Calvin Ge1, Susan Peters1, Ann Olsson2, Lützen Portengen1, Joachim Schüz2, Josué Almansa1, Thomas Behrens3, Beate Pesch3, Benjamin Kendzia3, Wolfgang Ahrens4, Vladimir Bencko5, Simone Benhamou6, Paolo Boffetta7,8, Bas Bueno-de-Mesquita9, Neil Caporaso10, Dario Consonni11, Paul Demers12, Eleonóra Fabiánová13,14, Guillermo Fernández-Tardón15, John Field16, Francesco Forastiere17, Lenka Foretova18, Pascal Guénel19, Per Gustavsson20, Vikki Ho21, Vladimir Janout22, Karl-Heinz Jöckel23, Stefan Karrasch24,25,26, Maria Teresa Landi10, Jolanta Lissowska27, Danièle Luce28, Dana Mates29, John McLaughlin30, Franco Merletti31, Dario Mirabelli31, Nils Plato20, Hermann Pohlabeln4, Lorenzo Richiardi31, Peter Rudnai32, Jack Siemiatycki21, Beata Świątkowska33, Adonina Tardón15, Heinz-Erich Wichmann34,35, David Zaridze36, Thomas Brüning3, Kurt Straif2, Hans Kromhout1, Roel Vermeulen1. 1. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands. 2. International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France. 3. Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr University, Bochum, Germany. 4. Leibniz Institute for Prevention Research and Epidemiology-Bremen Institute for Prevention Research and Social Medicine (BIPS), Bremen, Germany. 5. Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic. 6. Inserm Unit 1018, Villejuif, France. 7. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York. 8. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. 9. The National Institute for Public Health and Environmental Protection, Bilthoven, the Netherlands. 10. National Cancer Institute, Bethesda, Maryland. 11. Unità di epidemiologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 12. Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada. 13. Regional Authority of Public Health, Banská Bystrica, Slovakia. 14. Faculty of Health, Catholic University, Ružomberok, Slovakia. 15. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Institute of Health Research of the Principality of Asturias-Foundation for Biosanitary Research of Asturias (ISPA-FINBA), Faculty of Medicine, University of Oviedo, Oviedo, Spain. 16. Roy Castle Lung Cancer Research Programme, Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom. 17. Consiglio Nazionale delle Ricerche-Istituto per la Ricerca e l'Innovazione Biomedica (CNR-Irib), Palermo, Italy. 18. Masaryk Memorial Cancer Institute, Brno, Czech Republic. 19. Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Inserm Unit 1018, University Paris-Saclay, Villejuif, France. 20. The Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. 21. University of Montreal Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada. 22. Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic. 23. Institute for Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany. 24. Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Inner City Clinic, University Hospital of Munich and. 25. Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany. 26. Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Neuherberg, Germany. 27. The M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. 28. Université de Rennes I, Inserm Unit 1085, École des hautes études en santé publique (EHESP), Institut de recherche en santé, environnement et travail (Irset), Pointe-à-Pitre, France. 29. National Institute of Public Health, Bucharest, Romania. 30. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 31. Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy. 32. National Public Health Center, Budapest, Hungary. 33. The Nofer Institute of Occupational Medicine, Lodz, Poland. 34. Institut für Medizinische Informatik Biometrie Epidemiologie, Ludwig-Maximilians-Universität, Munich, Germany. 35. Institut für Epidemiologie, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany; and. 36. Russian Cancer Research Centre, Moscow, Russia.
Abstract
Rationale: Millions of workers around the world are exposed to respirable crystalline silica. Although silica is a confirmed human lung carcinogen, little is known regarding the cancer risks associated with low levels of exposure and risks by cancer subtype. However, little is known regarding the disease risks associated with low levels of exposure and risks by cancer subtype. Objectives: We aimed to address current knowledge gaps in lung cancer risks associated with low levels of occupational silica exposure and the joint effects of smoking and silica exposure on lung cancer risks. Methods: Subjects from 14 case-control studies from Europe and Canada with detailed smoking and occupational histories were pooled. A quantitative job-exposure matrix was used to estimate silica exposure by occupation, time period, and geographical region. Logistic regression models were used to estimate exposure-disease associations and the joint effects of silica exposure and smoking on risk of lung cancer. Stratified analyses by smoking history and cancer subtypes were also performed.Measurements and Main Results: Our study included 16,901 cases and 20,965 control subjects. Lung cancer odds ratios ranged from 1.15 (95% confidence interval, 1.04-1.27) to 1.45 (95% confidence interval, 1.31-1.60) for groups with the lowest and highest cumulative exposure, respectively. Increasing cumulative silica exposure was associated (P trend < 0.01) with increasing lung cancer risks in nonsilicotics and in current, former, and never-smokers. Increasing exposure was also associated (P trend ≤ 0.01) with increasing risks of lung adenocarcinoma, squamous cell carcinoma, and small cell carcinoma. Supermultiplicative interaction of silica exposure and smoking was observed on overall lung cancer risks; superadditive effects were observed in risks of lung cancer and all three included subtypes.Conclusions: Silica exposure is associated with lung cancer at low exposure levels. An exposure-response relationship was robust and present regardless of smoking, silicosis status, and cancer subtype.
Rationale: Millions of workers around the world are exposed to respirable crystalline silica. Although silica is a confirmed human lung carcinogen, little is known regarding the cancer risks associated with low levels of exposure and risks by cancer subtype. However, little is known regarding the disease risks associated with low levels of exposure and risks by cancer subtype. Objectives: We aimed to address current knowledge gaps in lung cancer risks associated with low levels of occupational silica exposure and the joint effects of smoking and silica exposure on lung cancer risks. Methods: Subjects from 14 case-control studies from Europe and Canada with detailed smoking and occupational histories were pooled. A quantitative job-exposure matrix was used to estimate silica exposure by occupation, time period, and geographical region. Logistic regression models were used to estimate exposure-disease associations and the joint effects of silica exposure and smoking on risk of lung cancer. Stratified analyses by smoking history and cancer subtypes were also performed.Measurements and Main Results: Our study included 16,901 cases and 20,965 control subjects. Lung cancer odds ratios ranged from 1.15 (95% confidence interval, 1.04-1.27) to 1.45 (95% confidence interval, 1.31-1.60) for groups with the lowest and highest cumulative exposure, respectively. Increasing cumulative silica exposure was associated (P trend < 0.01) with increasing lung cancer risks in nonsilicotics and in current, former, and never-smokers. Increasing exposure was also associated (P trend ≤ 0.01) with increasing risks of lung adenocarcinoma, squamous cell carcinoma, and small cell carcinoma. Supermultiplicative interaction of silica exposure and smoking was observed on overall lung cancer risks; superadditive effects were observed in risks of lung cancer and all three included subtypes.Conclusions: Silica exposure is associated with lung cancer at low exposure levels. An exposure-response relationship was robust and present regardless of smoking, silicosis status, and cancer subtype.
Authors: Susan Peters; Roel Vermeulen; Lützen Portengen; Ann Olsson; Benjamin Kendzia; Raymond Vincent; Barbara Savary; Jérôme Lavoué; Domenico Cavallo; Andrea Cattaneo; Dario Mirabelli; Nils Plato; Joelle Fevotte; Beate Pesch; Thomas Brüning; Kurt Straif; Hans Kromhout Journal: J Environ Monit Date: 2011-10-14
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