Environment and Breast Cancer: Science Review

Evidence From Humans
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Extended mortality follow-up of a cohort of dry cleaners
Blair, A., Petralia, S. A., Stewart, P. A. Ann Epidemiol. 2003. 13:1, 50-6.
Topic area
Environmental pollutant
Study Participants
Number of Controls
5369 (2566 white women, 1483 black women)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Members for more than one year of a dry cleaning union in St. Louis compared to US population
Exposure Investigated
Exposures investigated
Work in dry cleaning in jobs classified by exposure based on monitoring data.
Exposure assessment comment
Trichloroethylene came into use in dry cleaning in the 1960s and became the predominant method. Workers who handled previously cleaned clothes were classified as unexposed, even though they would have had exposure from off-gasing. Job classification benefits from availability of some monitoring data. Duration of exposure is not assessed. Prior to 1960s, workers were exposed primarily to Stoddard solvent.
Statistical Analysis
Breast cancer outcome investigated
Mortality from breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
African Americans
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Standardized mortality ratio
Strength of associations reported
SMR 1.0 (95% CI 0.8-1.3)
Black women SMR 1.4; 95% CI 0.90-2.0)
Medium/high exposure SMR 1.2 (95% CI 0.8-1.7)
Results Comments
Lack of control for confounding is problematic.
Author address
Department of Occupational Epidemiology, Branch Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.