Occupational case-control studies: II. Recommendations for exposure assessment

A case-referent study of occupational risk indicators of renal cell adenocarcinoma was conducted. Each incident case in Finland in 1977-1978 was matched with two population referents. Lifelong job histories were collected and translated into indicators of industry, occupation, and occupational exposures. The analyses of 338 sets of cases and referents revealed elevated risks for a history of employment in white-collar occupations; the printing industry; the chemical industry; the manufacturing of metal products; mail, telephone, and telegraph services; and iron and metalware work. A decreased risk was observed for male farmers. An elevated risk and an exposure-response relationship were found for gasoline exposure. The excess risk was highest at a latency period of approximately 30 years. The findings support the hypothesis that exposure to some constituent(s) of gasoline increases the incidence of renal adenocarcinoma in humans. Suggestions of elevated risks appeared for exposures to inorganic lead, cadmium, and nonchlorinated solvents.

The true test of the long-term response of workers exposed to a hazardous agent is usually the epidemiological studies performed on same. This necessitates the long-term knowledge of exposure levels. Usually, the extent to which the exposures measured during recent experiences are representative of past exposures is difficult to assess as only limited historic measurements are available, and oftentimes the limited data are difficult to relate to today's measurement techniques. It is fallacious to assume that the conditions were worse in the past as it is fallacious to assume that they were better. The methodology of estimating past exposures to an agent based on industry-wide survey techniques is discussed.