Lung Cancer Risks Associated with Occupational Exposure to

Overview

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Key numbers

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• trol subjects using a quantitative job-exposure matrix (SYN-JEM). Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for
• mated that 23% of those working in the European Union (EU) in obtained ethical approvals from their respective countries (Canada,
• recently (2011–2012) it has been estimated that 38% of workers in the current study: asbestos (abbreviation, unit: asbestos, fibers (f)/
• least one carcinogen in their current job, 31% were exposed to mul- valent chromium (chromium-VI, mg=m3 -years), nickel (nickel,
• Table 1. Description of the case-control studies on lung cancer included in these analyses in the SYNERGY project.
• Overall 14 countries 1985–2010 16,901 83% 20,965 70% 1922–2010 H = 21% NOK = 7:3%
• ExpoSYN.19 Empirical linear models were developed using (ORs) and 95% confidence intervals (CIs) were computed for
• sure combination subgroup. Indeed, a total of 284 women (3.6%) defined as having smoked at least one cigarette per day for 6
• 3–5) of the selected occupational lung carcinogens (Table 2). We stopped smoking within the last 2 years before diagnosis or
• Table 2. Study population characteristics of the SYNERGY pooled analysis by lung cancer status and sex.
• Asbestos yes 6,802 (41.3%) 6,958 (51.1%) 510 (11.3%) 482 (14.6%)
• Asbestos no 9,649 (58.7%) 6,647 (48.9%) 4,004 (88.7%) 2,814 (85.4%)
• Chromium-VI yes 3,820 (23.2%) 4,131 (30.4%) 146 (3.2%) 159 (4.8%)
• Chromium-VI no 12,631 (76.8%) 9,474 (69.6%) 4,368 (96.8%) 3,137 (95.2%)
• Nickel yes 3,140 (19.1%) 3,216 (23.6%) 131 (2.9%) 151 (4.6%)
• Nickel no 13,311 (80.9%) 10,389 (76.4%) 4,383 (97.1%) 3,145 (95.4%)
• cative scale were assessed using an interaction term between never RERI estimates along with 95% CIs based on the delta method are
• lence of occupational exposures among women. asbestos (13%) and silica (8%), and they also co-occurred to
• Table 2 shows the main characteristics of the study participants occupational exposures are illustrated for lung cancer overall
• trol subjects were included in the present analysis. presented in numbers in Tables S1 and S2 for men and women,
• exposure to each of these is shown in Table 2, while Figure 1 was generally the highest for Sqc followed by SCC. Most of the
• asbestos was by far the most frequent single exposure; about 40% asbestos/chromium-VI, asbestos/nickel, chromium-VI/PAH, and
• of male controls and 11% of female controls were considered to nickel/PAH showed statistically significant negative departures
• always co-occurred with each other, although chromium-VI also in relation to AC (RERI: 0.24; 95% CI: 0.02, 0.46; p = 0.05).
• asbestos, 70% of those exposed to PAH were also exposed to dence intervals, several pairwise joint exposures were associated
• sures (n = 12,398 men, n = 2,073 women). The total of the columns represents the overall—individual plus co-exposed—prevalence of each exposure, while
• within the column the proportion of “co-exposure” to each of the other exposures is also shown. Percentages lower than 0.4% are not displayed because of lack
• sures in relation to lung cancer risk in SYNERGY for men (n = 13,605 lung cancer cases and 16,451 control subjects). Note: CI, confidence interval; OR, odds
• resulted in a more than additive effect (RERI: 3.45; 95% CI: 0.10, Main and joint effects of occupational exposures between the
• 6.8; p = 0.01), and asbestos/silica (OR = 4.32; 95% CI: 1.35, 7.29; selected lung carcinogens, RERIs, and tests for multiplicative
• p = 0.02) and chromium-VI/silica (OR = 5.80; 95% CI: 1.10, interaction (p-values) in lung cancer risk among men stratified by
• sures in relation to major histological subtypes of lung cancer in SYNERGY for men (n = 11,353 lung cancer cases and n = 16,451 control subjects). Note: CI,
• sures in relation to lung cancer risk in SYNERGY for women (n = 3,296 lung cancer cases and n = 4,514 control subjects). Note: CI, confidence interval; OR,
• numbers in Table S3. All ORs were elevated for the different submultiplicative associations in former smokers (p = 0.04) and
• sures in relation to major histological subtypes of lung cancer in SYNERGY for women (n = 2,632 lung cancer cases and n = 4,514 control subjects). Note: CI,
• interaction (p-values) among male workers (n = 13,605 lung cancer cases and n = 16,451 control subjects) in SYNERGY by smoking status (never, former, and
• ies on the pairwise joint effects of five occupational carcinogens estimation (AWES: n = 38; SYNERGY: n = 5).
• gistic effect was observed for chromium-VI/silica exposure for general population (79%) and that most information was obtained
• associated with wider CIs among the never smoker subgroup as participation in a few studies (Table 1), which may have resulted
• SYNERGY (65% in men and 30% in women) is substantially cation systems to ISCO-68. Self-reported occupational histories
• higher than in CAREX Europe (23%) and the recent study in are considered more reliable than self-reported occupational expo-
• Australia (38%), likely explained by the different denominators sures.24 The original studies in SYNERGY, except MORGEN,

Methods (brief)

• Epidemiology Unit, Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
• Department of Environmental Epidemiology, The Nofer Institute of Occupational Medicine, Lodz, Poland
• access to the collected data, responsibility for data analysis and interpretation,
• and controls, calendar years when the data was collected, the
• quantitative exposure measurements, i.e., samples collected sures and lung cancer risk were evaluated using unconditional

Implications

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Wiki pages this source may touch

• Fish — marine, non-predatory (sardines, anchovies, salmon, cod)
• Seaweed/kelp foods (nori, wakame, kombu, dulse — as food products)
• Nickel
• Tin
• Chromium

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