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. 1999 Dec;107(Suppl 6):885–890. doi: 10.1289/ehp.99107s6885

Lung cancer and environmental tobacco smoke: occupational risk to nonsmokers.

K G Brown 1
PMCID: PMC1566198  PMID: 10592148

Abstract

The principal epidemiologic evidence that environmental tobacco smoke (ETS) increases the risk of lung cancer in (lifelong) nonsmokers is from studies of nonsmoking women married to smokers. This article estimates exposure-response curves for 14 studies (1, 249+ cases, 7 countries) with data on lung cancer categorized by the number of cigarettes/day smoked by the husband. The pooled results from the five U.S. studies alone are extrapolated to ETS levels in the workplace using measures of serum cotinine and nicotine samples from personal monitors as markers of exposure to ETS. It is predicted that the increase in lung cancer risk for nonsmoking women from average ETS exposure at work (among those exposed at work) is on the order of 25% (95% confidence interval (CI) = 8, 41) relative to background risk (i.e., with no ETS exposure from any source). This compares to an estimate of 39% (95% CI = 5, 65) for nonsmoking women whose husbands smoke at the adult male smoker's average of 25 cigarettes/day. At the 95th percentiles of exposure, the estimate from spousal smoking is 85% (95% CI = 32, 156), compared to 91% (95% CI = 34, 167) from workplace ETS exposure. Subject to the validity of the assumptions required in this approach, the outcome supports the conclusion that there is a significant excess risk from occupational exposure to ETS. The excess risk from ETS at work is typically lower than that from spousal smoking, but may be higher at the 95th percentiles of exposure.

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Selected References

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  1. Akiba S., Kato H., Blot W. J. Passive smoking and lung cancer among Japanese women. Cancer Res. 1986 Sep;46(9):4804–4807. [PubMed] [Google Scholar]
  2. Berlin J. A., Longnecker M. P., Greenland S. Meta-analysis of epidemiologic dose-response data. Epidemiology. 1993 May;4(3):218–228. doi: 10.1097/00001648-199305000-00005. [DOI] [PubMed] [Google Scholar]
  3. Cardenas V. M., Thun M. J., Austin H., Lally C. A., Clark W. S., Greenberg R. S., Heath C. W., Jr Environmental tobacco smoke and lung cancer mortality in the American Cancer Society's Cancer Prevention Study. II. Cancer Causes Control. 1997 Jan;8(1):57–64. doi: 10.1023/a:1018483121625. [DOI] [PubMed] [Google Scholar]
  4. Garfinkel L., Auerbach O., Joubert L. Involuntary smoking and lung cancer: a case-control study. J Natl Cancer Inst. 1985 Sep;75(3):463–469. [PubMed] [Google Scholar]
  5. Garfinkel L. Selection, follow-up, and analysis in the American Cancer Society prospective studies. Natl Cancer Inst Monogr. 1985 May;67:49–52. [PubMed] [Google Scholar]
  6. Garfinkel L. Time trends in lung cancer mortality among nonsmokers and a note on passive smoking. J Natl Cancer Inst. 1981 Jun;66(6):1061–1066. doi: 10.1093/jnci/66.6.1061. [DOI] [PubMed] [Google Scholar]
  7. Greenland S., Longnecker M. P. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol. 1992 Jun 1;135(11):1301–1309. doi: 10.1093/oxfordjournals.aje.a116237. [DOI] [PubMed] [Google Scholar]
  8. Hackshaw A. K., Law M. R., Wald N. J. The accumulated evidence on lung cancer and environmental tobacco smoke. BMJ. 1997 Oct 18;315(7114):980–988. doi: 10.1136/bmj.315.7114.980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hirayama T. Cancer mortality in nonsmoking women with smoking husbands based on a large-scale cohort study in Japan. Prev Med. 1984 Nov;13(6):680–690. doi: 10.1016/s0091-7435(84)80017-1. [DOI] [PubMed] [Google Scholar]
  10. Hole D. J., Gillis C. R., Chopra C., Hawthorne V. M. Passive smoking and cardiorespiratory health in a general population in the west of Scotland. BMJ. 1989 Aug 12;299(6696):423–427. doi: 10.1136/bmj.299.6696.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Humble C. G., Samet J. M., Pathak D. R. Marriage to a smoker and lung cancer risk. Am J Public Health. 1987 May;77(5):598–602. doi: 10.2105/ajph.77.5.598. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jenkins R. A., Palausky A., Counts R. W., Bayne C. K., Dindal A. B., Guerin M. R. Exposure to environmental tobacco smoke in sixteen cities in the United States as determined by personal breathing zone air sampling. J Expo Anal Environ Epidemiol. 1996 Oct-Dec;6(4):473–502. [PubMed] [Google Scholar]
  13. Kabat G. C., Stellman S. D., Wynder E. L. Relation between exposure to environmental tobacco smoke and lung cancer in lifetime nonsmokers. Am J Epidemiol. 1995 Jul 15;142(2):141–148. doi: 10.1093/oxfordjournals.aje.a117612. [DOI] [PubMed] [Google Scholar]
  14. Kalandidi A., Katsouyanni K., Voropoulou N., Bastas G., Saracci R., Trichopoulos D. Passive smoking and diet in the etiology of lung cancer among non-smokers. Cancer Causes Control. 1990 Jul;1(1):15–21. doi: 10.1007/BF00053179. [DOI] [PubMed] [Google Scholar]
  15. Koo L. C., Ho J. H., Saw D., Ho C. Y. Measurements of passive smoking and estimates of lung cancer risk among non-smoking Chinese females. Int J Cancer. 1987 Feb 15;39(2):162–169. doi: 10.1002/ijc.2910390207. [DOI] [PubMed] [Google Scholar]
  16. Lam T. H., Kung I. T., Wong C. M., Lam W. K., Kleevens J. W., Saw D., Hsu C., Seneviratne S., Lam S. Y., Lo K. K. Smoking, passive smoking and histological types in lung cancer in Hong Kong Chinese women. Br J Cancer. 1987 Nov;56(5):673–678. doi: 10.1038/bjc.1987.264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Liu Q., Sasco A. J., Riboli E., Hu M. X. Indoor air pollution and lung cancer in Guangzhou, People's Republic of China. Am J Epidemiol. 1993 Jan 15;137(2):145–154. doi: 10.1093/oxfordjournals.aje.a116654. [DOI] [PubMed] [Google Scholar]
  18. Logan R. F., Langman M. J. Screening for gastric cancer after gastric surgery. Lancet. 1983 Sep 17;2(8351):667–670. doi: 10.1016/s0140-6736(83)92541-2. [DOI] [PubMed] [Google Scholar]
  19. Pershagen G., Hrubec Z., Svensson C. Passive smoking and lung cancer in Swedish women. Am J Epidemiol. 1987 Jan;125(1):17–24. doi: 10.1093/oxfordjournals.aje.a114504. [DOI] [PubMed] [Google Scholar]
  20. Pirkle J. L., Flegal K. M., Bernert J. T., Brody D. J., Etzel R. A., Maurer K. R. Exposure of the US population to environmental tobacco smoke: the Third National Health and Nutrition Examination Survey, 1988 to 1991. JAMA. 1996 Apr 24;275(16):1233–1240. [PubMed] [Google Scholar]
  21. Stellman S. D., Garfinkel L. Smoking habits and tar levels in a new American Cancer Society prospective study of 1.2 million men and women. J Natl Cancer Inst. 1986 Jun;76(6):1057–1063. [PubMed] [Google Scholar]
  22. Wang T. J., Zhou B. S., Shi J. P. Lung cancer in nonsmoking Chinese women: a case-control study. Lung Cancer. 1996 Mar;14 (Suppl 1):S93–S98. doi: 10.1016/s0169-5002(96)90214-7. [DOI] [PubMed] [Google Scholar]
  23. Wells A. J. Lung cancer from passive smoking at work. Am J Public Health. 1998 Jul;88(7):1025–1029. doi: 10.2105/ajph.88.7.1025. [DOI] [PMC free article] [PubMed] [Google Scholar]

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