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. 1992 Oct;49(10):721–727. doi: 10.1136/oem.49.10.721

Lung cancer and occupation: results of a multicentre case-control study.

A Morabia 1, S Markowitz 1, K Garibaldi 1, E L Wynder 1
PMCID: PMC1012148  PMID: 1419861

Abstract

The objective of the current study was to estimate the risk of lung cancer attributable to occupational factors and not due to tobacco. At 24 hospitals in nine metropolitan areas in the United States, 1793 male lung cancer cases were matched for race, age, hospital, year of interview, and cigarette smoking (never smoker, ex-smoker, smoker (1-19 and > or = 20 cigarettes per day)) to two types of controls (cancer and non-cancer hospital patients). Information on usual occupation, exposure to specific potential carcinogens, and cigarette smoking was obtained by interview. Risk of lung cancer was increased significantly for electricians; sheetmetal workers and tinsmiths; bookbinders and related printing trade workers; cranemen, derrickmen, and hoistmen; moulders, heat treaters, annealers and other heated metal workers; and construction labourers. All of these occupations are potentially exposed to known carcinogens. Odds ratios (ORs) were increased for exposure to coal dust (adjusted OR = 1.5; 95% confidence interval (95% CI) 1.1-2.1). After stratification, this association was statistically significant only after 10 or more years of exposure. Lung cancer was also related to exposure to asbestos (adjusted OR = 1.8; 95% CI 1.5-2.2). The ORs increased with increasing duration of exposure to asbestos for all smoking categories except for current smokers of 1-19 cigarettes per day. The statistical power to detect ORs among occupations that were previously reported to be at increased risk of lung cancer but that failed to show an OR of at least 1.5 in the current study was small. The cumulative population attributable risk (PAR) of lung cancer due to occupation was 9.2%. It is concluded that occupational factors play an important part in the development of lung cancer independently of cigarette smoking. Because occupations at high risk of lung cancer were under-represented, the cumulative PAR of the present study is likely to be an underestimate of the true contribution of occupation to risk of lung cancer.

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Selected References

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  1. Ames R. G., Amandus H., Attfield M., Green F. Y., Vallyathan V. Does coal mine dust present a risk for lung cancer? A case-control study of U.S. coal miners. Arch Environ Health. 1983 Nov-Dec;38(6):331–333. doi: 10.1080/00039896.1983.10545816. [DOI] [PubMed] [Google Scholar]
  2. Armstrong B. K., McNulty J. C., Levitt L. J., Williams K. A., Hobbs M. S. Mortality in gold and coal miners in Western Australia with special reference to lung cancer. Br J Ind Med. 1979 Aug;36(3):199–205. doi: 10.1136/oem.36.3.199. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BRESLOW L., HOAGLIN L., RASMUSSEN G., ABRAMS H. K. Occupations and cigarette smoking as factors in lung cancer. Am J Public Health Nations Health. 1954 Feb;44(2):171–181. doi: 10.2105/ajph.44.2.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Benhamou S., Benhamou E., Flamant R. Occupational risk factors of lung cancer in a French case-control study. Br J Ind Med. 1988 Apr;45(4):231–233. doi: 10.1136/oem.45.4.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Blot W. J., Davies J. E., Brown L. M., Nordwall C. W., Buiatti E., Ng A., Fraumeni J. F., Jr Occupation and the high risk of lung cancer in Northeast Florida. Cancer. 1982 Jul 15;50(2):364–371. doi: 10.1002/1097-0142(19820715)50:2<364::aid-cncr2820500234>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  6. Blot W. J., Morris L. E., Stroube R., Tagnon I., Fraumeni J. F., Jr Lung and laryngeal cancers in relation to shipyard employment in coastal Virginia. J Natl Cancer Inst. 1980 Sep;65(3):571–575. [PubMed] [Google Scholar]
  7. Boffetta P., Harris R. E., Wynder E. L. Case-control study on occupational exposure to diesel exhaust and lung cancer risk. Am J Ind Med. 1990;17(5):577–591. doi: 10.1002/ajim.4700170504. [DOI] [PubMed] [Google Scholar]
  8. Breslow N. E., Day N. E., Halvorsen K. T., Prentice R. L., Sabai C. Estimation of multiple relative risk functions in matched case-control studies. Am J Epidemiol. 1978 Oct;108(4):299–307. doi: 10.1093/oxfordjournals.aje.a112623. [DOI] [PubMed] [Google Scholar]
  9. Coggon D., Pannett B., Osmond C., Acheson E. D. A survey of cancer and occupation in young and middle aged men. I. Cancers of the respiratory tract. Br J Ind Med. 1986 May;43(5):332–338. doi: 10.1136/oem.43.5.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Costa A., Bonadonna G., Villa E., Valagussa P., Silvestrini R. Labeling index as a prognostic marker in non-Hodgkin's lymphomas. J Natl Cancer Inst. 1981 Jan;66(1):1–5. [PubMed] [Google Scholar]
  11. Costello J., Ortmeyer C. E., Morgan W. K. Mortality from lung cancer in U.S. coal miners. Am J Public Health. 1974 Mar;64(3):222–224. doi: 10.2105/ajph.64.3.222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Damber L. A., Larsson L. G. Occupation and male lung cancer: a case-control study in northern Sweden. Br J Ind Med. 1987 Jul;44(7):446–453. doi: 10.1136/oem.44.7.446. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Decoufle P., Lloyd J. W., Salvin L. G. Mortality by cause among stationary engineers and stationary firemen. J Occup Med. 1977 Oct;19(10):679–682. doi: 10.1097/00043764-197710000-00010. [DOI] [PubMed] [Google Scholar]
  14. Francis D. P., Curran J. W., Essex M. Epidemic acquired immune deficiency syndrome: epidemiologic evidence for a transmissible agent. J Natl Cancer Inst. 1983 Jul;71(1):1–4. [PubMed] [Google Scholar]
  15. Frazier T. M., Wegman D. H. Exploring the use of death certificates as a component of an occupational health surveillance system. Am J Public Health. 1979 Jul;69(7):718–720. doi: 10.2105/ajph.69.7.718. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Frumkin H., Berlin J. Asbestos exposure and gastrointestinal malignancy review and meta-analysis. Am J Ind Med. 1988;14(1):79–95. doi: 10.1002/ajim.4700140110. [DOI] [PubMed] [Google Scholar]
  17. Hammond E. C., Selikoff I. J., Lawther P. L., Seidman H. Inhalation of benzpyrene and cancer in man. Ann N Y Acad Sci. 1976;271:116–124. doi: 10.1111/j.1749-6632.1976.tb23100.x. [DOI] [PubMed] [Google Scholar]
  18. Hodgson M. J., Parkinson D. K., Sabo S., Owens G. R., Feist J. H. Asbestosis among electricians. J Occup Med. 1988 Aug;30(8):638–640. doi: 10.1097/00043764-198808000-00007. [DOI] [PubMed] [Google Scholar]
  19. Howe G. R., Lindsay J., Miller A. B. Cancer incidence and mortality in relation to occupation in 700,000 members of the Canadian labour force. Cancer Detect Prev. 1980;3(2):487–497. [PubMed] [Google Scholar]
  20. Kjuus H., Skjaerven R., Langård S., Lien J. T., Aamodt T. A case-referent study of lung cancer, occupational exposures and smoking. II. Role of asbestos exposure. Scand J Work Environ Health. 1986 Jun;12(3):203–209. doi: 10.5271/sjweh.2157. [DOI] [PubMed] [Google Scholar]
  21. Kvåle G., Bjelke E., Heuch I. Occupational exposure and lung cancer risk. Int J Cancer. 1986 Feb 15;37(2):185–193. doi: 10.1002/ijc.2910370204. [DOI] [PubMed] [Google Scholar]
  22. Lerchen M. L., Wiggins C. L., Samet J. M. Lung cancer and occupation in New Mexico. J Natl Cancer Inst. 1987 Oct;79(4):639–645. [PubMed] [Google Scholar]
  23. Levin L. I., Zheng W., Blot W. J., Gao Y. T., Fraumeni J. F., Jr Occupation and lung cancer in Shanghai: a case-control study. Br J Ind Med. 1988 Jul;45(7):450–458. doi: 10.1136/oem.45.7.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. MORRISON S. L. Occupational mortality in Scotland. Br J Ind Med. 1957 Apr;14(2):130–132. doi: 10.1136/oem.14.2.130. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Martischnig K. M., Newell D. J., Barnsley W. C., Cowan W. K., Feinmann E. L., Oliver E. Unsuspected exposure to asbestos and bronchogenic carcinoma. Br Med J. 1977 Mar 19;1(6063):746–749. doi: 10.1136/bmj.1.6063.746. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Menck H. R., Henderson B. E. Occupational differences in rates of lung cancer. J Occup Med. 1976 Dec;18(12):797–801. doi: 10.1097/00043764-197612000-00005. [DOI] [PubMed] [Google Scholar]
  27. Milne K. L., Sandler D. P., Everson R. B., Brown S. M. Lung cancer and occupation in Alameda County: a death certificate case-control study. Am J Ind Med. 1983;4(4):565–575. doi: 10.1002/ajim.4700040410. [DOI] [PubMed] [Google Scholar]
  28. Pastorino U., Berrino F., Gervasio A., Pesenti V., Riboli E., Crosignani P. Proportion of lung cancers due to occupational exposure. Int J Cancer. 1984 Feb 15;33(2):231–237. doi: 10.1002/ijc.2910330211. [DOI] [PubMed] [Google Scholar]
  29. Ronco G., Ciccone G., Mirabelli D., Troia B., Vineis P. Occupation and lung cancer in two industrialized areas of northern Italy. Int J Cancer. 1988 Mar 15;41(3):354–358. doi: 10.1002/ijc.2910410306. [DOI] [PubMed] [Google Scholar]
  30. Schoenberg J. B., Stemhagen A., Mason T. J., Patterson J., Bill J., Altman R. Occupation and lung cancer risk among New Jersey white males. J Natl Cancer Inst. 1987 Jul;79(1):13–21. [PubMed] [Google Scholar]
  31. Selikoff I. J., Hammond E. C., Seidman H. Mortality experience of insulation workers in the United States and Canada, 1943--1976. Ann N Y Acad Sci. 1979;330:91–116. doi: 10.1111/j.1749-6632.1979.tb18711.x. [DOI] [PubMed] [Google Scholar]
  32. Vineis P., Simonato L. Proportion of lung and bladder cancers in males resulting from occupation: a systematic approach. Arch Environ Health. 1991 Jan-Feb;46(1):6–15. doi: 10.1080/00039896.1991.9937423. [DOI] [PubMed] [Google Scholar]
  33. Wynder E. L., Stellman S. D. Comparative epidemiology of tobacco-related cancers. Cancer Res. 1977 Dec;37(12):4608–4622. [PubMed] [Google Scholar]

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