Occupational Exposure to Metal Working Fluids and Bladder Cancer: A Systematic Review

الموضوعات :

Zahra Moradpour ¹ ( Occupational Health and Safety Engineering, Environmental Health Research Center, Golestan University of Medical Sciences, Golestan, Iran )
Mahdi Jalali ² ( Department of Occupational Health Engineering, School of Health, Neyshabur University of Medical Sciences, Neyshabur, Iran )
Sajjad Farhadi ³ ( Department of Occupational Health Engineering, School of Health, Neyshabur University of Medical Sciences, Neyshabur, Iran )
Masoomeh Vahabi Shekarloo ⁴ ( Department of Occupational Health, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran )
Seyed Alireza Mosavi Jarrahi ⁵ ( School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran )
Zahra Sedaghat ⁶ ( Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran )
Mohammad Reza Taherian ⁷ ( Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran )
Ghasem Hesam ⁸ ( Occupational Health and Safety Engineering, Environmental Health Research Center, Golestan University of Medical Sciences, Golestan, Iran )

تاريخ الإرسال : 14 السبت , صفر, 1444 تاريخ التأكيد : 03 الأربعاء , صفر, 1446 تاريخ الإصدار : 21 الثلاثاء , ربيع الأول, 1446

الکلمات المفتاحية: Metalworking fluids, Bladder cancer, Review, SMR,

ملخص المقالة :

Metalworking fluids (MWFs) are complex compounds of oils and chemical additives widely used to cool and lubricate metal machining operations. When sprayed, MWF produces concentrations up to twice the allowable level of US ambient air pollution standards. The study was designed to assess possible relationships between occupational exposure to MWFs and the risk of bladder cancer. Literature entered the study was published from February 2000 to 2021 and provides information on exposure to metalworking fluids and the risk of bladder cancer. We searched PubMed, Scopus, and Web of Sciences from 2000 to 2021. The following subject and keywords were used in the search: “bladder cancer” and “metalworking fluids”. Out of 8 studies, 4 were case-control and 4 were cohort and all of them had high NOS scores. The strong exposure-response relationship between bladder cancer and metalworking fluids reinforces the evidence for MWFs as a bladder carcinogen. The literature review in this study also shows that smoking can increase the risk of bladder cancer due to exposure to metalworking fluids.

المصادر:

1. Moradpour Z., Ramezanifar S., Asgari Gandomani E., Zendehdel R., 2022. Semi-quantitative Respiratory Health Risk Assessment of Exposure to Metalworking Fluids (Oil Mists) in an Automotive Industry. Journal of Chemical Health Risks. 12(0), 0-0
2. EPA., 2014. air pollution standards. In National ambient air quality standards for ozone. US ambient air pollution standards. The US.
3. Mirer F.E., 2010. New evidence on the health hazards and control of metalworking fluids since completion of the OSHA advisory committee report. American Journal of Industrial Medicine. 53(8), 792-801.
4. Calvert G.M., Ward E., Schnorr T.M., Fine L.J., 1998. Cancer risks among workers exposed to metalworking fluids: a systematic review. American Journal of Industrial Medicine. 33(3), 282-292.
5. Park R.M., 2018. Risk assessment for metalworking fluids and cancer outcomes. American Journal of Industrial Medicine. 61(3), 198-203.
6. Colin R., Grzebyk M., Wild P., Hédelin G., Bourgkard È., 2018. Bladder cancer and occupational exposure to metalworking fluid mist: a counter-matched case-control study in French steel-producing factories. Occupational and Environmental Medicine. 75(5), 328-336.
7. Park D., Choi B., Kim S., Kwag H., Joo K., Jeong J., 2005. Criteria for a recommended standard: Occupational exposure to metalworking fluids Criteria for a recommended standard: Occupational exposure to metalworking fluids. Journal of Occupational Health. 47(4), 319-326.
8. Costello S., Chen K., Picciotto S., Lutzker L., Eisen E., 2020. Metalworking fluids and cancer mortality in a US autoworker cohort (1941–2015). Scandinavian Journal of Work, Environment & Health. 46(5), 525-532.
9. Geier J., Lessmann H., Dickel H., Frosch P.J., Koch P., Becker D., Jappe U., Aberer W., 2004. Patch test results with the metalworking fluid series of the German Contact Dermatitis Research Group (DKG). Contact Dermatitis. 51(3), 118-130.
10. Suuronen K., Jolanki R., Luukkonen R., Alanko K., Susitaival P., 2007. Self‐reported skin symptoms in metal workers. Contact Dermatitis. 57(4), 259-264.
11. Costello S., Friesen M.C., Christiani D.C., Eisen E.A., 2011. Metalworking fluids and malignant melanoma in autoworkers. Epidemiology. 22(1), 90-97.
12. OEL., 2020. Occupational Exposure Limit. Ministry of Health. Iran.
13. Colt J.S., Friesen M.C., Stewart P.A., Donguk P., Johnson A., Schwenn M., Karagas M.R., Armenti K., Waddell R., Verrill C., 2014. A case-control study of occupational exposure to metalworking fluids and bladder cancer risk among men. Occupational and Environmental Medicine. 71(10), 667-674.
14. Goonewardene S.S., Persad R., Motiwala H., Albala D., 2020. Systematic Review Results on Bladder Cancer Epidemiology, Occupational Hazards and Risk Factors. Management of Non-Muscle Invasive Bladder Cancer. 53-61.
15. Josse P.R., Koutros S., Tardon A., Rothman N., Silverman D.T., Friesen M.C., 2021. Adapting Decision Rules to Estimate Occupational Metalworking Fluid Exposure in a Case-Control Study of Bladder Cancer in Spain. Annals of Work Exposures and Health. 66(3), 392–401.
16. Bourgkard E., Wild P., Courcot B., Diss M., Ettlinger J., Goutet P., Hémon D., Marquis N., Mur J.M., Rigal C., 2009. Lung cancer mortality and iron oxide exposure in a French steel-producing factory. Occupational and Environmental Medicine. 66(3), 175-181.
17. Friesen M.C., Costello S., Eisen E.A., 2009. Quantitative exposure to metalworking fluids and bladder cancer incidence in a cohort of autoworkers. American Journal of Epidemiology. 169(12), 1471-1478.
18. Cumberbatch M.G., Cox A., Teare D., Catto J.W., 2015. Contemporary occupational carcinogen exposure and bladder cancer: a systematic review and meta-analysis. JAMA Oncology. 1(9), 1282-1290.
19. Weiderpass E., Vainio H., 2015. The need for further preventive measures for occupational bladder cancer. JAMA oncology. 1(9), 1291-1292.
20. Peterson J., Welch V., Losos M., Tugwell P., 2011. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute. 2(1), 1-12.
21. Shea B., Robertson J., Peterson J., Welch V., Losos M., 2020. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis bias and confounding Newcastle-Ottowa Scale. Accessed 16 Jan 2020.
22. Colt J.S, Friesen M., Stewart P., Donguk P., Johnson A., Schwenn M., Karagas M.R., Cherala S., Waddell R., Verrill C., Ward M.H., 2011. Exposure to metalworking fluids and risk of bladder cancer. In ISEE Conference Abstracts 23. 2011(1).
23. Thompson D., Kriebel D., Quinn M.M., Wegman D.H., Eisen E.A., 2005. Occupational exposure to metalworking fluids and risk of breast cancer among female autoworkers. American Journal of Industrial Medicine. 47(2), 153-160.
24. Bourgkard E., Wild P., Courcot B., Diss M., Ettlinger J., Goutet P., Hémon D., Marquis N., Mur J.M., Rigal C., Rohn-Janssens M.P., Moulin J.J., 2009. Lung cancer mortality and iron oxide exposure in a French steel-producing factory. Occupational and Environmental Medicine. 66(3), 175-181.
25. Friesen M.C., Park D.U., Colt J.S., Baris D., Schwenn M., Karagas M.R., Armenti K.R., Johnson A., Silverman D.T, Stewart P.A., 2014. Developing estimates of frequency and intensity of exposure to three types of metalworking fluids in a population-based case–control study of bladder cancer. American Journal of Industrial Medicine. 57(8), 915-927.
26. Malloy E.J., Miller K.L., Eisen E.A., 2007. Rectal cancer and exposure to metalworking fluids in the automobile manufacturing industry. Occupational and Environmental Medicine. 64(4), 244-249.
27. Izano M.A., Sofrygin O.A., Picciotto S., Bradshaw P.T., Eisen E.A., 2019. Metalworking Fluids and Colon Cancer Risk: Longitudinal Targeted Minimum Loss-based Estimation. Environmental Epidemiology. 3(1), e035.
28. Garcia E., Bradshaw P.T., Eisen E.A., 2018. Breast cancer incidence and exposure to metalworking fluid in a cohort of female autoworkers. American Journal of Epidemiology. 187(3), 539-547.
29. Friesen M.C., Betenia N., Costello S., Eisen E.A., 2012. Metalworking fluid exposure and cancer risk in a retrospective cohort of female autoworkers. Cancer Causes & Control. 23(7), 1075-1082.
30. IARC., 1994. IARC monographs on the evaluation of carcinogenic risk to humans: some industrial chemicals. 260-268.
31. Boada L.D., Henríquez-Hernández L.A., Navarro P., Zumbado M., Almeida-González M., Camacho, M. Álvarez-León E.E., Valencia-Santana J.A., Luzardo O.P., 2015. Exposure to polycyclic aromatic hydrocarbons (PAHs) and bladder cancer: evaluation from a gene-environment perspective in a hospital-based case-control study in the Canary Islands (Spain). International Journal of Occupational and Environmental Health. 21(1), 23-30.
32. Roelofzen J.H., Aben K.K., Van de Kerkhof P.C., Van der Valk P.G., Kiemeney L.A., 2015. Dermatological exposure to coal tar and bladder cancer risk: A case-control study. Urologic Oncology: Seminars and Original Investigations. 33(1), 20.e19-20.e22.

نص كامل:



Occupational Exposure to metalworking fluids and bladder cancer: A systematic review

Zahra Moradpour1, Ghasem Hesam1, Mehrdad Ansaripour2&3, Masoomeh Vahabi Shekarloo1, Seyed Alireza Mosavi Jarrahi4, Mohammad Reza Taherian5, , Zahra Sedaghat6, Rezvan Zendehdel7*

1-Student Research Committee, Department of Occupational Health Engineering and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2- MSc in Safety and Reliability Engineering for Oil and Gas, Iranian Offshore Oil Company (IOOC), Iran.

3-MSc in Safety and Reliability Engineering for Oil and Gas, University of Aberdeen, United Kingdom (UK).

4- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5- Student Research committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

6- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

7. Department of Occupational Health Engineering and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

*Corresponding Author: Rezvan Zendehdel, Email: [e-mail]

Running title: metalworking fluids and bladder cancer

Abstract

Metalworking fluids (MWFs) are complex compounds of oils and chemical additives that are widely used to cool and lubricate metal machining operations. When they are sprayed, MWF produces concentrations up to twice the allowable level of US ambient air pollution standards. The study was designed to assess possible relationships between occupational exposure to MWFs and the risk of bladder cancer. Literature entered the study that published from February 2000 to 2021 and provides information on exposure to metalworking fluids and the risk of bladder cancer.  We searched PubMed, Scopus and Web of sciences from 2000 to 2021. The following subject and keywords were used in search: “bladder cancer” and “metalworking fluids”. Out of 8 studies, 4 were case-control and 4 were cohort and all of them had high NOS scores. The strong exposure-response relationship between bladder cancer and metalworking fluids reinforces evidence for MWFs as a bladder carcinogen. The literature review in this study also shows that smoking can increase the risk of bladder cancer due to exposure to metalworking fluids.

Keywords: metalworking fluids, bladder cancer, review, SMR.

 

Introduction

Metalworking fluids (MWFs) are complex compounds of oils and chemical additives that are widely used to cool and lubricate metal machining operations 1. When sprayed, MWF produces airborne particulate matter (PM) at concentrations up to twice the allowable level of US ambient air pollution standards 2. MWFs, classified as direct (mineral oils), soluble (water-emulsified oils), or synthetic (oil-free), continue to pose potential risks to millions of workers in metalworking jobs. The routes of exposure are dermal, with the bulk liquid phase and spraying MWF dust, and inhalation with dust, fog, and vapors. The health effects of MWF exposure have been extensively investigated 3-5.

MWFs contain additives, such as lubricants, extreme-pressure resistant, antimisting, antiwear and colouring agents, corrosion inhibitors, biocides, biostatics or perfumes 6. In 1998, the National Institute for Occupational Safety and Health (NIOSH) published a standard exposure limit document (REL) for occupational exposure to MWF 0.5 mg / m3 for total PM (TPM) and 0.4 for respirable PM 7. Potential carcinogens in MWF include hydrocarbons, chlorinated paraffins, aliphatic amines, nitrosamines, PAHs, formaldehyde-releasing agents, diathanolamine, and many other special additives 5. Efforts to reduce exposure to this potentially carcinogenic MWF have been ongoing for decades 8. There are numerous epidemiological studies that address MWFs with numerous concerns for human health, including respiratory and skin diseases for workers 9-10, malignancies 11 and others related health problems.

The International Agency for Research on Cancer (IARC) has assessed the risk of carcinogenicity due to exposure to semi-refined MWFs as Group A2 12. In the literature, an increased risk of bladder cancer has been reported for machinists and mechanics, both of whom use MWF 13-15. Most of these studies are related to relatively old job periods (before the mid-1990s). However, recent follow-up and exposure studies have also reported an increased risk of bladder cancer among workers who have been exposed to oil dust 13, 16-19. 

Based on a review of the literature, this paper reviews and summarizes the most important research on human health risks associated with occupational exposure to MWF. The study was designed to assess possible relationships between occupational exposure to MWFs and the risk of bladder cancer.

Methods

Data sources and searches:

The articles used in this study include all cohort and case-control studies that have been published since February 2000 and provide information on exposure to metalworking fluids and bladder cancer risk. The population studied in these articles was mostly automobile manufacturing workers, but other occupations were also considered. We searched PubMed, Scopus and Web of sciences from 2000 to 2021. The following subject and keywords were used in search: “bladder cancer” and “metalworking fluids”. 

Data extraction:

Mendeley software was used to manage and screen. Title, abstract and full text were selected based on inclusion and exclusion criteria. Data extraction was performed by two independent authors (ZS and ZM) through a standardized form for extraction of data including study characteristic (author’s name, publication year, starting year 2000) and study population characteristic (sex, occupations and etc.). Studies that included OR, RR, SMR, and HR values were included in the study, and studies that did not have the mentioned items were excluded from the study, even if they had thematic relevance. A total of 8 studies were identified, of which 4 were case-control studies and 4 cohorts. In case-control studies, no direct measurements were made to estimate the exposure of individuals to metalworking fluids. Therefore, the degree of exposure of people to metalworking fluids was estimated with information including employment history, cumulative exposure index and job-exposure matrix. Also, in cohort studies exposure assessment has been described in previous publications. To provide quantitative combined estimates of standardized mortality ratios (SMRs) for bladder cancer in relation to exposure to metalworking fluids, the number of cancer deaths observed and SMRs were abstracted from each study. In other articles, relative risk (RR), odds ratio (OR) and hazard ratio (HR) was also considered. For cohort studies with subsequent updates, only the most recent results were considered for consolidated estimates.

Risk of bias assessment:

Three independent reviewers (ZM, MV & GH) assessed the study quality based on the nine- star Newcastle Ottawa scale (NOS) 20-21: selection (representativeness of the population), comparability of groups (adjustment for confounders such as age, sex) and ascertainment of outcome. The NOS assigns four stars for selection, two stars for comparability and three stars for outcome. The NOS score more than 7 were acknowledge as high quality.

Results

For this study, three databases of PubMed, Scopus and Web of Science were examined. A total of 2679 articles were found from these three sites. After applying the filter by limitation of words, the number of articles found decreased to 384. In the next step, duplicate articles were removed and the total number of articles reached 359. These articles were reviewed by the research team and most of the articles were removed due to irrelevance, lack of inclusion criteria and lack of necessary information. Finally, 8 articles were reviewed. Table 1 shows the characteristics of the studies including the author's name, Workers’ Gender, sample size, Working Context, Study year, Risk Adjusted for Smoking Habits, and exposure assessment.

Table 1. Characteristics of the studies (n = 8) included in the review.

First author	Workers’ Gender	Sample Size	Working Context	Study year	Risk Adjusted for Smoking Habits	Exposure Assessment
Regis colin	Male	cases=84 controls=251	French steel-producing factories	2018	yes	job-exposure matrix
Joanne Colt	Male	cases=895 controls=1031	Various	2014	yes	Occupational history data
Joanne S Colt	Male Woman	cases=1158 controls=1402	Various	2011	yes	Historical measurements data
Melissa C. Friesen	Woman	4825	autoworkers	2012	Not	Occupational history data
Sadie Costello	Male Woman	38549	automobile manufacturing plants	2020	Not	Historical measurements data
E Bourgkard	Male Woman	17701	French carbon steel-producing factory	2009	yes	job-exposure matrix
Melissa C. Friesen	Male	21999	automotive workers	2009	Not	Historical measurements data
Melissa C. Friesen	Male Woman	cases=1171 controls=1418	Various	2014	Not	Occupational history data

 

Out of 8 studies, 4 were case-control and 4 were cohort and all of them had high NOS scores (table 2). Four studies considered different types of metalworking fluids. 3 studies reported OR, 2 studies SMR, 2 studies HR and one study RR. In total, half of the studies also considered smoking habits.

Table 2. Results of the included studies in relation to study design, NOS Score and statistical results achieved.

 

Discussion

We conducted a review of the association between exposure to metalworking fluids and the incidence of bladder cancer in potentially exposed individuals. In none of the articles reviewed, the exposure to metalworking fluids was directly measured. Instead, exposure information is extracted through job-exposure matrix, occupational history data and Historical measurements data. The working context of these studies is also related to industry and occupational exposure.

Exposure to metalworking fluids has been linked to several cancers 22-25. In a study, Friesen et al. examined the association between exposure to metalworking fluids and cancer. In this study, SMR= 0.7 was reported for exposure to metalworking fluids and bladder cancer 26. Sadie Costello et al. also followed up 38,549 automobile manufacturing workers in a potential exposure to metalworking fluids in a cohort study.  The SMR for bladder cancer in this study was also  and equal to 0.95 (0.81-1.12) 8. Although SMR is   in both studies, their values are different. Especially in the Sadie Costello et al. study, its value is very close to 1. In the literature, an increased risk of bladder cancer has been reported for machinists and mechanics exposed to MWF 27.

Four studies examined the types of metalworking fluids, two of which that are case- control study reported OR and two that are cohort study reported HR. Workers at six French steel-producing factories were studied for exposure to metalworking fluids by Colin et al. in 2018. According to the results of this study, in the 25 years before diagnosis, OR increased significantly with the duration of straight MWF exposure (OR = 1.13 (1.02-1.25)). The study by Colt et al. confirms this result and the risk of bladder cancer for straight metalworking fluids was high (OR= 1.7 (1.1–2.8)). In addition, the use of soluble MWFs increased the risk by 50% (95% CI = 0.96-2.5). 13. In both studies, the authors suggested that metalworking fluids are a bladder carcinogen. In the case of cohort studies, the HR for bladder cancer was higher in relation to soluble metalworking fluids in the Sadie Costello et al. study (straight HR=> 1.8, soluble HR= > 11.1, synthetic = > 0.5) 8. The results of the study of Friesen et al. were not in line with the study mentioned above. In the study by Friesen et al., straight metalworking fluids had the highest risk of bladder cancer (straight HR= 2.07 (1.19-3.62), soluble HR= 1.02 (0.56-1.88), synthetic = 0.78 (0.38-1.61)) 17. The association with direct oils, seen here, illustrates the role of PAHs in the etiology of bladder cancer as observed in other PAH-exposed industries 28-29.

Simultaneous exposure to metalworking fluids and smoking has also been investigated in four studies. In the study by Colin et al., ORs increased with the duration of smoking (P <0.001), the average number of cigarettes consumed per day (P = 0.002) and the number of packs per year (P <0.001) (Current smoker OR= 10.87 (3.39-34.9)) 6. In the study by Colt et al., The simultaneous effects of smoking and metalworking fluids were investigated. In this study, there was a significant interaction between smoking and precision metalworking (OR= 2.9 (2.2- 3.7)), and the increased risk of bladder cancer was significantly higher among smokers 13. Another study by Bourgkard et al. found that the relative risk increased with increasing number of cigarettes per day. The relative risk for smoking more than 20 cigarettes per day was estimated to be 53.5 (95% CI 12.9 to 222.7).

Studies show an increased risk of bladder cancer among workers who are exposed to straight MWFs and secondarily to soluble MWFs, which may be explained by the presence of carcinogens. In addition, the literature review in this study generally shows that smoking can increase the risk of bladder cancer due to exposure to metalworking fluids. 

Acknowledgement

This study is related to the project NO. 1400/65165 From Student Research Committee, Shahid Beheshti University of Medical Sciences,Tehran,Iran.

We also appreciate the “Student Research Committee” and “Research & Technology Chancellor” in Shahid Beheshti University of Medical Sciences for their financial support of this study.

Ethics approval

Ethical approval was approved from the Shahid Beheshti University of Medical Sciences Ethics Committee (IR.SBMU.RETECH.REC.1400.977).

Competing interests

None declared.

Author contribution

Zahra Moradpour: investigation, writing original draft, and writing—review and editing. Ghasem Hesam: data collecting and writing. Zahra Sedaghat: writing—review, and editing. Masoomeh Vahabi Shekarloo: data collecting and writing. Behnam Hajipour-Verdom: writing—review, and editing. Rezvan Zendehdel: investigation, writing original draft, and writing—review and editing.

References

1.        Moradpour, Z.; Ramezanifar, S.; Asgari Gandomani, E.; Zendehdel, R., Semi-quantitative Respiratory Health Risk Assessment of Exposure to Metalworking Fluids (Oil Mists) in an Automotive Industry. Journal of Chemical Health Risks 2022.

2.        EPA, air pollution standards. In National ambient air quality standards for ozone, US ambient air pollution standards: US, 2014.

3.        Mirer, F. E., New evidence on the health hazards and control of metalworking fluids since completion of the OSHA advisory committee report. American journal of industrial medicine 2010, 53 (8), 792-801.

4.        Calvert, G. M.; Ward, E.; Schnorr, T. M.; Fine, L. J., Cancer risks among workers exposed to metalworking fluids: a systematic review. American journal of industrial medicine 1998, 33 (3), 282-292.

5.        Park, R. M., Risk assessment for metalworking fluids and cancer outcomes. American journal of industrial medicine 2018, 61 (3), 198-203.

6.        Colin, R.; Grzebyk, M.; Wild, P.; Hédelin, G.; Bourgkard, È., Bladder cancer and occupational exposure to metalworking fluid mist: a counter-matched case–control study in French steel-producing factories. Occupational and environmental medicine 2018, 75 (5), 328-336.

7.        Park, D.; Choi, B.; Kim, S.; KWAG, H.; Joo, K.; JEONG, J., Criteria for a recommended standard: Occupational exposure to metalworking fluids Criteria for a recommended standard: Occupational exposure to metalworking fluids, 1998. Journal of occupational health 2005, 47 (4), 319-326.

8.        Costello, S.; Chen, K.; Picciotto, S.; Lutzker, L.; Eisen, E., Metalworking fluids and cancer mortality in a US autoworker cohort (1941–2015). Scandinavian journal of work, environment & health 2020, 46 (5), 525.

9.        Geier, J.; Lessmann, H.; Dickel, H.; Frosch, P. J.; Koch, P.; Becker, D.; Jappe, U.; Aberer, W.; Schnuch, A.; Uter, W., Patch test results with the metalworking fluid series of the German Contact Dermatitis Research Group (DKG). Contact dermatitis 2004, 51 (3), 118-130.

10.        Suuronen, K.; Jolanki, R.; Luukkonen, R.; Alanko, K.; Susitaival, P., Self‐reported skin symptoms in metal workers. Contact Dermatitis 2007, 57 (4), 259-264.

11.        Costello, S.; Friesen, M. C.; Christiani, D. C.; Eisen, E. A., Metalworking fluids and malignant melanoma in autoworkers. Epidemiology 2011, 90-97.

12.        Ministry of Health, Occupational Exposure Limit. Fifth ed.; Environmental and Occupational Health Center, T. a. M. E., Ed. Iran, 2020.

13.        Colt, J. S.; Friesen, M. C.; Stewart, P. A.; Donguk, P.; Johnson, A.; Schwenn, M.; Karagas, M. R.; Armenti, K.; Waddell, R.; Verrill, C., A case-control study of occupational exposure to metalworking fluids and bladder cancer risk among men. Occupational and environmental medicine 2014, 71 (10), 667-674.

14.        Goonewardene, S. S.; Persad, R.; Motiwala, H.; Albala, D., Systematic Review Results on Bladder Cancer Epidemiology, Occupational Hazards and Risk Factors. Management of Non-Muscle Invasive Bladder Cancer 2020, 53-61.

15.        Josse, P. R.; Koutros, S.; Tardon, A.; Rothman, N.; Silverman, D. T.; Friesen, M. C., Adapting Decision Rules to Estimate Occupational Metalworking Fluid Exposure in a Case–Control Study of Bladder Cancer in Spain. Annals of Work Exposures and Health 2021.

16.        Bourgkard, E.; Wild, P.; Courcot, B.; Diss, M.; Ettlinger, J.; Goutet, P.; Hémon, D.; Marquis, N.; Mur, J.-M.; Rigal, C., Lung cancer mortality and iron oxide exposure in a French steel-producing factory. Occupational and environmental medicine 2009, 66 (3), 175-181.

17.        Friesen, M. C.; Costello, S.; Eisen, E. A., Quantitative exposure to metalworking fluids and bladder cancer incidence in a cohort of autoworkers. American journal of epidemiology 2009, 169 (12), 1471-1478.

18.        Cumberbatch, M. G.; Cox, A.; Teare, D.; Catto, J. W., Contemporary occupational carcinogen exposure and bladder cancer: a systematic review and meta-analysis. JAMA oncology 2015, 1 (9), 1282-1290.

19.        Weiderpass, E.; Vainio, H., The need for further preventive measures for occupational bladder cancer. JAMA oncology 2015, 1 (9), 1291-1292.

20.        Peterson, J.; Welch, V.; Losos, M.; Tugwell, P., The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute 2011, 2 (1), 1-12.

21.        Shea, B.; Robertson, J.; Peterson, J.; Welch, V.; Losos, M., The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis bias and confounding Newcastle-Ottowa Scale. 2020.

22.        Malloy, E. J.; Miller, K. L.; Eisen, E. A., Rectal cancer and exposure to metalworking fluids in the automobile manufacturing industry. Occupational and environmental medicine 2007, 64 (4), 244-249.

23.        Thompson, D.; Kriebel, D.; Quinn, M. M.; Wegman, D. H.; Eisen, E. A., Occupational exposure to metalworking fluids and risk of breast cancer among female autoworkers. American journal of industrial medicine 2005, 47 (2), 153-160.

24.        Izano, M. A.; Sofrygin, O. A.; Picciotto, S.; Bradshaw, P. T.; Eisen, E. A., Metalworking Fluids and Colon Cancer Risk: Longitudinal Targeted Minimum Loss-based Estimation. Environmental Epidemiology 2019, 3 (1).

25.        Garcia, E.; Bradshaw, P. T.; Eisen, E. A., Breast cancer incidence and exposure to metalworking fluid in a cohort of female autoworkers. American journal of epidemiology 2018, 187 (3), 539-547.

26.        Friesen, M. C.; Betenia, N.; Costello, S.; Eisen, E. A., Metalworking fluid exposure and cancer risk in a retrospective cohort of female autoworkers. Cancer causes & control 2012, 23 (7), 1075-1082.

27.        Cancer, I. A. f. R. o., IARC monographs on the evaluation of carcinogenic risk to humans: some industrial chemicals. In IARC monographs on the evaluation of carcinogenic risk to humans: some industrial chemicals, 1994; pp 560-560.

28.        Boada, L. D.; Henríquez-Hernández, L. A.; Navarro, P.; Zumbado, M.; Almeida-González, M.; Camacho, M.; Álvarez-León, E. E.; Valencia-Santana, J. A.; Luzardo, O. P., Exposure to polycyclic aromatic hydrocarbons (PAHs) and bladder cancer: evaluation from a gene-environment perspective in a hospital-based case-control study in the Canary Islands (Spain). International journal of occupational and environmental health 2015, 21 (1), 23-30.

29.        Roelofzen, J. H.; Aben, K. K.; Van de Kerkhof, P. C.; Van der Valk, P. G.; Kiemeney, L. A. In Dermatological exposure to coal tar and bladder cancer risk: A case-control study, Urologic Oncology: Seminars and Original Investigations, Elsevier: 2015; pp 20. e19-20. e22.

 

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