Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Apr;41(4):1005-1015.
doi: 10.1007/s00345-023-04327-w. Epub 2023 Feb 27.

Occupational asbestos exposure and urinary bladder cancer: a systematic review and meta-analysis

Nicolò Franco  1 , Alessandro Godono  1 , Marco Clari  2 , Catalina Ciocan  1 , Carlotta Zunarelli  3 , Enrico Pira  1 , Paolo Boffetta  3   4
Affiliations
Meta-Analysis

Occupational asbestos exposure and urinary bladder cancer: a systematic review and meta-analysis

Nicolò Franco et al. World J Urol. 2023 Apr.

Abstract

Purpose: There is conflicting evidence on the association between asbestos exposure and bladder cancer. We performed a systematic review and meta-analysis to provide evidence on occupational asbestos exposure and the risk of mortality and incidence of bladder cancer.

Methods: We searched three relevant electronic databases (Pubmed, Scopus, and Embase) from inception to October 2021. The methodological quality of included articles was evaluated using the US National Institutes of Health tool. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for bladder cancer, as well as respective 95% confidence intervals (CIs), were extracted or calculated for each included cohort. Main and subgroup meta-analyses according to first year of employment, industry, sex, asbestos type, and geographic region were performed.

Results: Fifty-nine publications comprising 60 cohorts were included. Bladder cancer incidence and mortality were not significantly associated with occupational asbestos exposure (pooled SIR: 1.04, 95% CI: 0.95-1.13, P = 0.000; pooled SMR: 1.06, 95% CI: 0.96-1.17, P = 0.031). Bladder cancer incidence was higher among workers employed between 1908 and 1940 (SIR: 1.15, 95% CI: 1.01-1.31). Mortality was elevated in asbestos workers cohorts (SMR: 1.12, 95% CI: 1.06-1.30) and in the subgroup analysis for women (SMR: 1.83, 95% CI: 1.22-2.75). No association was found between asbestos types and bladder cancer incidence or mortality. We observed no difference in the subgroup analysis for countries and no direct publication bias evidence.

Conclusion: There is evidence that workers with occupational asbestos exposure have a bladder cancer incidence and mortality similar to the general population.

Keywords: Asbestos; Occupational health; Systematic review; Urinary bladder cancer.

PubMed Disclaimer

Conflict of interest statement

Paolo Boffetta was involved in litigation on asbestos exposure. Enrico Pira has acted as Court-appointed expert witness and as consultant to parties (judge, prosecutor, and defendant attorney) in asbestos litigations. All other authors reported no conflict of interest.

Figures

Fig. 1
Fig. 1
a Forest plot of the pooled standardized incidence ratio and 95% confidence intervals of urinary bladder cancer incidence associated with occupational asbestos exposure, using random-effect models. b Forest plot of the pooled standardized mortality ratio and 95% confidence intervals of urinary bladder cancer mortality associated with occupational asbestos exposure, using random-effect models
See this image and copyright information in PMC

References

    1. Pira E, Donato F, Maida L, Discalzi G. Exposure to asbestos: past, present and future. J Thorac Dis. 2018;10:S237–S245. doi: 10.21037/jtd.2017.10.126. - DOI - PMC - PubMed
    1. Seaton A. Asbestos: past, present and future. Schweiz Med Wochenschr. 1995;125:453–457. - PubMed
    1. U.S. Geological Survey (2021) Mineral commodity summaries 2021
    1. Boffetta P, Donato F, Pira E, et al. Risk of mesothelioma after cessation of asbestos exposure: a systematic review and meta-regression. Int Arch Occup Environ Health. 2019;92:949–957. doi: 10.1007/s00420-019-01433-4. - DOI - PubMed
    1. Klebe S, Leigh J, Henderson DW, Nurminen M. Asbestos, smoking and lung cancer: an update. Int J Environ Res Pub Health. 2019;17(1):258. doi: 10.3390/ijerph17010258. - DOI - PMC - PubMed