American Journal of Epidemiology Vol. 152, No. 1 : 32-40
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Occupational Exposure and Lung Cancer Risk: A Population-based Case-Referent Study in Sweden
1 Department of Occupational Health, Stockholm County Council, Stockholm, Sweden.
2 Division of Occupational Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
3 Division of Environmental Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
4 Department of Environmental Health, Stockholm County Council, Stockholm, Sweden.
5 Department of Epidemiology and Public Health, Imperial College, London, United Kingdom.
This case-referent study investigated the lung cancer risk from occupational exposure to diesel exhaust, mixed motor exhaust, other combustion products, asbestos, metals, oil mist, and welding fumes. All cases of lung cancer in males aged 40–75 years among stable residents of Stockholm County, Sweden, were identified from 1985 to 1990. Referents were selected as a stratified (age, inclusion year) random sample. Information on lifetime occupational history, residency, and tobacco smoking was obtained from the study subjects or from next of kin. Response rates of 87% and 85% resulted in 1,042 cases and 2,364 referents, respectively. Occupational exposures were assessed by an occupational hygienist who coded the intensity and probability of each exposure. Risk estimates were adjusted for tobacco smoking, other occupational exposures, residential radon, and environmental exposure to traffic-related air pollution. For the highest quartile of cumulative exposure versus no exposure, the relative risk was 1.63 (95% confidence interval (CI): 1.14, 2.33) for diesel exhaust, 1.60 (95% CI: 1.09, 2.34) for combustion products, and 1.68 (95% CI: 1.15, 2.46) for asbestos. Dose-response analyses indicated an increase in lung cancer risk of 14% per fiber-year/ml for asbestos exposure. No increased risk was found for the other exposure factors. An overall attributable proportion of 9.5% (95% CI: 5.5, 13.9) was estimated for lung cancer related to diesel exhaust, other combustion products, and asbestos.
air pollutants; asbestos; hydrocarbons, aromatic; lung neoplasms; occupational diseases; occupational exposure; polycyclic hydrocarbons; vehicle emissions
Abbreviations: CI, confidence interval; PAHs, polycyclic aromatic hydrocarbons
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