Application of a job-exposure matrix to a case-control study of lung cancer
1
201 of adenocarcinoma was seen with increasing duration of employment in occupations with potential exposure, but only for light smokers. Dietary vitamin A consumption did not confound the occupational associations. Hypotheses have been generated regarding interplay of risk factors in the etiology of different histologic subtypes of lung cancer. Studies of specific histologic ty- pes of lung cancer are needed to elucidate the role of various environmental and oc- cupational risk factors. Application of a Job-Exposure Matrix to a Case-Control Study of Lung Cancer. Hinds, M.W., Kolonel, L.N., Lee, J. Epi- demiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI 96813, U.S.A.J. Natl. Cancer Inst. 75: 193-197, 1985. Interview information was obtained on primary and secondary occupations for 261 male lung cancer patients and 444 controls residing on the island of Oahu, HI. with the use of a computerized job-exposure matrix (JEM), exposure levels were assig- ned to each subject for each of 5 known and 2 likely lung carcinogens. A multiple logistic regression model was used to com- pute the odds ratio (OR) for exposure to each carcinogen, adjusted for age, ethni- city, and pack-years of smoking. On the basis of the criterion of either a dose- response effect or a statistically signi- ficant OR (P < .05) or both, 5 of the 7 carcinogens (4 of the 5 known carcinogens) were found to be associated with lung cancer risk. However, on the basis of the single criterion of a significant OR, only 3 of the 7 carcinogens (2 of the 5 known carcinogens) were associated with lung cancer risk. Due to its relative insensi- tivity, this JEM may have limited useful- ness in the identification of exposure- disease relationships and should not be applied uncritically. Involuntary Smoking and Lung Cancer: A Case-Control Study. Garfinkel, L., Auerbach, O., Joubert, L. Veterans Administration Medical Center, East Orange, NJ, U.S.A.J. Natl. Cancer Inst. 75: 463-469, 1985. In a case-control study in 4 hospitals from 1971 to 1981, 134 cases of lung can- cer and 402 cases of colon-rectum cancer (the controls) were identified in non- smoking women. All cases and controls were confirmed by histologic review of slides, and nonsmoking status and expo- sures were verified by interview. Odds ra- tios (OR) increased with increasing number of cigarettes smoked by the husband, par- ticularly for cigarettes smoked at home. The OR for women whose husbands smoked 20 or more cigarettes at home was 2.11 (95% confi- dence limits: 1.13, 3.95). A logistic regression analysis showed a significant positive trend of increasing risk with increased exposure to the husband's smoking at home, controlled for age, hos- pital, socioeconomic class, and year of diagnosis. Comparison of women classified by number of hours exposed a day to smoke in the last 5 years and in the last 25 years showed no increase in risk of lung cancer. Mineral Particles, Mineral Fibers, and Lung Cancer. Churg, A., Wiggs, B. Department of Pathology, Uni- versity of British Columbia, Vancouver, BC V6T IW5, Canada. Environ. Res. 37: 364-372, 1985. The total fibrous and nonfibrous mineral content of the lung has been analyzed in a series of 14 men with lung cancer but no history of occupational dust exposure, and in a series of 14 control men matched for age, smoking history, and general oc- cupational class. The lung can~er patients had an average of 525 + or - 369 x 10f exogenous mi- neral fibers/g dry lung, while the controls had averages of 261 + or ~ 175 mineral particles and 6 17.4 + or - 19.6 x 10 exogenous mineral par- ticles and 4.7 + or - 3.2 x I0~ mineral fibers/g dry lung. These differences are statistically sig- nificant for both particles and fibers. Kaolinite, talc, mica, feldspars, and crystalline silica com- prised the majority of particles of both groups. Approximately 90% of the particles were smaller than 2 mum in diameter and approximately 60% smaller than 1 mum; the mean particle size in the cancer group was i.i + or - 0.2 mum and in the control group 1.3 + or - 0.2 mum. In both groups, patients who had smoked more than 35 pack years had great- er numbers of particles than patients who had smo- ked less than 35 pack years. It is concluded that, in this study, lungs from patients with lung cancer had statistically greater numbers of mineral par- ticles and fibers than lungs from controls, and that smoking influences total long-term retention of particles from all sources. Lung Cancer Among Asbestos Cement Workers. A Swedish Cohort Study and a Review. Ohlson, C.G., Hogstedt, C. Department of Occupati- onal Medicine, Medical Center Hospital, Orebro, Sweden. Br. J. Ind. Med. 42: 397-402, 1985. A cohort study of 1176 Swedish asbestos cement workers did not indicate any asbestos related excess mortality. Possible explanations of the ne- gative outcome are relatively low exposure levels and the predominant use of crysotile in production. Such a tentative conclusion is supported by a review of five mortality studies of workers exposed to as- bestos cement that report considerable differences in relative risks for lung cancer. These differen- ces could be explained by various degrees of cumu- lative exposure, the amount of amphiboles in the production, and methodological shortcomings. A median exposure of 10-20 fiber-years does not seem to cause an increased risk of lung cancer, particu- larly when only chrysotile is used.
Transcript of Application of a job-exposure matrix to a case-control study of lung cancer
201
of adenocarcinoma was seen with increasing duration of employment in occupations with
potential exposure, but only for light smokers. Dietary vitamin A consumption did not confound the occupational associations. Hypotheses have been generated regarding interplay of risk factors in the etiology of different histologic subtypes of lung cancer. Studies of specific histologic ty- pes of lung cancer are needed to elucidate the role of various environmental and oc- cupational risk factors.
Application of a Job-Exposure Matrix to a Case-Control Study of Lung Cancer. Hinds, M.W., Kolonel, L.N., Lee, J. Epi- demiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI 96813, U.S.A.J. Natl. Cancer Inst.
75: 193-197, 1985. Interview information was obtained on
primary and secondary occupations for 261 male lung cancer patients and 444 controls residing on the island of Oahu, HI. with the use of a computerized job-exposure
matrix (JEM), exposure levels were assig- ned to each subject for each of 5 known and 2 likely lung carcinogens. A multiple logistic regression model was used to com- pute the odds ratio (OR) for exposure to each carcinogen, adjusted for age, ethni- city, and pack-years of smoking. On the basis of the criterion of either a dose- response effect or a statistically signi- ficant OR (P < .05) or both, 5 of the 7 carcinogens (4 of the 5 known carcinogens) were found to be associated with lung cancer risk. However, on the basis of the single criterion of a significant OR, only 3 of the 7 carcinogens (2 of the 5 known carcinogens) were associated with lung cancer risk. Due to its relative insensi- tivity, this JEM may have limited useful- ness in the identification of exposure- disease relationships and should not be
applied uncritically.
Involuntary Smoking and Lung Cancer: A Case-Control Study. Garfinkel, L., Auerbach, O., Joubert, L. Veterans Administration Medical Center, East Orange, NJ, U.S.A.J. Natl. Cancer Inst. 75: 463-469, 1985.
In a case-control study in 4 hospitals from 1971 to 1981, 134 cases of lung can- cer and 402 cases of colon-rectum cancer (the controls) were identified in non- smoking women. All cases and controls were confirmed by histologic review of slides, and nonsmoking status and expo- sures were verified by interview. Odds ra- tios (OR) increased with increasing number of cigarettes smoked by the husband, par- ticularly for cigarettes smoked at home.
The OR for women whose husbands smoked
20 or more cigarettes at home was 2.11 (95% confi-
dence limits: 1.13, 3.95). A logistic regression analysis showed a significant positive trend of increasing risk with increased exposure to the husband's smoking at home, controlled for age, hos- pital, socioeconomic class, and year of diagnosis. Comparison of women classified by number of hours exposed a day to smoke in the last 5 years and in the last 25 years showed no increase in risk of lung cancer.
Mineral Particles, Mineral Fibers, and Lung Cancer. Churg, A., Wiggs, B. Department of Pathology, Uni- versity of British Columbia, Vancouver, BC V6T IW5, Canada. Environ. Res. 37: 364-372, 1985.
The total fibrous and nonfibrous mineral content of the lung has been analyzed in a series of 14 men with lung cancer but no history of occupational dust exposure, and in a series of 14 control men matched for age, smoking history, and general oc- cupational class. The lung can~er patients had an average of 525 + or - 369 x 10f exogenous mi- neral fibers/g dry lung, while the controls had averages of 261 + or ~ 175 mineral particles and
6 17.4 + or - 19.6 x 10 exogenous mineral par- ticles and 4.7 + or - 3.2 x I0 ~ mineral fibers/g dry lung. These differences are statistically sig- nificant for both particles and fibers. Kaolinite, talc, mica, feldspars, and crystalline silica com- prised the majority of particles of both groups. Approximately 90% of the particles were smaller than 2 mum in diameter and approximately 60% smaller than 1 mum; the mean particle size in the cancer group was i.i + or - 0.2 mum and in the control group 1.3 + or - 0.2 mum. In both groups, patients who had smoked more than 35 pack years had great- er numbers of particles than patients who had smo- ked less than 35 pack years. It is concluded that, in this study, lungs from patients with lung cancer had statistically greater numbers of mineral par- ticles and fibers than lungs from controls, and that smoking influences total long-term retention of
particles from all sources.
Lung Cancer Among Asbestos Cement Workers. A
Swedish Cohort Study and a Review. Ohlson, C.G., Hogstedt, C. Department of Occupati- onal Medicine, Medical Center Hospital, Orebro, Sweden. Br. J. Ind. Med. 42: 397-402, 1985.
A cohort study of 1176 Swedish asbestos cement workers did not indicate any asbestos related excess mortality. Possible explanations of the ne- gative outcome are relatively low exposure levels and the predominant use of crysotile in production. Such a tentative conclusion is supported by a review of five mortality studies of workers exposed to as- bestos cement that report considerable differences in relative risks for lung cancer. These differen- ces could be explained by various degrees of cumu- lative exposure, the amount of amphiboles in the production, and methodological shortcomings. A median exposure of 10-20 fiber-years does not seem to cause an increased risk of lung cancer, particu- larly when only chrysotile is used.
