Occupation and bladder cancer risk in a population-based case-control study in New Hampshire.
To identify occupations with excess bladder cancer risk in New Hampshire, where bladder cancer mortality rates have been elevated for decades. Lifetime occupational histories were obtained from interviews with 424 cases and 645 controls in a population-based case-control study. Unconditional logistic regression models were used to estimate odds ratios (Ors) and 95% confidence intervals (CI) for each occupation, adjusted for age and smoking. Analyses by duration of employment were carried out and interactions with smoking were examined. Male tractor-trailer truck drivers had an elevated risk for bladder cancer (OR = 2.4, CI = 1.4-4.1), with a significant positive trend in risk with increasing duration of employment (P (trend) = 0.0003). Male metal/plastic processing machine operators also had a significant excess (OR = 4.9, CI = 1.6-15.1), attributable mainly to molding/casting machine operators (OR = 16.6, CI = 2.1-131). Elevated risk was also observed for male fabricators, assemblers, and hand workers (OR = 1.8, CI = 1.0-3.4). Women in certain sales occupations (sales clerks, counter clerks, and cashiers) had a significant excess risk (OR = 2.2, CI = 1.3-3.9) and a significant trend with duration of employment (P (trend) = 0.016), as did female health service workers (OR = 4.1, CI = 1.6-10.7; P (trend) = 0.014). There was a positive interaction between smoking and employment as a health service worker (p = 0.036). These findings are generally consistent with previous studies. Elevated risks for male molding/casting machine operators, female salesworkers, and female health service workers, especially those with a history of smoking, require further investigation.