Major histopathological patterns of lung cancer related to arsenic exposure in German uranium miners.
OBJECTIVE
The mechanisms of action of arsenic in the development of lung cancer are still not yet elucidated. Considering the relationship between arsenic and squamous cell carcinomas of the skin, we hypothesized that arsenic exposure may be more closely associated with squamous cell carcinoma of the lung.


METHODS
A comprehensive histopathological database and a detailed job-exposure matrix developed for former German uranium miners with exposure to arsenic, radon, and quartz were analyzed to quantitatively assess the effect of arsenic regarding cell type of lung cancer. The distributions of major lung cancer cell types in 1,786 German uranium miners were associated with levels of arsenic exposure under control for the other lung carcinogens. To evaluate the arsenic effects in association with a frequent occupational lung disease in miners stratification by silicosis was performed.


RESULTS
There was an arsenic-related increase of the proportion of squamous cell carcinoma of the lung but restricted to miners without silicosis. The increase was found at all levels of co-exposure to radon and quartz dust. In miners with silicosis, the proportion of adenocarcinoma increased with rising arsenic exposure. Arsenic exposure was associated with non-small cell lung cancer. Silicosis turned out as major determinant of the cell type related with arsenic.


CONCLUSIONS
These results indicate a cell type characteristic effect of arsenic in the development of lung cancer.
Taeger
Dirk
D
BGFA-Research Institute of Occupational Medicine, German Social Accident Insurance, Ruhr University, Bochum, Germany. taeger@bgfa.de
Johnen
Georg
G
Wiethege
Thorsten
T
Tapio
Soile
S
Möhner
Matthias
M
Wesch
Horst
H
Tannapfel
Andrea
A
Müller
Klaus-Michael
KM
Brüning
Thomas
T
Pesch
Beate
B
D000230:Adenocarcinoma / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects; D001152:Arsenicals / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D004391:Dust; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008906:Mining; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology*; D011791:Quartz / Q000009:adverse effects; D011886:Radon / Q000009:adverse effects; D012829:Silicosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D014501:Uranium
D000393:Air Pollutants; D001152:Arsenicals; D004391:Dust; D011791:Quartz; D014501:Uranium; D011886:Radon