1. Case control study of the relationship
between occupational risk-factors
and occurrence of bladder cancer in workers in
Northern Israel
Abargil Sigal
ABSTRACT
Background:
Bladder cancer is a relatively common tumor, more common in men than in woman. It is the
third most common among occupational cancers. Thus, identification and control of
occupational risk factors for bladder cancer could result in reduction in the burden of this
illness in Israel.
Main goal:
To ascertain the major occupational risk factors for TCC in northern Israel.
Methods:
A matched case control study of TCC patients treated at the Rambam hospital during 2007. A
dedicated questionnaire was used to collect information on socio-demographic parameters,
smoking habits, and detailed occupational history.
Results:
About 71% of the TCC patients are manual workers as compared to only 42% among the
controls (BPH patients), p< 0.004. Of the TCC patients about 59% reported being exposed to
various chemicals in their work while only about 14% of the controls reported such exposures
(p<0.001). Among TCC patients, 10 reported being exposed in their regular work to gasoline
and fuel products as compared with only 3 patients from the control group; 6 TCC cases
reported exposure to concrete/cement materials and 5 reported being exposed to paints. Such
exposures were not reported by anyone of the control group. As expected smoking was
strongly associated with the risk of TCC (OR=22.8, 95% CI= 4.9-106.4). No relation could be
demonstrated between TCC and coffee drinking, use of artificial sweeteners or history of
nephrolithiasis. In multivariate analysis no statistical significant association could be
demonstrated between the occurrence of bladder cancer and occupational exposures.
Conclusion:
In a case control study of TCC patients from northern Israel we could demonstrate higher
than expected occurrence of the disease in individuals exposed in their ordinary jobs to fuels,
paints and concrete/cement. The well known association between smoking and the occurrence
of bladder cancer was demonstrated also in this study.
These findings point to the need to introduce prevention/intervention measures in groups of
exposed workers.
Key words:
Bladder cancer, benign hypertrophy of the prostate, occupational exposures, chemical
materials, case- control study

2. Case control study of the relationship
between occupational risk-factors
and occurrence of bladder cancer in workers in
Northern Israel
By: Abargil Sigal
Supervised by: Professor Rafael Carel
Professor Shai Lin
THESIS SUBMITTED IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE MASTER DEGREE
University of Haifa
Faculty of social Welfare & Health sciences
School of Public Health
November, 2007

3. Case control study of the relationship
between occupational risk-factors
and occurrence of bladder cancer in workers in
Northern Israel
Abargil Sigal
THESIS SUBMITTED IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE MASTER DEGREE
University of Haifa
Faculty of social Welfare & Health sciences
School of Public Health
November, 2007