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Cotton dust, endotoxin and cancer mortality among the Shanghai textile workers cohort: a 30-year analysis.

Authors
Fang-SC; Mehta-AJ; Hang-JQ; Eisen-EA; Dai-HL; Zhang-HX; Su-L; Christiani-DC
Source
Occup Environ Med 2013 Oct; 70(10):722-729
NIOSHTIC No.
20042855
Abstract
Background: Although occupational exposure to cotton dust and endotoxin is associated with adverse respiratory health, associations with cancer are unclear. We investigated cancer mortality in relation to cotton dust and endotoxin exposure in the Shanghai textile workers cohort. Methods: We followed 444 cotton textile and a reference group of 467 unexposed silk workers for 30 years (26,777 person-years). HRs for all cancers combined (with and without lung cancer) and gastrointestinal cancer were estimated in Cox regression models as functions of cotton textile work and categories of cumulative exposure (low, medium, high), after adjustment for covariates including pack-years smoked. Different lag years accounted for disease latency. Results: Risks of mortality from gastrointestinal cancers and all cancers combined, with the exclusion of lung cancer, were increased in cotton workers relative to silk workers. When stratified by category of cumulative cotton exposure, in general, risks were greatest for 20-year lagged medium exposure (all cancers HR=2.7 (95% CI 1.4 to 5.2); cancer excluding lung cancer HR=3.4 (1.7-7.0); gastrointestinal cancer HR=4.1 (1.8-9.7)). With the exclusion of lung cancer, risks of cancer were more pronounced. When stratified by category of cumulative endotoxin exposure, consistent associations were not observed for all cancers combined. However, excluding lung cancer, medium endotoxin exposure was associated with all cancers and gastrointestinal cancer in almost all lag models. Conclusions: Cotton dust may be associated with cancer mortality, especially gastrointestinal cancer, and endotoxin may play a causative role. Findings also indirectly support a protective effect of endotoxin on lung cancer.
Keywords
Cancer; Cancer-rates; Endotoxins; Textile-mills; Textile-workers; Textiles; Textiles-industry; Cotton-dust; Cotton-fibers; Cotton-industry; Cotton-mill-workers; Airborne-dusts; Exposure-assessment; Dose-response; Workplace-studies; Byssinosis; Long-term-study; Mortality-data; Mortality-rates; Mortality-surveys; Mathematical-models; Analytical-models; Statistical-analysis; Risk-analysis; Chronic-exposure; Organic-dusts; Cigarette-smoking; Smoking; Gastrointestinal-system-disorders; Lung-cancer
Contact
Dr Shona C. Fang, Harvard School of Public Health, 665 Huntington Avenue, Building 1-Room 1411, Boston, MA 02115, USA
CODEN
OEMEEM
Publication Date
20131001
Document Type
Journal Article
Email Address
sfang@hsph.harvard.edu
Funding Amount
1348724
Funding Type
Grant
Fiscal Year
2014
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-002421; B20130801
Issue of Publication
10
ISSN
1351-0711
Source Name
Occupational and Environmental Medicine
State
MA; CA
Performing Organization
Harvard University
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