Abstract
Aims: To estimate the attributable fractions (AF) of lung cancer to occupational exposures in an area characterized by its high lung cancer incidence and a past in heavy industry.
Methods: A population-based case-control study was performed in the Northern part of Lorraine, France (2006 to 2010). Cases were defined as males with histologically confirmed lung cancer. Controls were selected by a random digit dialing procedure in the study area. All cases and controls were interviewed in a face to face interview in order to fill in standardised questionnaires on risk factors of lung cancer. Occupational exposures were assessed using both a lifelong list of all jobs held for at least one month, specific questionnaires of industrial activities and job-tasks questionnaire. Qualitative and quantitative occupational exposure indices were then calculated. AF and CI95% were computed for each occupational exposure index and globally for all significant occupational exposures.
Results: 219 cases and 520 controls were included in this study. After adjustment on age, smoking duration, time since quitting smoking, a significant dose-response relationships were found with log of cumulative exposure per unit for asbestos (OR: 1.175, p=0.003), silica (OR: 1.109, p=0.001) and Polycyclic Aromatic Hydrocarbons (OR: 1.175, p=0.007). AF were ranged between 38% (CI95% 27-48) and 57% (CI95% 42-68) according to different models, for these three agents or their association.
Conclusion: According to very high AF observed in this study, these results strongly suggest to include occupational risk factors in definition of populations at high risk of lung cancer for the secondary prevention of lung cancer.
- © 2011 ERS
