Cancer Risks among Textile Workers in China

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。该队列先前已聚集为乳房自我检查有效性的干预试验。在最初的调查中，我们确定了癌症发病率（1989-1998），开发了一个全面的工作/暴露矩阵来重建历史暴露，并进行了一项巢式病例队列研究，以调查15种特定部位癌症的关联。最有力的先前假设是内毒素，棉花粉尘的污染物，会降低患肺癌的风险。与这一假设一致，我们观察到内毒素累积暴露与肺癌风险之间存在非常强的负剂量反应梯度，这在早期职业暴露（滞后20年）中最为明显。出乎意料的是，内毒素对肝癌、食道癌、胃癌、直肠癌、胰腺癌和乳腺癌的负剂量反应梯度非常相似。我们还观察到特定部位的癌症风险与暴露于其他物质（如二氧化硅和肺癌、卵巢癌和子宫内膜癌）之间的关联。在这个竞争性的更新申请中，我们建议将队列的随访时间延长8年至2006年，从而提供机会确定我们关于内毒素的初始观察结果的一致性，并大大提高检验其他关联（例如，膀胱癌和染料）的统计能力。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。一些相关的非职业潜在混杂因素（如配偶吸烟史）的数据将补充现有的有关吸烟、饮酒和生殖史的协变量数据。拟议研究的结果将为内毒素潜在的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。暴露于内毒素，特别是在纺织工业中常见的其他物质，在美国和世界各地的许多职业和环境环境中都很普遍。因此，这项研究的结果有很好的希望为疾病预防策略提供信息，也可能具有治疗意义。公共卫生相关性：这一竞争性更新（R01CA80180）是一项调查上海267,400名纺织女工癌症风险的最新研究。我们将研究内毒素和其他暴露对肺癌、消化道、乳腺癌和生殖器官癌症的剂量-反应关系。

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. PUBLIC HEALTH RELEVANCE: This competing renewal (R01CA80180) is for an updated study to investigate cancer risks among 267,400 women textile workers in Shanghai. We will investigate dose-response relations for endotoxin and other exposures for cancers of the lung, digestive tract, breast, and reproductive organs.