title: Lung cancer risk in male workers occupationally exposed to diesel motor emissions in Germany.
abstract: BACKGROUND
  Although in several epidemiological studies exposure to diesel motor emissions (DME) shows an elevated lung cancer risk, it is still controversial whether DME is a human carcinogen.
  
  
  METHODS
  In a pooled analysis of two case-control studies on lung cancer in Germany a total of 3498 male cases with histologically or cytologically ascertained lung cancer and 3541 male population controls were included. Information about lifelong occupational and smoking history was obtained by questionnaire. Drivers of lorries, buses, taxies, diesel locomotives and forklift trucks, bulldozers, graders, excavators, and tractors, were considered as exposed to DME and their cumulative exposure was estimated. All odds ratios were adjusted for smoking and asbestos exposure.
  
  
  RESULTS
  The evaluation of lung cancer risk for all jobs with DME-exposure combined showed an odds ratio of OR=1.43 (95%-CI: 1.23-1.67). Most pronounced was the increase in lung cancer risk in heavy equipment operators (OR=2. 31 95%-CI: 1.44-3.70). The risk of tractor drivers increased with length of employment and reached statistical significance for exposures longer than 30 years (OR=6.81, 95%-CI: 1.17-39.51). The group of professional drivers (e.g., trucks, buses, and taxies), showed an increased risk only in West Germany (OR=1.44, 95%-CI: 1. 18-1.76), but not in East Germany (OR=0.83, 95%-CI: 0.60-1.14). DME-exposure in other traffic related jobs (e.g., diesel engine locomotive drivers, switchmen, forklift operators) was associated with an odds ratio of OR=1.53 (95%-CI: 1.04-2.24).
  
  
  CONCLUSIONS
  The study provides further evidence that occupational exposure to diesel motor emissions is associated with an increased lung cancer risk.
authors.affiliation: GSF-Institute of Epidemiology, National Research Center for Environment and Health, Neuherberg. brueske.hohlfeld@gsf.de
authors.forename: I
authors.initials: I
authors.lastname: Brüske-Hohlfeld
authors.forename: M
authors.initials: M
authors.lastname: Möhner
authors.forename: W
authors.initials: W
authors.lastname: Ahrens
authors.forename: H
authors.initials: H
authors.lastname: Pohlabeln
authors.forename: J
authors.initials: J
authors.lastname: Heinrich
authors.forename: M
authors.initials: M
authors.lastname: Kreuzer
authors.forename: K H
authors.initials: KH
authors.lastname: Jöckel
authors.forename: H E
authors.initials: HE
authors.lastname: Wichmann
mesh_terms: D000368:Aged; D001194:Asbestos / Q000009:adverse effects; D002273:Carcinogens / Q000009:adverse effects; D016022:Case-Control Studies; D016001:Confidence Intervals; D004651:Employment; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D016273:Occupational Exposure; D016017:Odds Ratio; D011890:Railroads; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors; D001335:Vehicle Emissions / Q000009:adverse effects*
chemical_list: D002273:Carcinogens; D001335:Vehicle Emissions; D001194:Asbestos