{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T10:46:38Z","timestamp":1782384398081,"version":"3.54.5"},"reference-count":40,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100021570","name":"Dutch Ministry of Defence","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100021570","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2026,4,21]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Hexavalent chromium (Cr(VI)) is a human carcinogen. It is unclear whether Cr(VI) can cause cancer of the small intestine, oral cavity, pancreas, prostate and urinary bladder. We performed a systematic review and meta-analyses of epidemiological studies on occupational exposure to Cr(VI) and incidence and mortality of these cancer sites.<\/jats:p>\n                  <jats:p>A comprehensive review of human studies on Cr(VI) and cancer was performed in Embase and Scopus. 131 potentially relevant epidemiological studies were identified. Study quality was assessed using the Newcastle-Ottawa Scale. 29 publications including 81 observations for meta-analyses were based on cohort or case\u2013control studies with exposure assessment of sufficient quality. Site-specific random-effects meta-analyses were done separately for incidence and mortality. Sensitivity analyses focused on the studies with the highest quality scores.<\/jats:p>\n                  <jats:p>\n                    No indications for an association between Cr(VI) exposure and oral or small intestine cancer were found. Incidence of pancreatic cancer was not associated with Cr(VI) exposure (meta-relative risk (RR) 1.04; 95%\u2009CI 0.85 to 1.28) while for specific mortality RR was 1.41 (95% CI 0.96 to 2.08) with moderate heterogeneity (I\n                    <jats:sup>2<\/jats:sup>\n                    =41%) and an asymmetric funnel plot (Egger\u2019s test; p=0.002). For incidence of prostate cancer meta RR was 1.16 (95% CI 0.99 to 1.37) while the RR for mortality was 1.03 (95% CI 0.84 to 1.25). For bladder cancer, RR was 1.04 (95% CI 0.91 to 1.20) for incidence and 1.76 (95% CI 1.20 to 2.60) for mortality.\n                  <\/jats:p>\n                  <jats:p>This comprehensive meta-analysis of epidemiological studies did not provide sufficient evidence that occupational Cr(VI) exposure may cause cancer of the oral cavity, small intestine, pancreas, prostate or the urinary bladder in humans.<\/jats:p>","DOI":"10.1136\/oemed-2025-110733","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:20:28Z","timestamp":1778174428000},"page":"162-169","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between occupational exposure to chromium (VI) and cancers of the oral cavity, small intestine, pancreas, prostate and urinary bladder: systematic review and meta-analyses"],"prefix":"10.1136","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2941-6259","authenticated-orcid":false,"given":"Jan-Paul","family":"Zock","sequence":"first","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly J","family":"Rijs","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5662-1971","authenticated-orcid":false,"given":"Susan","family":"Peters","sequence":"additional","affiliation":[{"name":"Institute for Risk Asessment Sciences, Utrecht University, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle J","family":"Vlaanderen","sequence":"additional","affiliation":[{"name":"Institute for Risk Asessment Sciences, Utrecht University, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"2026062501401036000_83.3.162.1","unstructured":"National institute for occupational safety and health . 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