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Cancer Med. 2015 Dec;4(12):1948-62. doi: 10.1002/cam4.544. Epub 2015 Oct 28.

Bladder cancer and occupational exposure to diesel and gasoline engine emissions among Canadian men.

Author information

Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada.
CHAIM Research Centre, Carleton University, Ottawa, Ontario, Canada.
Occupational Cancer Research Center, Toronto, Ontario, Canada.
Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, University of Quebec, Laval, Quebec, Canada.
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.


The International Agency for Research on Cancer has classified diesel exhaust as a carcinogen based on lung cancer evidence; however, few studies have investigated the effect of engine emissions on bladder cancer. The purpose of this study was to investigate the association between occupational exposure to diesel and gasoline emissions and bladder cancer in men using data from the Canadian National Enhanced Cancer Surveillance System; a population-based case-control study. This analysis included 658 bladder cancer cases and 1360 controls with information on lifetime occupational histories and a large number of possible cancer risk factors. A job-exposure matrix for engine emissions was supplemented by expert review to assign values for each job across three dimensions of exposure: concentration, frequency, and reliability. Odds ratios (OR) and their corresponding 95% confidence intervals were estimated using logistic regression. Relative to unexposed, men ever exposed to high concentrations of diesel emissions were at an increased risk of bladder cancer (OR = 1.64, 0.87-3.08), but this result was not significant, and those with >10 years of exposure to diesel emissions at high concentrations had a greater than twofold increase in risk (OR = 2.45, 1.04-5.74). Increased risk of bladder cancer was also observed with >30% of work time exposed to gasoline engine emissions (OR = 1.59, 1.04-2.43) relative to the unexposed, but only among men that had never been exposed to diesel emissions. Taken together, our findings support the hypothesis that exposure to high concentrations of diesel engine emissions may increase the risk of bladder cancer.


Bladder cancer; Case-control study; engine emissions; expert assessment; job-exposure matrix; occupational cancer

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