title: Occupational risk factors have to be considered in the definition of high-risk lung cancer populations.
abstract: BACKGROUND
  The aim of this study was to compute attributable fractions (AF) to occupational factors in an area in North-Eastern France with high lung cancer rates and a past of mining and steel industry.
  
  
  METHODS
  A population-based case-control study among males aged 40-79 was conducted, including confirmed primary lung cancer cases from all hospitals of the study region. Controls were stratified by broad age-classes, district and socioeconomic classes. Detailed occupational and personal risk factors were obtained in face-to-face interviews. Cumulative occupational exposure indices were obtained from the questionnaires. Attributable fractions were computed from multiple unconditional logistic regression models.
  
  
  RESULTS
  A total of 246 cases and 531 controls were included. The odds ratios (ORs) adjusted on cumulative smoking and family history of lung cancer increased significantly with the cumulative exposure indices to asbestos, polycyclic aromatic hydrocarbons and crystalline silica, and with exposure to diesel motor exhaust. The AF for occupational factors exceeded 50%, the most important contributor being crystalline silica and asbestos.
  
  
  CONCLUSIONS
  These AFs are higher than most published figures. This can be because of the highly industrialised area or methods for exposure assessments. Occupational factors are important risk factors and should not be forgotten when defining high-risk lung cancer populations.
authors.affiliation: INRS, rue du Morvan CS 60027, 54519, Vandoeuvre les Nancy, Cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Wild
authors.forename: M
authors.initials: M
authors.lastname: Gonzalez
authors.forename: E
authors.initials: E
authors.lastname: Bourgkard
authors.forename: N
authors.initials: N
authors.lastname: Courouble
authors.forename: C
authors.initials: C
authors.lastname: Clément-Duchêne
authors.forename: Y
authors.initials: Y
authors.lastname: Martinet
authors.forename: J
authors.initials: J
authors.lastname: Févotte
authors.forename: C
authors.initials: C
authors.lastname: Paris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects*; D016022:Case-Control Studies; D005602:France; D006801:Humans; D007221:Industry; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D008906:Mining; D016273:Occupational Exposure; D011084:Polycyclic Aromatic Hydrocarbons / Q000009:adverse effects; D012307:Risk Factors; D012822:Silicon Dioxide / Q000009:adverse effects*; D013232:Steel
chemical_list: D011084:Polycyclic Aromatic Hydrocarbons; D013232:Steel; D001194:Asbestos; D012822:Silicon Dioxide