Occhealth Bulletin
26 February 2010
Linking lung cancer to occupation
Category: Reviews
In 2004, there were 1.4 million new cases of lung cancer and 1.3 million deaths as a result of the disease, worldwide. Tobacco smoking is the largest contributory factor but it is also well-known that exposure to certain chemicals and hazardous materials in the workplace may increase the risk of developing lung cancer. Studies have estimated that in men and women 10% and 5% of deaths, respectively, are as a result of exposure to 8 occupational lung carcinogens including arsenic, asbestos and diesel fumes.
A recent study by Carsonni and co-workers aimed to determine the link between lung cancer and occupation in the population-based Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study. The researchers carried out their work on 2,100 incident lung cancer cases and 2,120 population controls from the Lombardy region of Northern Italy between April 2002 and June 2005. Clinical details were collected for the lung cancer cases and classified into histological sub-types. Subjects were required to undergo a computer-assisted personal interview, blood sampling and a self-administered questionnaire. The questionnaire was designed to collect information about occupational history including industry, job title and time at each job (>6 months). Once occupations were identified they were coded using international standard industrial classifications and translated into List A - occupations known to be associated with lung cancer (eg iron and steel founding, asphalt workers) or List B – occupations suspected to be associated with lung cancer (eg glass workers, filling station attendants).
Of the men included in the study, 177 cases and 100 controls had worked in List A occupations whilst 345 cases and 346 controls had worked in List B occupations. For women, only 3 cases and 2 controls had ever worked in List A occupations and 24 cases and 26 controls in List B occupations. The researchers determined that there was “a relative risk excess of 74% for men ever employed in occupations known (List A) to be associated with lung cancer, with the largest contributions from the ceramic and refractory brick and the nonferrous basic industries”. Due to small numbers of women exposed, the relative risk was predictably higher but considered imprecise because of the low sample size. In terms of List B occupations, the researchers found no overall increased risk except for those that worked as filling station attendants and bus and truck drivers (men) and dry cleaners and launderers (women). The researchers concluded that their study illustrates the importance of continually monitoring and controlling work-related exposures particularly in occupations where there is a known association with lung cancer incidence.
REFERENCE
Consonni, D., de Matteis, S., Lubin, JH., Wacholder, S., Tucker, M., Pesatori, AC., Caporaso, NE., Bertazzi, PA. and Landi, MT. (2010) Lung cancer and occupation in a population-based case-control study. American Journal of Epidemiology Vol 171, issue 3.
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