Excess number of bladder cancers in workers exposed to ortho-toluidine and aniline

Abstract

A retrospective cohort study of the incidence of bladder cancer was conducted in response to a union request for an evaluation of a possible excess number of cases of bladder cancer at a chemical plant in western New York State. Workers at the plant were exposed to two potential bladder carcinogens--ortho-toluidine (o-toluidine) and aniline. Incidence rates of bladder cancer among workers at the plant were compared with those of the population of New York State (excluding New York City). Among all 1749 workers at the plant, 13 cases of bladder cancer were observed versus 3.61 expected [standardized incidence ratio (SIR) = 3.60; 90% confidence interval (CI) = 2.13-5.73]. Among the 708 workers who worked in areas in which o-toluidine and aniline were used, 7 cases were observed versus 1.08 expected (SIR = 6.48; 90% CI = 3.04-12.2). Among the 288 maintenance, shipping, and janitorial workers thought to have been possibly exposed, 4 cases were observed versus 1.09 expected (SIR = 3.66; 90% CI = 1.25-8.37). Among the remaining 753 workers who were probably not exposed, 2 bladder cancers were observed versus 1.43 expected (SIR = 1.39; 90% CI = 0.25-4.39). Increased risk of bladder cancer was strongly associated with increased duration of employment in the department where o-toluidine and aniline were used (P less than .001). Among workers with 10 or more years of employment in the department, the SIR was 27.2 (90% CI = 11.8-53.7). o-Toluidine is an animal carcinogen more potent than aniline and is known to produce bladder tumors in rats; hence, it is more likely that o-toluidine is responsible for the observed excess number of cases of bladder cancer, although aniline may have played a role.