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Laryngeal Cancer Risks in Workers Exposed to Lung Carcinogens: Exposure-Effect Analyses Using a Quantitative Job Exposure Matrix

  • Amy L. Hall
  • , Hans Kromhout
  • , Joachim Schüz
  • , Susan Peters
  • , Lützen Portengen
  • , Roel Vermeulen
  • , Antonio Agudo
  • , Wolfgang Ahrens
  • , Paolo Boffetta
  • , Paul Brennan
  • , Cristina Canova
  • , David I. Conway
  • , Maria Paula Curado
  • , Alexander W. Daudt
  • , Leticia Fernandez
  • , Mia Hashibe
  • , Claire M. Healy
  • , Ivana Holcatova
  • , Kristina Kjaerheim
  • , Rosalina Koifman
  • Pagona Lagiou, Danièle Luce, Gary J. MacFarlane, Ana Menezes, Gwenn Menvielle, Jerry Polesel, Heribert Ramroth, Lorenzo Richiardi, Isabelle Stücker, Peter Thomson, Marta Vilensky, Victor Wunsch-Filho, Amy Lee Yuan-Chin, Ariana Znaor, Kurt Straif, Ann Olsson
  • International Agency for Research on Cancer
  • Utrecht University
  • Parc Taulí Hospital Universitari
  • Leibniz Institute for Prevention Research and Epidemiology
  • University of Bremen
  • University of Padua
  • University of Glasgow
  • Epidemiology - CIPE/ACCAMARGO
  • Universidade Federal do Rio Grande do Sul
  • National School of Public Health
  • University of Utah
  • Trinity College Dublin
  • Charles University
  • Cancer Registry of Norway Institute of Population-Based Cancer Research
  • Fundação Oswaldo Cruz
  • National and Kapodistrian University of Athens
  • Inserm U1085—IRSET
  • University of Aberdeen
  • Universidade Federal de Pelotas
  • Sorbonne Université
  • IRCCS Centro di Riferimento Oncologico - Aviano PN
  • Heidelberg University 
  • University of Turin
  • Université Paris-Saclay
  • The University of Hong Kong
  • Universidad de Buenos Aires
  • Universidade de São Paulo

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Introduction: Various established occupational lung carcinogens are also suspected risk factors for laryngeal cancer. However, individual studies are often inadequate in size to investigate this relatively rare outcome. Other limitations include imprecise exposure assessment and inadequate adjustment for confounders. Methods: This study applied a quantitative job exposure matrix (SYN-JEM) for four established occupational lung carcinogens to five case-control studies within the International Head and Neck Cancer Epidemiology Consortium. We used occupational histories for 2256 laryngeal cancer cases and 7857 controls recruited from 1989 to 2007. We assigned quantitative exposure levels for asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined (to address highly correlated exposures) via SYN-JEM. We assessed effects of occupational exposure on cancer risk for males (asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined) and females (asbestos and respirable crystalline silica), adjusting for age, study, tobacco smoking, alcohol consumption, and asbestos exposure where relevant. Results: Among females, odds ratios (ORs) were increased for ever versus never exposed. Among males, P values for linear trend were <0.05 for estimated cumulative exposure (all agents) and <0.05 for exposure duration (respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined); strongest associations were for asbestos at >90th percentile cumulative exposure (OR = 1.3, 95% confidence interval [CI] = 1.0, 1.6), respirable crystalline silica at 30+ years duration (OR = 1.4, 95% CI = 1.2, 1.7) and 75th-90th percentile cumulative exposure (OR = 1.4, 95% CI = 1.1, 1.8), chromium-VI at >75th percentile cumulative exposure (OR = 1.9, 95% CI = 1.2, 3.0), and chromium-VI and nickel combined at 20-29 years duration (OR = 1.5, 95% CI = 1.1, 2.2). Conclusions: These findings support hypotheses of causal links between four lung carcinogens (asbestos, respirable crystalline silica, chromium-VI, and nickel) and laryngeal cancer.

Original languageEnglish
Pages (from-to)145-154
Number of pages10
JournalEpidemiology
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • Asbestos
  • Case-control studies
  • chromium(VI)
  • Laryngeal neoplasms
  • Nickel
  • Occupational exposure
  • Respirable crystalline silica

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