title: Airborne exposures and risk of gastric cancer: a prospective cohort study.
abstract: There is an unexplained male predominance among patients with gastric cancer, and many carcinogens are found in male-dominated dusty occupations. However, the relation between occupational exposures and risk of gastric cancer remains unclear. To investigate whether airborne occupational exposures might influence the risk of noncardia gastric cancer, we used a large, prospective cohort study of male Swedish construction workers. These workers were, during the period 1971-1993, regularly invited to health examinations by a nationwide occupational health service organization. Data on job titles and other variables were collected through self-administered questionnaires and forms completed by the health organization's staff. Industrial hygienists assessed 12 specific airborne occupational exposures for 200 job titles. Gastric cancer, death or emigration occurring during follow-up in 1971-2002 were identified by linkage to the Swedish registers of Cancer, Causes of Death and Total Population, respectively. Incidence rate ratios (IRR) and 95% confidence intervals (CI), adjusted for attained age, tobacco smoking, calendar period and body mass, were derived from Cox regression. Among 256,357 cohort members, contributing 5,378,012 person-years at risk, 948 noncardia gastric cancers were identified. Increased risk of this tumor was found among workers exposed to cement dust (IRR 1.5 [95% CI 1.1-2.1]), quartz dust (IRR 1.3 [95% CI 1.0-1.7]) and diesel exhaust (IRR 1.4 [95% CI 1.1-1.9]). Dose-response relations were observed for these exposures. No consistent positive associations were found regarding exposure to asbestos, asphalt fumes, concrete dust, epoxy resins, isocyanates, metal fumes, mineral fibers, organic solvents or wood dust. In conclusion, this study provides some support to the hypothesis that specific airborne exposures increase the risk of noncardia gastric cancer.
authors.affiliation: Unit of Esophageal and Gastric Research (ESOGAR), Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. krister.sjodahl@ki.se
authors.forename: Krister
authors.initials: K
authors.lastname: Sjödahl
authors.forename: Catarina
authors.initials: C
authors.lastname: Jansson
authors.forename: Ingvar A
authors.initials: IA
authors.lastname: Bergdahl
authors.forename: Johanna
authors.initials: J
authors.lastname: Adami
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Jesper
authors.initials: J
authors.lastname: Lagergren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D001194:Asbestos / Q000633:toxicity; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011446:Prospective Studies; D011791:Quartz / Q000633:toxicity; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000209:etiology*; D001335:Vehicle Emissions / Q000633:toxicity
chemical_list: D000395:Air Pollutants, Occupational; D001335:Vehicle Emissions; D001194:Asbestos; D011791:Quartz