Bladder tumours and occupation: a coroner's notification scheme

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Abstract
Veys, C. A. (1974).British Journal of Industrial Medicine,31, 65-71. Bladder tumours and occupation: a coroner's notification scheme. The disease of bladder cancer accounted for 2 763 male and 1 107 female deaths in England and Wales during 1971. How much of this total is influenced by aetiological factors in the working environment is still largely unknown and is only now beginning to be studied. In order to elucidate this question further, a coroner's notification scheme for all bladder tumours occuring within a defined geographical area was started in 1965. Details of all persons dying, on whose death certificate a bladder tumour was mentioned, were notified to the coroner's office within a six-year period (1965-70). A necropsy was carried out in almost all cases. A subsequent searching enquiry into the lifetime occupational history was conducted and this was then related to two industrial check-lists previously drawn up, on which the occupations listed exhibited either a true cause and effect relationship, or were merely associated in statistical terms. The finding that about 20% of persons dying of this disease had a suspicious occupational history of exposure to a carcinogen was broadly in agreement with some other recent surveys whose methodology was different. In only one third of these cases, however, could the working environment be directly and realistically implicated. The study supports the conclusion that the importance of occupational factors in the aetiology of bladder tumours has hitherto been underestimated.