title: Lung cancer risk among bricklayers in a pooled analysis of case-control studies.
abstract: Bricklayers may be exposed to several lung carcinogens, including crystalline silica and asbestos. Previous studies that analyzed lung cancer risk among these workers had several study design limitations. We examined lung cancer risk among bricklayers within SYNERGY, a large international pooled analysis of case-control studies on lung cancer and the joint effects of occupational carcinogens. For men ever employed as bricklayers we estimated odds ratios (OR) and 95% confidence intervals (CI) adjusted for study center, age, lifetime smoking history and employment in occupations with exposures to known or suspected lung carcinogens. Among 15,608 cases and 18,531 controls, there were 695 cases and 469 controls who had ever worked as bricklayers (OR: 1.47; 95% CI: 1.28-1.68). In studies using population controls the OR was 1.55 (95% CI: 1.32-1.81, 540/349 cases/controls), while it was 1.24 (95% CI: 0.93-1.64, 155/120 cases/controls) in hospital-based studies. There was a clear positive trend with length of employment (p < 0.001). The relative risk was higher for squamous (OR: 1.68, 95% CI: 1.42-1.98, 309 cases) and small cell carcinomas (OR: 1.78, 95% CI: 1.44-2.20, 140 cases), than for adenocarcinoma (OR: 1.17, 95% CI: 0.95-1.43, 150 cases) (p-homogeneity: 0.0007). ORs were still elevated after additional adjustment for education and in analyses using blue collar workers as referents. This study provided robust evidence of increased lung cancer risk in bricklayers. Although non-causal explanations cannot be completely ruled out, the association is plausible in view of the potential for exposure to several carcinogens, notably crystalline silica and to a lesser extent asbestos.
authors.affiliation: Epidemiology Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Dario
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authors.lastname: Consonni
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authors.lastname: De Matteis
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authors.lastname: Brüske
authors.forename: Maria Teresa
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authors.forename: Neil E
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authors.lastname: Gustavsson
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authors.forename: Ignatius Tak-Sun
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authors.lastname: Yu
authors.forename: Karl-Heinz
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authors.lastname: Jöckel
authors.forename: Wolfgang
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authors.lastname: Ahrens
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authors.forename: Franco
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authors.lastname: Merletti
authors.forename: Lorenzo
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authors.lastname: Richiardi
authors.forename: Lorenzo
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authors.lastname: Simonato
authors.forename: Francesco
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authors.lastname: Forastiere
authors.forename: Jack
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authors.lastname: Siemiatycki
authors.forename: Marie-Élise
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authors.lastname: Parent
authors.forename: Adonina
authors.initials: A
authors.lastname: Tardón
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: David
authors.initials: D
authors.lastname: Zaridze
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.forename: John K
authors.initials: JK
authors.lastname: Field
authors.forename: Andrea
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authors.lastname: 't Mannetje
authors.forename: Neil
authors.initials: N
authors.lastname: Pearce
authors.forename: John
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authors.lastname: McLaughlin
authors.forename: Paul
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authors.lastname: Demers
authors.forename: Jolanta
authors.initials: J
authors.lastname: Lissowska
authors.forename: Neonila
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authors.lastname: Szeszenia-Dabrowska
authors.forename: Vladimir
authors.initials: V
authors.lastname: Bencko
authors.forename: Lenka
authors.initials: L
authors.lastname: Foretova
authors.forename: Vladimir
authors.initials: V
authors.lastname: Janout
authors.forename: Peter
authors.initials: P
authors.lastname: Rudnai
authors.forename: Eleonóra
authors.initials: E
authors.lastname: Fabiánová
authors.forename: Rodica
authors.initials: R
authors.lastname: Stanescu Dumitru
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Joachim
authors.initials: J
authors.lastname: Schüz
authors.forename: Kurt
authors.initials: K
authors.lastname: Straif
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology*; D018288:Carcinoma, Small Cell / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D016022:Case-Control Studies; D060389:Construction Industry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007390:International Agencies; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D011379:Prognosis; D012307:Risk Factors
keywords: bricklayers; case-control studies; epidemiology; lung neoplasms; occupational health