Work-related bladder cancer risk on the rise

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Work-related risks for bladder cancer are on the rise, but the occupations putting workers at risk seem to be evolving, according to a meta-analysis published online in JAMA Oncology (Oct. 8, 2015).

Work-related risks for bladder cancer are on the rise, but the occupations putting workers at risk seem to be evolving, according to a meta-analysis published online in JAMA Oncology (Oct. 8, 2015).

Among the occupations most at increased bladder cancer risk: hairdressers, nurses, and waiters.

The findings underscore the significance of asking about social and occupational history when evaluating patients with hematuria, says one urologic cancer expert.

Researchers from the United Kingdom described modern-day occupations by bladder cancer incidence and mortality risk in their review of 263 articles, which was updated as recently as June 2015.

While bladder cancer risk rose in 42 of 61 occupational classes and bladder cancer-specific mortality risk increased in 16 of 40 occupational classes, the common cancer’s incidence risk fell in six of 61 occupational classes and bladder cancer-specific death risk decreased in two of 40 classes.

Risk varied among men and women over time but was highest in men.

Next: What workers are at highest risk?

Workers at highest bladder cancer risks include those exposed to aromatic amines, such as tobacco, dye, and leather workers; hairdressers; and printers, as well as people exposed to polycystic aromatic hydrocarbons, including chimney sweeps, nurses, waiters, aluminum workers, seamen, and oil/petroleum workers. Agricultural sector workers had the lowest bladder cancer risks.

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Bladder cancer mortality occurred most in occupations exposing workers to heavy metals and polycystic aromatic hydrocarbons. These occupations include metal or aluminum workers, electricians, mechanics, and military and public safety workers exposed to diesel and combustion products, as well as workers exposed to aromatic amines, including domestic assistants and cleaners, rubber workers, painters, and hairdressers.

Bladder cancer risk seems to be increasing faster in women. This could be related to more women being in the work force and the emergence of carcinogens in female-dominated occupations, according to a JAMApress release on the study.

The apparent increases in occupational bladder cancer incidence and mortality are occurring despite manufacturing and legislative changes to improve workplace hygiene. Better detection and screening efforts could help to explain these increases, according to the authors.

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“Efforts to reduce the impact of BC [bladder cancer] on workers should be targeted to occupations at risk of mortality,” concluded the authors, led by James W.F. Catto, MBChB, PhD, of the University of Sheffield, United Kingdom.

Next: Study outlines 2 key points for urologists, patients

The meta-analysis outlines two key points for urologists and their patients, according to Urology Times Editorial Consultant J. Brantley Thrasher, MD, of the University of Kansas Medical Center, Kansas City. One is that occupational hazards remain prevalent for bladder cancer and workers exposed to these carcinogens need to be better protected.

The second key point: “For the urologist, it's imperative for us to take a good social and occupational history as a potential risk factor for bladder cancer,” Dr. Thrasher told Urology Times. “I am especially interested in the patient's exposure to many of these carcinogens, based on occupation, a hobby, or past history, when I am doing my history associated with a microhematuria workup. Just knowing the patient's occupation could provide critical information in a situation where you might suspect bladder cancer.”