REVIEW article
Front. Public Health
Sec. Occupational Health and Safety
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1667873
This article is part of the Research TopicNavigating Environmental Hazards in the Workplace: Impacts and InterventionsView all 25 articles
Occupational hazards and bladder cancer – an umbrella review of the risk in workers exposed during the last 30 years
Provisionally accepted
Marina Ruxandra Otelea1*
Cristina Mandanach1
Claudia Mariana Handra1Agripina rascu1Sorina Hohor1
Irina-Luciana Gurzu2Stefan Alexandru Catalin Rascu1- 1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2Universitatea de Medicina si Farmacie Grigore T Popa lasi Facultatea de Medicina, Iași, Romania
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Background. Occupational exposure accounts as the second preventable risk factors for bladder 19 cancer, after smoking. Objective. To extract evidence based data from the systematic reviews which 20 included studies mainly from the last 30 years, based on a clearly defined method of exposure 21 assessment. Methods: A literature search in PUBMED, WEB OF SCIENCE, SCIENCE DIRECT 22 AND EMBASE was conducted using variations of key words "bladder cancer", "occupational 23 exposure" and/or "occupation". The inclusion criteria for the umbrella review were the followings: 24 systematic reviews and meta-analysis focused on occupational exposure, with a clear definition of the 25 exposure assessment, a risk estimate for bladder cancer and including a majority of data from 1993-26 2023. We did not include other forms of reviews, or systematic reviews focused on general 27 population and environmental exposure. Data were synthetized based either on occupations or on 28 occupational hazards. After the overlap checking, remaining reviews were assessed for quality using 29 AMSTAR 2 criteria and afterwards classified for high, moderate or low evidence using the GRADE 58 scale Results: We found relevant associations with high level of evidence for firefighters, 59 hairdressers, painters, workers in petroleum industry and dry cleaners exposed to tetra-60 chloroethylene. Concerning hazards, exposure to ortho-toluidine was also confirmed to be a risk by 61 recent studies. Welders, veterans and those exposed to hexavalent chromium higher risk need more 62 well designed studies to be confirmed. Conclusion: Despite longstanding recognition of certain 63 risks, occupational exposure remains insufficiently investigated. Recent data provides arguments for 64 occupations and hazards to be considered in the individual risk assessment for bladder cancer.
Keywords: Bladder cancer, Occupational carcinogens, Occupational Exposure, cancer risk, Umbrella review
Received: 17 Jul 2025; Accepted: 17 Sep 2025.
Copyright: © 2025 Otelea, Mandanach, Handra, rascu, Hohor, Gurzu and Rascu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marina Ruxandra Otelea, marina.otelea@umfcd.ro
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