Integration of laboratory and epidemiologic studies to evaluate genotoxic exposure in tool and die workers.

In summary, the data presented here provides perspective on the analysis of cancer in a relatively small population of tool and die workers. Each part of the effort establishes evidence for or against the presence of a workplace carcinogenic effect. Overall, the weight of evidence leads to the hypothesis that cutting fluids are a likely candidate for observed increases in urinary system cancer and perhaps other sites. Because cutting fluids and a wide variety of metals are used together, the interaction of these entities need be considered in the overall process of carcinogenesis in the workplace.