Lung cancer and occupation in nonsmokers: a multicenter case-control study in Europe.
BACKGROUND
Tobacco smoking is the main cause for lung cancer worldwide, making it difficult to examine the carcinogenic role of other risk factors because of possible confounding by smoking. Therefore, the present study aimed to investigate the association between lung cancer and occupation independent of smoking.


METHODS
A case-control study of lung cancer was carried out between March 1998 and January 2002 in 16 centers from 7 European countries, including 223 never-smoking cases and 1039 controls. Information on lifestyle and occupation was obtained through detailed questionnaires. Job and industries were classified as entailing exposure to known or suspected carcinogens; in addition, expert assessment provided exposure estimates to specific agents.


RESULTS
The odds ratio of lung cancer among women employed for more than 12 years in suspected high-risk occupations was 1.75 (95% confidence interval = 0.63-4.85). A comparable increase in risk was not detected for employment in established high-risk occupations or among men. Increased risk of lung cancer was suggested among individuals exposed to nonferrous metal dust and fumes, crystalline silica, and organic solvents.


CONCLUSIONS
Occupations were found to play a limited role in lung cancer risk among never-smokers. Jobs entailing exposure to suspected lung carcinogens should receive priority in future studies among women. Nonferrous metal dust and fumes and silica may exert a carcinogenic effect independently from smoking.
Zeka
Ariana
A
International Agency for Research on Cancer, Lyon, France.
Mannetje
Andrea't
A
Zaridze
David
D
Szeszenia-Dabrowska
Neonila
N
Rudnai
Peter
P
Lissowska
Jolanta
J
Fabiánová
Eleonóra
E
Mates
Dana
D
Bencko
Vladimir
V
Navratilova
Marie
M
Cassidy
Adrian
A
Janout
Vladimir
V
Travier
Noemie
N
Fevotte
Joelle
J
Fletcher
Tony
T
Brennan
Paul
P
Boffetta
Paolo
P
D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007221:Industry; D008019:Life Style; D016015:Logistic Models; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution