title: Impact of occupational carcinogens on lung cancer risk in a general population.
abstract: BACKGROUND
  Exposure to occupational carcinogens is an important preventable cause of lung cancer. Most of the previous studies were in highly exposed industrial cohorts. Our aim was to quantify lung cancer burden attributable to occupational carcinogens in a general population.
  
  
  METHODS
  We applied a new job-exposure matrix (JEM) to translate lifetime work histories, collected by personal interview and coded into standard job titles, into never, low and high exposure levels for six known/suspected occupational lung carcinogens in the Environment and Genetics in Lung cancer Etiology (EAGLE) population-based case-control study, conducted in Lombardy region, Italy, in 2002-05. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in men (1537 cases and 1617 controls), by logistic regression adjusted for potential confounders, including smoking and co-exposure to JEM carcinogens. The population attributable fraction (PAF) was estimated as impact measure.
  
  
  RESULTS
  Men showed an increased lung cancer risk even at low exposure to asbestos (OR: 1.76; 95% CI: 1.42-2.18), crystalline silica (OR: 1.31; 95% CI: 1.00-1.71) and nickel-chromium (OR: 1.18; 95% CI: 0.90-1.53); risk increased with exposure level. For polycyclic aromatic hydrocarbons, an increased risk (OR: 1.64; 95% CI: 0.99-2.70) was found only for high exposures. The PAFs for any exposure to asbestos, silica and nickel-chromium were 18.1, 5.7 and 7.0%, respectively, equivalent to an overall PAF of 22.5% (95% CI: 14.1-30.0). This corresponds to about 1016 (95% CI: 637-1355) male lung cancer cases/year in Lombardy.
  
  
  CONCLUSIONS
  These findings support the substantial role of selected occupational carcinogens on lung cancer burden, even at low exposures, in a general population.
authors.affiliation: Unit of Epidemiology, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and EPOCA Research Centre, Department of Occupational and Environmental Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: De Matteis
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.forename: Jay H
authors.initials: JH
authors.lastname: Lubin
authors.forename: Margaret
authors.initials: M
authors.lastname: Tucker
authors.forename: Susan
authors.initials: S
authors.lastname: Peters
authors.forename: Roel Ch
authors.initials: RCh
authors.lastname: Vermeulen
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Bertazzi
authors.forename: Neil E
authors.initials: NE
authors.lastname: Caporaso
authors.forename: Angela C
authors.initials: AC
authors.lastname: Pesatori
authors.forename: Sholom
authors.initials: S
authors.lastname: Wacholder
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Landi
mesh_terms: D000368:Aged; D000395:Air Pollutants, Occupational / Q000032:analysis; D002273:Carcinogens / Q000633:toxicity*; D004522:Educational Status; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data*; D016272:Occupational Health; D009790:Occupations / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000395:Air Pollutants, Occupational; D002273:Carcinogens