Lung cancer risk and occupational exposure to meat and live animals

An increased risk of lung cancer has been reported for butchers and meat workers in several cohort studies, although confounding from tobacco smoking could not be ruled out in any of these studies. These exposures, as well as a potential risk associated with contact with live animals, are addressed here in a large case-control study with full adjustment for smoking. More than 5,900 subjects were included in a case-control study conducted in 7 European countries. For each job they employed local experts who assessed the exposure to a number of occupational agents, including (i) meat aerosols and (ii) live animals, on the basis of detailed occupational questionnaires. Information on tobacco consumption and other risk factors was also collected. A small increased risk of lung cancer was observed with exposure to meat aerosols, after adjusting for smoking, (odds ratio (OR)=1.27, 95% confidence interval (CI): 0.92, 1.75), which was most apparent for the upper tertile of cumulative exposure (OR=1.73, 95% CI: 1.03, 2.92). A similar overall effect was observed for exposure to live animals, with an increased risk observed for a high frequency of exposure, (OR=1.69, 95% CI: 1.21, 2.36) and a high intensity of exposure, (OR=1.85, 95% CI: 1.16, 2.94), with significant trends for increasing frequency (p=0.012), intensity (p=0.015) and cumulative exposure (p=0.024). In conclusion, this study provides evidence for an association between exposure to meat aerosols and lung cancer apparent in the highest tertile of exposure. The authors identified a more consistent association with exposure to live animals.     

Occupational Exposures and Risk of Adenocarcinoma of the Lung in Uruguay

Objectives: To investigate occupational risks of lung adenocarcinoma in Uruguay and to confirm a previously reported increased risk among butchers.Methods: We conducted a case–control study among men in four major hospitals in Montevideo, based on interviews to 338 cases of lung adenocarcinoma and 1014 hospital-based controls. We calculated odds ratios (ORs) of lung adenocarcinoma for employment in 22 jobs, after adjustment for tobacco smoking and other potential confounders.Results: The OR was increased for employment as farmer, tractor driver, painter and medical worker, but no trend was suggested for duration of employment. Long-term employment as mason, glass worker or textile worker resulted in an increased OR. The OR for employment as butcher was 1.2 (95% confidence interval 0.7–2.1). The OR increased with increasing duration of self-reported exposure to formaldehyde.Conclusions: Occupational exposures seem to play a limited role in causing lung adenocarcinoma among men in Uruguay. Employment as butcher was not confirmed as an important risk factor.     

Occupational physical activity and risk for prostate cancer in a nationwide cohort study in Sweden

We investigated effects of occupational physical activity on relative risk for prostate cancer. From Swedish nationwide censuses in 1960 and 1970, we defined two cohorts of men whose occupational titles allowed classification of physical activity levels at work in 1960 (n=1,348,971) and in 1970 (n=1,377,629). A third cohort included only men whose jobs required a similar level of physical activity in both 1960 and 1970 (n=673,443). The incidence of prostate cancer between 1971 and 1989 was ascertained through record linkage to the Swedish Cancer Register. A total of 43,836, 28,702, and 19,670 prostate cancers, respectively, occurred in the three cohorts. In all three cohorts, the relative risk for prostate cancer increased with decreasing level of occupational physical activity (P<0.001), using Poisson regression. Among men with the same physical activity levels in 1960 and 1970, the rate ratio was 1.11 for men with sedentary jobs as compared with those whose jobs had very high/high activity levels after adjustment for age at follow-up, calendar year of follow-up and place of residence (95% CI 1.05-1.17; P for trend <0.001). There was no association between occupational activity and prostate cancer mortality. Since we had no data on other potential risk factors the observed associations for both incidence and mortality might have been confounded. Further studies are needed to better understand the potential role of physical activity for prostate cancer.     

Adult-onset acute leukemia and employment in the meat industry: a New Zealand case-control study

Objectives: To assess the risks for adult-onset acute leukemia associated with employment in the New Zealand meat industry. Methods: A total of 110 incident leukemia cases identified from referrals to one of six treatment centers between 1989 and 1991 were compared with 199 general population controls. Detailed occupational exposure histories were obtained by interview. Results: There was an elevated risk associated with ever having worked in an abattoir (OR = 2.3, 95% CI 1.0–5.2), which appeared confined to those with over 2 years exposure (OR = 4.9, 95% CI 1.5–15.6). The excess risk was confined to abattoir workers having direct contact with animals or animal products (OR = 5.2, 95% CI 1.2–22.2). Ever having worked as a butcher was associated with elevated risk (OR = 2.9, 95% CI 1.1–7.2), confined to those individuals who worked as a butcher in an abattoir (OR = 4.8) or who butchered livestock on farms (OR = 8.2). No increased risk was found for work as a retail/wholesale butcher or meatpacker (OR = 1.2). Conclusions: This study found increased leukemia risks associated with employment in the meat industry. These were confined to abattoir workers with over 2 years employment in the industry, and to persons whose jobs involved contact with animals or animal tissue, implying that biological exposures may be responsible.     

Breast cancer risk in male alcoholics in Sweden

Objective: To investigate the association between alcoholism and risk of male breast cancer. Methods: We conducted a retrospective population-based cohort study in Sweden of men diagnosed with alcoholism between 1965 and 1995. The cohort was followed up through interlinkages with nationwide registries (the national cancer registry, immigration registry, causes of death registry, and population registry), using the national registration numbers. Standardized incidence ratios (SIRs), calculated using the Swedish national cancer incidence rate as reference, were used as estimates of relative risks. Results: A total of 145,811 men were enrolled into the cohort, contributing 1,499,504 person-years of follow-up. Sixteen incident breast cancer cases were identified, and the mean age at diagnosis was 68 years. We excluded the first year of follow-up (cases and person-years) from the analysis to avoid detection bias. The overall SIR (excluding the first year of follow-up) was 1.1 (95% CI 0.6–2.0). Although based on small numbers we found no indication of a differential SIR according to duration of follow-up, age at cohort enrolment, or age at follow-up (attained age or age at cancer diagnosis). Conclusion: The observed associations are not compatible with an increase in breast cancer risk among male alcoholics.     

Analysis of Mortality of Stomach Cancer in China from 1990-1992

OBJECTIVE To assess the impact of stom‘ach cancer on the Chinese population by epidemiological analysis of its distributional mortality.METHODS Data from 1990-1992 on stomach cancer mortality collected by a sampling survey involved one tenth of the total Chinese population.RESULTS The crude mortality rate of stomach cancer in China was 25.2per 10^5 (32.8 per 10^5for males and 17.0 per 10^5 for females), which comprised23.2% of the total cancer deaths from 1990 to 1992, making stomach cancerthe leading cause of cancer death. The stomach cancer mortality rate ofmales was 1.9 times of that of females. The Chinese mortality rates ofstomach cancer adjusted by the world standard population were 40.8 per105 and 18.6 per 105 for males and females, which were 4.2-7.9 (for males)and 3.8-8.0 (for females) times of those in developed countries. Age-adjusted mortality rates of stomach cancer in China have distinctgeographical differences: form the lowest of 2.5 per 10^5 to the highest of153.0 per 10^5 in the 263 selected sites, and 15.3 per 10^5 in urban areas and24.4 per 10^5 in rural areas, a difference of 1.6 times.CONCW$10N The prevention and treatment of stomach cancer in L;n~na,especially in the countryside and the under-developed areas in thenorthwest, should be a long-term focus in preventing of cancers of thedigestive system. Urgent measures for prevention and early detection of stomach cancer should be taken.     

Occupational X-ray examinations and lung cancer risk

Occupational X-ray examination programs have been conducted in many countries to screen for occupational and nonoccupational respiratory diseases, resulting in widespread exposure to X-radiation. We conducted a multicentre case-control study of lung cancer in the Czech Republic, Hungary, Poland, Romania, Russia and Slovakia, including 2,589 cases and 2,859 controls enrolled during 1998-2002. We collected detailed information on occupational X-ray examinations, occupations and tobacco smoking. We calculated odds ratios of lung cancer via multiple logistic regression after adjustment for age, sex, center and tobacco smoking. Among controls 24.9% reported no X-ray examination, 62.9% reported 1-30 examinations and 12.2% reported more than 30 examinations. When we chose individuals with no examination as the reference group, the odds ratios of lung cancer were 1.21 (95% confidence interval [CI] 0.99-1.48), 1.33 (95% CI 1.08-1.64), 1.49 (95% CI 1.18-1.87), 1.52 (95% CI 1.17-1.99) and 2.15 (95% CI 1.50-3.08) for 1-10, 11-20, 21-30, 31-40 and more than 40 examinations, respectively (p-value of test for linear trend <0.0001). The association between X-ray examinations and lung cancer risk was strong in countries with low prevalence of exposure and absent in countries with high prevalence of exposure. Odds ratios for X-ray examinations were lower among smokers than among nonsmokers. The magnitude of the increased risk observed is higher than expected on the basis of other studies of radiation-exposed populations. Although the association we detected between X-ray examinations and lung cancer risk may reflect a carcinogenic effect of repeated exposure to low-level ionizing radiation, reporting bias and particularly uncontrolled confounding by occupational exposure to carcinogens are also likely explanations of the results.     

Cancer incidence among male Swedish veterinarians and other workers of the veterinary industry: a record-linkage study

Objective: To investigate the risk of cancer among veterinarians in a large record-linkage study from Sweden. Methods: We used the nationwide, Swedish Cancer Environment Registry III, which links the Cancer Register data for 1971–1989 to the national population censuses from 1960 and 1970, to compare the incidence of cancer among male veterinarians to that of the remaining part of the active population using multivariable Poisson regression models and standardized incidence ratios. One thousand one hundred and seventy eight men classified as veterinarians or workers in the veterinary industry at either census were identified. Results: Veterinarians in the veterinary industry experienced increased risk of esophageal (relative risk (RR) 3.78, 95% confidence interval (CI) 1.42–10.09), colon (RR: 2.36, 95% CI: 1.42–3.91), pancreatic (RR: 2.10, 95% CI: 0.94–4.68) and brain (RR: 2.51, 95% CI: 1.04–6.03) cancers as well as melanoma of the skin (RR: 2.77, 95% CI: 1.24–6.17). Similar excess risks were observed when veterinarians were compared with individuals of similar socio-economic status. Conclusion: The increased risks of esophageal, colon, pancreatic and brain cancers as well as melanoma observed among veterinarians did not seem to be explained by the high socio-economic status of this occupational group. Therefore, it is possible that some of these results reflect the carcinogenicity of occupational exposures, including animal viruses, solar or ionizing radiations and anesthetics.     

Cigarette smoking and breast cancer risk: a population-based study in Sweden

In a Swedish population-based case-control study, smoking showed no convincing association with risk of postmenopausal breast cancer - regardless of timing or level of smoking exposure - either overall or among subgroups.     

1992～2005年辽宁庄河胃癌高发区1 003例胃癌病理形态学特征年代变化趋势

目的：从胃癌形态学方面，探讨辽宁省庄河地区胃癌高发区胃癌病理形态学特征及其年代变化趋势，探讨这种变化与胃癌发病影响因素之间的关系，为胃癌防治提供线索和依据。方法：选取1992-2005年在辽宁庄河市中心医院接受手术切除的胃癌标本共计1003例。标本均经4％甲醛固定，病理常规系统检查。结果：1003例胃癌患者平均发病年龄58．9岁（17～84岁）；不同年代胃癌高发年龄均为60～69岁，其次为50～59岁，男性胃癌患者明显多于女性患者（P〈0．001），男女患者之比为3．0：1。1003例胃癌患者中，共检出早期胃癌159例（15．9％），年均构成比为15．3％，中期胃癌195例（19．4％），晚期胃癌649例（64．7％）。各年间早期胃癌大体分型以Ⅲ型为主；进展期胃癌以BorrmannⅢ型为主。在淋巴结转移方面，早期胃癌各年间无淋巴结转移者多于有淋巴结转移者；进展期胃癌各年间有淋巴结转移者多于无淋巴结转移者。在组织学分型方面，乳头状管状腺癌、中分化管状腺癌、低分化管状腺癌和印戎细胞癌呈逐年下降趋势；黏液腺癌、未分化癌呈逐年升高趋势；若以Lauren分类为标准，在各年代间均以弥漫型胃癌占优势，并呈逐年上升趋势，肠型胃癌呈下降趋势，二者比值呈下降趋势。结论：随着年代的变迁，庄河地区胃癌临床流行病学特征有明显变化。     

Never smokers and lung cancer risk: a case-control study of epidemiological factors

We performed an analysis of potential epidemiological risk factors for lung cancer using data from 280 cases and 242 hospital-based controls, all lifetime never smokers (those who had smoked <100 cigarettes in their lifetimes) and frequency matched on age, gender and ethnicity. The data on demographic characteristics, medical history of respiratory diseases (asthma, emphysema, pneumonia and hay fever), weight and height, family history, female characteristics and environmental tobacco smoke (ETS) and dust exposure were derived from personal interviews. We performed a logistic regression analysis of these variables adjusting for age, gender, ethnicity, income and years of education. Exposure to ETS (OR = 2.08, 95% CI [1.25-3.43]) and dusts (OR = 2.43, 95% CI [1.53-3.88]) were associated with significantly increased risk. In the analysis for joint effects, exposure to both ETS and dusts conferred a higher risk (OR = 3.25, 95% CI [1.58-6.70]) than exposure to either alone. Family history of any cancer with onset before age 50 in at least 1 first degree relative was a significant risk predictor (OR = 1.70, 95% CI [1.10-2.64]). Individuals with a self-reported physician-diagnosed history of hay fever, but not asthma, had a decreased lung cancer risk (OR = 0.57, 95% CI [0.35-0.92]). In the multivariate analysis, exposure to ETS and dusts, and family history of cancer with onset before age 50 were significant risk factors, while a history of hay fever (occurring without asthma) was significantly protective.     

Cancer incidence among marine engineers,a population-based study (Iceland)

Objectives: Marine engineers are in their occupation exposed to different chemicals, organic solvents, exhaust gases, oils, and petroleum products, and were formerly exposed to asbestos. The aim was to study the cancer pattern, with particular attention to lung and bladder cancer, in an Icelandic cohort of marine engineers, indirectly controlling for their smoking habits. Methods: A cohort of 6603 male marine engineers was followed up from 1955 to 1998, a total of 167,715 person-years. The cohort was record linked by the engineers' personal identification numbers to population-based registers containing the vital and emigration status and cancer diagnosis. Standardized incidence ratios (SIRs) were calculated for all cancers and different cancer sites in relation to different lag time and year of graduation. Information on smoking habits was obtained by administering a questionnaire to a sample of the cohort (n = 1501). Results: In the total cohort 810 cancers were observed, whereas 794 were expected (SIR 1.0, 95% CI 1.0–1.1), and significantly increased risk of stomach cancer (SIR 1.3, 95% CI 1.0–1.5) and lung cancer (SIR 1.2, 95% CI 1.0–1.5) was found. Increased risk of all cancers (SIR 1.2, 95% CI 1.1–1.3), stomach cancer (SIR 1.5, 95% CI 1.1–1.9), lung cancer (SIR 1.4, 95% CI 1.2–1.8), pleural mesothelioma (SIR 4.8, 95% CI 1.3–12.3), and urinary bladder cancer (SIR 1.3, 95% CI 1.0–1.8) were observed when a 40-year lag time was applied. The engineers' smoking habits were similar to those in a sample of the general population. The predictive value for lung cancer was 1.03. Conclusions: The increased risk for mesothelioma is possibly attributable to the previous asbestos exposure. The excess of lung cancer could also be related to asbestos exposure. The high incidence of stomach cancer, lung cancer, and bladder cancer may be related to exposure to chemical risk factors, such as oils and petroleum products, as confounding due to smoking seems to be ruled out. In the light of the limited exposure information in the present study the importance of the different occupational exposures needs to be evaluated in further studies.     

Occupation and risk of upper aerodigestive tract cancer: the ARCAGE study

We investigated the association between occupational history and upper aerodigestive tract (UADT) cancer risk in the ARCAGE European case-control study. The study included 1,851 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1,949 controls. We estimated odds ratios (OR) and 95% confidence intervals (CI) for ever employment in 283 occupations and 172 industries, adjusting for smoking and alcohol. Men (1,457 cases) and women (394 cases) were analyzed separately and we incorporated a semi-Bayes adjustment approach for multiple comparisons. Among men, we found increased risks for occupational categories previously reported to be associated with at least one type of UADT cancer, including painters (OR = 1.74, 95% CI: 1.01-3.00), bricklayers (1.58, 1.05-2.37), workers employed in the erection of roofs and frames (2.62, 1.08-6.36), reinforced concreters (3.46, 1.11-10.8), dockers (2.91, 1.05-8.05) and workers employed in the construction of roads (3.03, 1.23-7.46), general construction of buildings (1.44, 1.12-1.85) and cargo handling (2.60, 1.17-5.75). With the exception of the first three categories, risks both increased when restricting to long duration of employment and remained elevated after semi-Bayes adjustment. Increased risks were also found for loggers (3.56, 1.20-10.5) and cattle and dairy farming (3.60, 1.15-11.2). Among women, there was no clear evidence of increased risks of UADT cancer in association with occupations or industrial activities. This study provides evidence of an association between some occupational categories and UADT cancer risk among men. The most consistent findings, also supported by previous studies, were obtained for specific workers employed in the construction industry.     

Cancer risk from occupational and environmental exposure to polycyclic aromatic hydrocarbons

Epidemiologic evidence on the relationship between polycyclic aromatic hydrocarbons (PAH) and cancer is reviewed. High occupational exposure to PAHs occurs in several industries and occupations. Covered here are aluminum production, coal gasification, coke production, iron and steel foundries, tar distillation, shale oil extraction, wood impregnation, roofing, road paving, carbon black production, carbon electrode production, chimney sweeping, and calcium carbide production. In addition, workers exposed to diesel engine exhaust in the transport industry and in related occupations are exposed to PAHs and nitro-PAHs. Heavy exposure to PAHs entails a substantial risk of lung, skin, and bladder cancer, which is not likely to be due to other carcinogenic exposures present in the same industries. The lung seems to be the major target organ of PAH carcinogenicity and increased risk is present in most of the industries and occupations listed above. An increased risk of skin cancer follows high dermal exposure. An increase in bladder cancer risk is found mainly in industries with high exposure to PAHs from coal tars and pitches. Increased risks have been reported for other organs, namely the larynx and the kidney; the available evidence, however, is inconclusive. The results of studies addressing environmental PAH exposure are consistent with these conclusions.     

Heterocyclic aromatic amine pesticide use and human cancer risk: Results from the U.S. Agricultural Health Study

Imazethapyr, a heterocyclic aromatic amine, is a widely used crop herbicide first registered for use in the United States in 1989. We evaluated cancer incidence among imazethapyr‐exposed pesticide applicators enrolled in the Agricultural Health Study (AHS). The AHS is a prospective cohort of 57,311 licensed pesticide applicators in the U.S., enrolled from 1993–1997. Among the 49,398 licensed pesticide applicators eligible for analysis, 20,646 applicators reported use of imazethapyr and 2,907 incident cancers developed through 2004. Imazethapyr exposure was classified by intensity‐weighted lifetime exposure days calculated as [years of use × days per year × intensity level]. Poisson regression analysis was used to evaluate the relationship between imazethapyr exposure and cancer incidence. We found significant trends in risk with increasing lifetime exposure for bladder cancer (p for trend 0.01) and colon cancer (p for trend 0.02). Rate ratios (RRs) were increased by 137% for bladder cancer and 78% for colon cancer when the highest exposed were compared to the nonexposed. The excess risk for colon cancer was limited to proximal cancers, (RR = 2.73, 95% confidence intervals 1.42, 5.25, p for trend 0.001). No association was observed for prostate, lung, rectum, kidney, oral, pancreas, lymphohematopoietic cancers or melanoma. These findings provide new evidence that exposure to aromatic amine pesticides may be an overlooked exposure in the etiology of bladder and colon cancer. The use of imazethapyr and other imidazolinone compounds should continue to be evaluated for potential risk to humans. Published 2008 Wiley‐Liss, Inc.     

Primary liver cancer and occupation in men: a case-control study in a high-incidence area in Northern Italy.

The objective of our study was to evaluate the association between occupation and risk of liver cancer. A hospital-based case-control study was carried out during 1997-1999 in the Province of Brescia, a highly industrialized area in Northern Italy with a high incidence of this neoplasm. The cases were 144 male patients with incident liver cancer (96% hepatocellular carcinoma). Controls were 283 male patients, matched to cases on age (+/-5 years), period and hospital of admission. Information on lifetime occupational history and alcohol consumption was obtained via interview. Specific occupational exposures to pesticides, solvents and other suspected hepatocarcinogens were evaluated. A blood sample was collected to detect hepatitis B and C infections. Odds ratios (OR) of occupational exposure and 95% confidence intervals (CI), adjusted for age, residence, education, heavy alcohol intake, hepatitis B surface antigen and hepatitis C virus antibodies positivity were computed. A statistically significant increased OR was observed for employment in repair of motor vehicles (OR 3.7; 95% CI 1.1-12.3; 9 exposed cases, 10 exposed controls). Increased ORs, although not statistically significant, were found for field-crop farm workers, food and beverage processors, blacksmiths and machine-tool operators, electrical fitters, clerical workers, manufacture of industrial machinery and personal and household services. A slightly increased OR was noted in workers exposed to toluene and xylene (OR 1.4; 95% CI 0.7-3.0, 23 cases, 36 controls); the OR was 2.8 (95% CI 1.0-7.6, 11 cases, 12 controls) for 20 or more years of exposure and 2.0 (95% CI 0.9-4.1, 21 cases, 28 controls) for 30 or more years of time since first exposure. The increase in OR seemed to be independent from that of alcohol or viral infections. Our study showed that the role of occupational exposures in liver carcinogenesis is limited. However, prolonged exposure to organic solvents such as toluene and xylene may represent a risk factor for liver cancer.     

A prospective study of obesity and cancer risk (Sweden)

Objective: We evaluated the relation between obesity and the risks for various forms of cancer. Methods: In a population-based cohort of 28,129 hospital patients (8165 men, 19,964 women) with any discharge diagnosis of obesity (9557 only diagnosis, 5266 primary, 13,306 secondary) during 1965–1993, cancer incidence was ascertained through 1993 by record linkage to the nationwide Swedish Cancer Registry. Cancer risk was estimated using the standardized incidence ratio (SIR, with 95% confidence interval), which is the ratio of the observed number of cancers to that expected. Results: Overall, a 33% excess incidence of cancer was seen in obese persons, 25% in men and 37% in women. Significant risk elevations were observed for cancers of the small intestine (SIR = 2.8; 95% CI 1.6–4.5), colon (1.3; 1.1–1.5), gallbladder (1.6; 1.1–2.3), pancreas (1.5; 1.1–1.9), larynx (2.1; 1.1–3.5), renal parenchyma (2.3; 1.8–2.8), bladder (1.2; 1.0–1.6), cervix uteri (1.4; 1.1–1.9), endometrium (2.9; 2.5–3.4), ovary (1.2; 1.1–1.5), brain (1.5; 1.2–1.9), and connective tissue (1.9; 1.1–3.0), and for lymphomas (1.4; 1.0–1.7), with higher risk observed for Hodgkin's disease only in men (3.3; 1.4–6.5) and for non-Hodgkin's lymphoma only in women (1.6; 1.2–2.1). The association of obesity with risk of breast, prostate and pancreas cancers was modified by age. Conclusions: Obesity is associated with more forms of cancer than previously reported.     

Pregnancy and risk of renal cell cancer: a population-based study in Sweden

Epidemiological findings indicate that hormonal influences may play a role in the etiology of renal cell cancer (RCC). The possible effect of childbearing remains enigmatic; while some investigators have reported a positive association between number of births and renal cell cancer risk, others have not. A case-control study, nested within a nation-wide Fertility Register covering Swedish women born 1925 and later, was undertaken to explore possible associations between parity and age at first birth and the risk of renal cell cancer. Among these women a total of 1465 cases of RCC were identified in the Swedish Cancer Register between 1958 and 1992 and information on the number of live childbirths and age at each birth was obtained by linkage to the Fertility Database. For each case, five age-matched controls were randomly selected from the same register. Compared to nulliparous women, ever-parous women were at a 40% increased risk of RCC (Odds Ratio [OR]=1.42; 95% CI 1.19-1.69). The corresponding OR for women of high parity (five or more live births) was 1.91 (95% CI 1.40-2.62). After controlling for age at first birth among parous women, each additional birth was associated with a 15% increase in risk (OR=1.15; 95% CI 1.08-1.22). The observed positive association between parity and renal cell cancer risk is unlikely to be fully explained by uncontrolled confounding, but warrants further evaluation in large studies, with allowance for body mass index.     

Occupational risk factors for lung cancer among nonsmoking women: a case-control study in Missouri (United States)

Occupationally related risk of lung cancer among women and among nonsmokers has not been widely studied. A recently conducted population-based, case-control study in Missouri (United States) provided the opportunity to evaluate risk of lung cancer associated with several occupational factors. Incident cases (n=429) were identified through the Missouri Cancer Registry for the period 1986 through 1991, and included 294 lifetime nonsmokers and 135 ex-smokers who had stopped at least 15 years prior to diagnosis or had smoked for less than one pack-year. Controls (n=1,021) were selected through driver's license and Medicare files. Risk was elevated among women exposed to asbestos (ever: odds ratio [OR]=3.5, 95 percent confidence interval [CI]=1.2–10.0; >9 yrs: OR=4.6, CI=1.1–19.2) and pesticides (ever: OR=2.4, CI=1.1–5.6; >17.5 yrs: OR=2.4, CI=0.8–7.0). Risk also was elevated among dry cleaning workers (ever: OR=1.8, CI=1.1–3.0; >1.125 yrs: OR=2.9, CI=1.5–5.4). Occupational risks for lung cancer among women merit further study.Drs Brownson and Chang are with the Missouri Department of Health, Columbia, MO, USA. Dr Alavanja is with the Epidemiology and Biostatistics Program, National Cancer Institute, Rockville, MD, USA. Dr Chang directs the Missouri Cancer Registry with the Missouri Department of Health. Address correspondence to Dr Brownson, Division of Chronic Disease Prevention and Health Promotion, Missouri Department of Health, 201 Business Loop 70 West, Columbia, MO 65203, USA. This study was supported in part by US National Cancer Institute contracts NO1-CP7-1096-01 and NO1-CP7-1096-02.