相当多的新信息。在美国和世界各地的许多职业和环境环境中，暴露于内毒素和纺织工业中常见的其他物质是普遍的。因此，这项研究的结果很有希望为疾病预防策略提供信息，也可能具有治疗意义。

DESCRIPTION: During the initial funding cycle, we conducted a comprehensive investigation of cancer risks in relation to occupational exposures among a cohort of 267,400 Shanghai women textile workers. The cohort had been assembled previously for an intervention trial of the efficacy of breast self-exam. In the initial investigation, we determined cancer incidence (1989-1998), developed a comprehensive job/exposure matrix to reconstruct historical exposures, and conducted a nested case-cohort study to investigate associations of 15 site-specific cancers. The strongest prior hypothesis was that endotoxin, a contaminant of cotton dust, would reduce risk for lung cancer. Consistent with this hypothesis, we observed a very strong inverse dose-response gradient of lung cancer risk with cumulative exposure to endotoxin that was most pronounced for early career exposures (lagged 20 years). Not anticipated were very similar inverse dose-response gradients with endotoxin for cancers of the liver, esophagus, stomach, rectum, pancreas, and breast. We also observed associations of site-specific cancer risks with exposures to other agents, such as silica and cancers of the lung, ovary, and endometrium. In this competing renewal application, we are proposing to extend follow-up of the cohort for an additional 8 years through 2006, thus providing the opportunity to determine the consistency of our initial observations regarding endotoxin, and greatly increasing statistical power to examine other associations (e.g., urinary bladder cancer and dyes). An ongoing study of EMF, shift work, and breast cancer that we are conducting in this cohort will provide quantitative data for those exposures. Data on some relevant non- occupational potential confounders (e.g., spousal smoking history) will supplement currently available covariate data on smoking, alcohol use, and reproductive history. The findings from the proposed study will add considerable new information on the potential anti-carcinogenic effect of endotoxin, and the influences of other occupational exposures on risks for multiple different cancers. Exposures to endotoxin, in particular, and to other agents that are common in the textile industry are widespread in many occupational and environmental settings in the US and throughout the world. As such, the findings from this research have good promise to inform disease prevention strategies, and may also have therapeutic implications.