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J Neurooncol. 2016 Dec;130(3):505-515. Epub 2016 Sep 23.

Occupational exposure to metals and risk of meningioma: a multinational case-control study.

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The Cancer and Radiation Epidemiology Unit, The Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, 5262000, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
The Cancer and Radiation Epidemiology Unit, The Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, 5262000, Ramat Gan, Israel.
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.
Institute of Occupational Medicine, Edinburgh, UK.
Monash University, Melbourne, Australia.
School of Medicine, University of Leeds, Leeds, UK.
Unité Mixte de Recherche Epidémiologique Transport Travail Environnement Université Lyon 1/IFSTTAR, Université de Lyon, Lyon, France.
Oregon State University, Corvallis, OR, USA.
Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Massey University, Wellington, New Zealand.
INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, Université du Québec, Laval, Québec, Canada.
University of Montreal Hospital Research Centre, Montreal, Québec, Canada.
Unit of Environmental Epidemiology, German Cancer Research Center, Heidelberg, Germany.
Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg University Mainz, Mainz, Germany.
International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France.


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.


Brain tumors; Meningioma; Metals; Occupational exposure; Risk factors

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