Occupational exposure to metals and risk of meningioma: a multinational case-control study
The aim of the study was to examine associations between occupational exposure to metals and meningioma risk in the international INTEROCC study. INTEROCC is a seven-country population-based case-control study including 1906 adult meningioma cases and 5565 population controls. Incident cases were recruited between 2000 and 2004. A detailed occupational history was completed and job titles were coded into standard international occupational classifications. Estimates of mean workday exposure to individual metals and to welding fumes were assigned based on a job-exposure-matrix. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated using conditional logistic regression. Although more controls than cases were ever exposed to metals (14 vs. 11 %, respectively), cases had higher median cumulative exposure levels. The ORs for ever vs. never exposure to any metal and to individual metals were mostly greater than 1.0, with the strongest association for exposure to iron (OR 1.26, 95 % CI 1.0–1.58). In women, an increased OR of 1.70 (95 % CI 1.0–2.89) was seen for ever vs never exposure to iron (OR in men 1.19, 95 % CI 0.91–1.54), with positive trends in relation with both cumulative and duration of exposure. These results remained after consideration of other occupational metal or chemical co-exposures. In conclusion, an apparent positive association between occupational exposure to iron and meningioma risk was observed, particularly among women. Considering the fact that meningioma is a hormone dependent tumor, the hypothesis that an interaction between iron and estrogen metabolism may be a potential mechanism for a carcinogenic effect of iron should be further investigated.
KeywordsMeningioma Occupational exposure Metals Risk factors Brain tumors
The authors would like to thank Rodrigo Villegas of CREAL for conducting preliminary analyses of metal data, and Avital Jarus-Hakak (Israel), Louise Nadon (Canada), Hélène Tardy (France), Florence Samkange-Zeeb (Germany), and Anne Sleeuwenhoek (UK), who coded the occupations or assisted in the data clean-up. We are grateful to Mary McBride (Canada) and Drs. Bruce Armstrong (Australia), Maria Blettner (Germany), Alistair Woodward (New Zealand) and Patricia McKinney (UK) for the use of the occupational data from their INTERPHONE study centres for the INTEROCC project.
Michelle C. Turner was funded by a Government of Canada Banting Postdoctoral Fellowship. The INTEROCC study was funded by the National Institutes for Health (NIH) Grant No. 1R01CA124759 (PI E Cardis). Coding of the French occupational data was in part funded by AFSSET (Convention No. ST-2005-004). The INTERPHONE study was supported by funding from the European Fifth Framework Program, ‘Quality of Life and Management of Living Resources’ (contract 100 QLK4-CT-1999901563) and the International Union against Cancer (UICC). The UICC received funds for this purpose from the Mobile Manufacturers’ Forum and GSM Association. In Australia, funding was received from the Australian National Health and Medical Research Council (EME Grant 219129) with funds originally derived from mobile phone service license fees; a University of Sydney Medical Foundation Program; the Cancer Council NSW and The Cancer Council Victoria. In Canada funding was received from the Canadian Institutes of Health Research (project MOP-42525); the Canada Research Chair programme; the Guzzo-CRS Chair in Environment and Cancer; the Fonds de la recherche en santé du Québec; the Canadian Institutes of Health Research (CIHR), the latter including partial support from the Canadian Wireless Telecommunications Association; the NSERC Chair in Risk Science at the University of Ottawa. In France, funding was received by l’Association pour la Recherche sur le Cancer (ARC) (Contrat N85142) and three network operators (Orange, SFR, Bouygues Telecom). In Germany, funding was received from the German Mobile Phone Research Program (Deutsches Mobilfunkforschungsprogramm) of the German Federal Ministry for the Environment, Nuclear Safety, and Nature Protection; the Ministry for the Environment and Traffic of the state of Baden- Wurttemberg; the Ministry for the Environment of the state of North Rhine-Westphalia; the MAIFOR Program (Mainzer Forschungsforderungsprogramm) of the University of Mainz. In New Zealand, funding was provided by the Health Research Council, Hawkes Bay Medical Research Foundation, the Wellington Medical Research Foundation, the Waikato Medical Research Foundation and the Cancer Society of New Zealand. Additional funding for the UK study was received from the Mobile Telecommunications, Health and Research (MTHR) program, funding from the Health and Safety Executive, the Department of Health, the UK Network Operators (O2, Orange, T-Mobile, Vodafone, ‘3’) and the Scottish Executive. All industry funding was governed by contracts guaranteeing the complete scientific independence of the investigators.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 6.Perry A, Louis DN, Budka H, von Deimling A, Sahm F, Rushing EJ, Mawrin C, Claus EB, Loeffler J, Sadetzki S (2016) Meningioma. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds) WHO classification of tumors of the central nervous system, 4th edn. IARC Press, Lyon, pp 232–237Google Scholar
- 18.IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 100C (2012) “Arsenic, Metals, Fibres, and Dusts”. Retrieved 15 Feb, 2016, from http://monographs.iarc.fr/ENG/Monographs/vol100c/
- 22.Summary of All Agents IARC (2015) Monographs of the evaluation of carcinogenic risks to humans. Retrieved 15 Feb, 2016, from http://monographs.iarc.fr/ENG/Classification/ClassificationsGroupOrder.pdf
- 25.International Labour Office (1969) International Classification of Occupations, Revised Edition. International Labour Organization, GenevaGoogle Scholar
- 26.International Labour Office (1990) International Standard Classification of Occupations: ISCO-88. International Labour Office, GenevaGoogle Scholar
- 27.International Standard Industrial Classification of all Economic Activities (Revision 2) (1975). New YorkGoogle Scholar
- 28.McLean D, van Tongeren M, Richardson L et al (2011) Evaluation of the quality and comparability of job coding across seven countries in the INTEROCC study. EPICOH 2011: 23rd International Conference on Epidemiology in Occupational Health. 7–9 September 2011. Oxford, UK: University of Oxford. Occup Environ Med 68:A61CrossRefGoogle Scholar
- 30.Treiman D (1977) Occupational prestige in comparative perspective. Press A, New YorkGoogle Scholar
- 33.Andrews RK, Blakely RL, Zerner B (1988) Nickel in proteins and enzymes. In: Sigel H, Sigel A (eds) Metal ions in biological systems, Volume 23: nickel and its role in biology. Marcel Decker Inc, New York, pp 219–221Google Scholar
- 40.Hayat MA (ed.) (2012) Tumors of the central nervous system, volume 7: meningiomas and schwannomas. Springer Science + Business Media B.V.Google Scholar
- 44.Strayer DS, Rubin E (2014) Cell adaptation, cell injury, and cell death. In: Rubin E, Reisner HM (eds). Essentials of Rubin’s pathology, 6th edn. Wolters Kluwer/Lippincott Williams & Wikins, Baltimore, pp 1–24Google Scholar