TY - JOUR
T1 - Diesel engine exhaust exposure, smoking, and lung cancer subtype risks
T2 - A pooled exposure-response analysis of 14 case-control studies
AU - Ge, Calvin
AU - Peters, Susan
AU - Olsson, Ann
AU - Portengen, Lützen
AU - Schüz, Joachim
AU - Almansa, Josué
AU - Ahrens, Wolfgang
AU - Bencko, Vladimir
AU - Benhamou, Simone
AU - Boffetta, Paolo
AU - Bueno-De-Mesquita, Bas
AU - Caporaso, Neil
AU - Consonni, Dario
AU - Demers, Paul
AU - Fabiánová, Eleonóra
AU - Fernández-Tardón, Guillermo
AU - Field, John
AU - Forastiere, Francesco
AU - Foretova, Lenka
AU - Guénel, Pascal
AU - Gustavsson, Per
AU - Janout, Vladimir
AU - Jöckel, Karl Heinz
AU - Karrasch, Stefan
AU - Landi, Maria Teresa
AU - Lissowska, Jolanta
AU - Luce, Daniéle
AU - Mates, Dana
AU - McLaughlin, John
AU - Merletti, Franco
AU - Mirabelli, Dario
AU - Pándics, Tamás
AU - Parent, Marie Élise
AU - Plato, Nils
AU - Pohlabeln, Hermann
AU - Richiardi, Lorenzo
AU - Siemiatycki, Jack
AU - Świątkowska, Beata
AU - Tardón, Adonina
AU - Wichmann, Heinz Erich
AU - Zaridze, David
AU - Straif, Kurt
AU - Kromhout, Hans
AU - Vermeulen, Roel
N1 - Publisher Copyright:
© 2020 by the American Thoracic Society.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Rationale: Although the carcinogenicity of diesel engine exhaust has been demonstrated in multiple studies, little is known regarding exposure-response relationships associated with different exposure subgroups and different lung cancer subtypes. Objectives: Weexpanded on a previous pooled case-control analysis on diesel engine exhaust and lung cancer by including three additional studies and quantitative exposure assessment to evaluate lung cancer and subtype risks associated with occupational exposure to diesel exhaust characterized by elemental carbon (EC) concentrations. Methods:We usedaquantitativeECjob-exposurematrix for exposure assessment. Unconditional logistic regression models were used to calculate lung cancer odds ratios and 95% confidence intervals (CIs) associated with various metrics of EC exposure. Lung cancer excess lifetime risks (ELR) were calculated using life tables accounting for allcause mortality. Additional stratified analyses by smoking history and lung cancer subtypes were performed in men. Measurements and Main Results: Our study included 16,901 lung cancer cases and 20,965 control subjects. In men, exposure response between EC and lung cancer was observed: Odds ratios ranged from 1.09 (95% CI, 1.00-1.18) to 1.41 (95% CI, 1.30-1.52) for the lowest and highest cumulative exposure groups, respectively. EC-exposed men had elevated risks in all lung cancer subtypes investigated; associations were strongest for squamous and small cell carcinomas and weaker for adenocarcinoma. EC lung cancer exposure response was observed in men regardless of smoking history, including in never-smokers. ELR associated with 45 years of EC exposure at 50, 20, and 1 mg/m3 were 3.0%, 0.99%, and 0.04%, respectively, for both sexes combined. Conclusions: We observed a consistent exposure-response relationship betweenECexposure and lung cancer in men. Reduction of workplace EC levels to background environmental levels will further reduce lung cancer ELR in exposed workers.
AB - Rationale: Although the carcinogenicity of diesel engine exhaust has been demonstrated in multiple studies, little is known regarding exposure-response relationships associated with different exposure subgroups and different lung cancer subtypes. Objectives: Weexpanded on a previous pooled case-control analysis on diesel engine exhaust and lung cancer by including three additional studies and quantitative exposure assessment to evaluate lung cancer and subtype risks associated with occupational exposure to diesel exhaust characterized by elemental carbon (EC) concentrations. Methods:We usedaquantitativeECjob-exposurematrix for exposure assessment. Unconditional logistic regression models were used to calculate lung cancer odds ratios and 95% confidence intervals (CIs) associated with various metrics of EC exposure. Lung cancer excess lifetime risks (ELR) were calculated using life tables accounting for allcause mortality. Additional stratified analyses by smoking history and lung cancer subtypes were performed in men. Measurements and Main Results: Our study included 16,901 lung cancer cases and 20,965 control subjects. In men, exposure response between EC and lung cancer was observed: Odds ratios ranged from 1.09 (95% CI, 1.00-1.18) to 1.41 (95% CI, 1.30-1.52) for the lowest and highest cumulative exposure groups, respectively. EC-exposed men had elevated risks in all lung cancer subtypes investigated; associations were strongest for squamous and small cell carcinomas and weaker for adenocarcinoma. EC lung cancer exposure response was observed in men regardless of smoking history, including in never-smokers. ELR associated with 45 years of EC exposure at 50, 20, and 1 mg/m3 were 3.0%, 0.99%, and 0.04%, respectively, for both sexes combined. Conclusions: We observed a consistent exposure-response relationship betweenECexposure and lung cancer in men. Reduction of workplace EC levels to background environmental levels will further reduce lung cancer ELR in exposed workers.
KW - Diesel exhaust
KW - Epidemiology
KW - Lung neoplasms
KW - Occupational exposure
UR - https://www.scopus.com/pages/publications/85089127431
U2 - 10.1164/rccm.201911-2101OC
DO - 10.1164/rccm.201911-2101OC
M3 - Article
C2 - 32330395
AN - SCOPUS:85089127431
SN - 1073-449X
VL - 202
SP - 402
EP - 411
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 3
ER -