title: Occupational exposure to metal compounds and lung cancer. Results from a multi-center case-control study in Central/Eastern Europe and UK.
abstract: OBJECTIVE
  To study the association between occupational exposure to metals including chromium, cadmium, nickel, and arsenic compounds, within a population-based study design, while adjusting for confounding factors.
  
  
  METHODS
  A population-based lung cancer case-control study in Central/Eastern Europe and UK was conducted in 1998-2003, including 2,853 cases and 3,104 controls. Exposure to 70 occupational agents was assessed by local expert-teams for all subjects. Odds ratios (OR) for exposure to dust and fumes/mist of chromium, nickel, cadmium, arsenic, as well as inorganic pigment dust and inorganic acid mist, were adjusting for smoking, age, center, sex, and exposure to other occupational agents including the metals under study.
  
  
  RESULTS
  Exposure to arsenic (prevalence = 1.4%) was associated with an increased lung cancer risk ((OR) 1.65, 95% confidence interval (95% CI):1.05-2.58). For chromium dust (prevalence = 4.8%, OR: 1.25, 95% CI: 0.95-1.65), a linear upward trend for duration and cumulative exposure was observed. A weak association was observed for exposure to cadmium fumes (prevalence = 1.8%, OR: 1.19, 95% CI: 0.77-1.82), which was strongest for the highest category of cumulative exposure (OR: 2.04, 95% CI: 1.07-3.90). No increased risk was observed for inorganic acid mist, inorganic pigment dust, or nickel, after adjustment for other metals. An independent effect of nickel cannot be excluded, due to its collinearity with chromium exposure.
  
  
  CONCLUSIONS
  Occupational exposure to metals is an important risk factor for lung cancer. Although the strongest risk was observed for arsenic, exposure to chromium dust was most important in terms of attributable risk due to its high prevalence.
authors.affiliation: Centre for Public Health Research, Wellington Campus, Massey University, Wellington, New Zealand. a.mannetje@massey.ac.nz
authors.forename: Andrea
authors.initials: A
authors.lastname: 't Mannetje
authors.forename: Vladimir
authors.initials: V
authors.lastname: Bencko
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.forename: David
authors.initials: D
authors.lastname: Zaridze
authors.forename: Neonila
authors.initials: N
authors.lastname: Szeszenia-Dabrowska
authors.forename: Peter
authors.initials: P
authors.lastname: Rudnai
authors.forename: Jolanta
authors.initials: J
authors.lastname: Lissowska
authors.forename: Eleonóra
authors.initials: E
authors.lastname: Fabiánová
authors.forename: Adrian
authors.initials: A
authors.lastname: Cassidy
authors.forename: Dana
authors.initials: D
authors.lastname: Mates
authors.forename: Lenka
authors.initials: L
authors.lastname: Foretova
authors.forename: Vladimir
authors.initials: V
authors.lastname: Janout
authors.forename: Joelle
authors.initials: J
authors.lastname: Fevotte
authors.forename: Tony
authors.initials: T
authors.lastname: Fletcher
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005060:Europe; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence
chemical_list: D008670:Metals