title: Lung cancer development in primary smelter workers: a nested case-referent study.
abstract: OBJECTIVE
  The objective of this study was to study the impact of work-related exposure to mainly arsenic and lead versus smoking in primary smelter workers developing lung cancer.
  
  
  METHODS
  In a cohort of 3979 primary smelter workers, 46 subjects had contracted respiratory malignancies. They were compared with 141 age-matched male referents by conditional logistic regression analysis.
  
  
  RESULTS
  Cases showed a significantly higher smoking rate as compared with referents: odds ratio (OR) = 4.0; 95% confidence interval (CI) = 1.6-10.1; P = 0.003. When restricted to smokers (33 cases, 63 referents), the cumulative air arsenic exposure index, but not the lead exposure indices, was significantly higher among the cases: OR = 1.07; 95% CI = 1.02-1.11; P = 0.005.
  
  
  CONCLUSIONS
  Cumulative arsenic exposure and smoking were identified as risk factors for the development of lung cancer; lead exposure, however, was not.
authors.affiliation: Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. nils-goran.lundstrom@envmed.umu.se
authors.forename: Nils-Göran
authors.initials: NG
authors.lastname: Lundström
authors.forename: Vagn
authors.initials: V
authors.lastname: Englyst
authors.forename: Lars
authors.initials: L
authors.lastname: Gerhardsson
authors.forename: Taiyi
authors.initials: T
authors.lastname: Jin
authors.forename: Gunnar
authors.initials: G
authors.lastname: Nordberg
mesh_terms: D020261:Arsenic Poisoning / Q000453:epidemiology*; D016022:Case-Control Studies; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis / Q000706:statistics & numerical data; D007855:Lead Poisoning / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008669:Metallurgy / Q000706:statistics & numerical data*; D015233:Models, Statistical; D009784:Occupational Diseases / Q000097:blood / Q000453:epidemiology*; D016273:Occupational Exposure / Q000032:analysis / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology