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Gulf War and Health: Insecticides and Solvents, Volume 2
exposed workers in coiling and wire drawing. An association with any exposure to solvents was found among aircraft-maintenance workers (SMR=1.6, 95% CI=0.9–2.8) (Blair et al., 1998). No associations were found in studies of workers exposed to aromatic or halogenated solvents (Anttila et al., 1995, 1998), in patients with solvent-related disorders (Berlin et al., 1995), and in aircraft-manufacturing workers (Garabrant et al., 1988).
Summary and Conclusion
In most occupational settings, multiple solvent exposures occurred, so exposures to specific solvents may be highly correlated. Because many studies used occupational titles as exposure surrogates, the ability to assess an association between specific solvents and breast cancer risk was compromised.
A number of studies assessed breast cancer risk and solvent exposure in general, and others provided exposure estimates for specific individual solvents, such as trichloroethylene, tetrachloroethylene, dry-cleaning solvents, benzene, and methylene chloride. The evidence was limited by nonspecific exposure assessments and a reliance on mortality from breast cancer. Nondifferential misclassification of exposure, poor control for confounding, and low statistical power due to small numbers were additional limitations. Table 6.21 identifies the key studies and relevant data points reviewed by the committee in drawing its conclusion. Unless indicated in the tables, the study populations include both men and women.
The committee concludes, from its assessment of the epidemiologic literature, that there is inadequate/insufficient evidence to determine whether an association exists between chronic exposure to solvents under review and breast cancer.
TABLE 6.21 Selected Epidemiologic Studies—Breast Cancer and Exposure to Organic Solvents
Estimated Relative Risk (95% CI)
Hansen et al., 2001
Biologically monitored workers in Denmark
Females, ever exposed
Boice et al., 1999
Aircraft-manufacturing workers in California
Potential routine exposure
Blair et al., 1998
Aircraft-maintenance workers in Utah (females)
Morgan et al., 1998
Aerospace workers in Arizona
Anttila et al., 1995
Finnish workers biologically monitored for exposure to halogenated hydrocarbons