Analysis of Environmental and Occupational Risk Factors in Bladder Cancer

10.6525/TEB.199903_15(3).0001

C. N. Chen；P. C. Chen；F. Y. Hsieh；H. W. Chen；C. H. Liu；T. J. Cheng；C. J. Chen；C. H. Huang；K. T. Chen

Epidemiology Bulletin

15卷3期（1999 / 03 / 01）

35 - 49

英文

Along with the high level of economic and industrial development, lifestyles of the Taiwan people have also changed. Smoking and exposures to certain environment and occupations are some major carcinogenic factors. Bladder cancer though is not one of the ten leading causes of cancer deaths in Taiwan, some 500 people die of this cancer each year and the trend is increasing. Risk factors of bladder cancer, according to available literature, are male, aged above 60, smoking, with exposure to aromatic amines, chemical dye stuff, rubber and arsenic. Exposures to other substances such as coal tar, petrol exhaust fumes,polycyclic aromatic hydrocarbons(PHAs),fluorinated drinking water,analgesics,lifestyles(including diet, coffee, tea, and artificial food additives),infection of the urinary system, and family genetics may also be carcinogenic factors. Workers of some special industries such as dyes, rubber, petrol, paints, textile and leather, and truck drivers have more risks to bladder cancer. Studies show that about 20-25% of all risk factors of bladder cancer is attributable to environmental and occupational exposures. Since the incubation period of bladder cancer can be as long as 25 years after exposure and the identification of hazardous substances is not easy, few eqidemiological studies on the environmental and occupational risk factors and cases of bladder cancer have been reported in Taiwan. The present study used the case-control approach in a comparative study of bladder cancer patients(313) and their controls(346) in two medical centers in the northern and southern parts of Taiwan in the last few years. By adjusting confounding effects, it was noted that individuas who had lived in the black-foot disease endemic areas, who smoked, had high risk occupational exposure and Special food habits (eating of salt-preserved food),and were with history of bladder infection and family history of bladder cancer and kidney cancer would have higher risk of bladder cancer. Drinking of alcoholic beverage, coffee, tea and drinking of well water were not found to be statistically associated with the disease. Further analysis by unconditional logistic regression showed that factors such as living experience in the black –foot disease endemic areas, smoking, special food habits (regular use of artificial sweeteners and highly salty food), and history of bladder infection or family history of bladder cancer and renal cancer were significantly associated with bladder cancer. In addition, urinary cell carcinoma in the black-foot disease endemic areas was not associated with either smoking or high-risk occupations. However, smoking was still a major risk factor of urinary cell carcinoma on non black-foot disease areas in Taiwan.

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