Cancer Causes & Control

, Volume 4, Issue 5, pp 449–454 | Cite as

Occupational risk factors for lung cancer among nonsmoking women: a case-control study in Missouri (United States)

  • Ross C. Brownson
  • Michael C. R. Alavanja
  • Jian C. Chang
Research Paper

Occupationally related risk of lung cancer among women and among nonsmokers has not been widely studied. A recently conducted population-based, case-control study in Missouri (United States) provided the opportunity to evaluate risk of lung cancer associated with several occupational factors. Incident cases (n=429) were identified through the Missouri Cancer Registry for the period 1986 through 1991, and included 294 lifetime nonsmokers and 135 ex-smokers who had stopped at least 15 years prior to diagnosis or had smoked for less than one pack-year. Controls (n=1,021) were selected through driver's license and Medicare files. Risk was elevated among women exposed to asbestos (ever: odds ratio [OR]=3.5, 95 percent confidence interval [CI]=1.2–10.0; >9 yrs: OR=4.6, CI=1.1–19.2) and pesticides (ever: OR=2.4, CI=1.1–5.6; >17.5 yrs: OR=2.4, CI=0.8–7.0). Risk also was elevated among dry cleaning workers (ever: OR=1.8, CI=1.1–3.0; >1.125 yrs: OR=2.9, CI=1.5–5.4). Occupational risks for lung cancer among women merit further study.

Key words

Asbestos case-control study lung neoplasms occupational diseases smoking United States women 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    American Cancer Society. Cancer Facts and Figures—1993. Atlanta, GA: American Cancer Society, 1993.Google Scholar
  2. 2.
    Doll R, Peto R. The Causes of Cancer. Quantitative Estimates of Avoidable Risks of Cancer in the United States Today. New York, NY: Oxford University Press, 1981.Google Scholar
  3. 3.
    Lerchen ML, Wiggins CL, Samet JM. Lung cancer and occupation in New Mexico. JNCI 1987; 79: 639–45.Google Scholar
  4. 4.
    Vineis P, Thomas T, Hayes RB, et al. Proportion of lung cancers in males, due to occupation, in different areas of the USA. Int J Cancer 1988; 42: 851–6.Google Scholar
  5. 5.
    Ives JC, Buffler PA, Selwyn BJ, Hardy RJ, Decker M. Lung cancer mortality among women employed in highrisk industries and occupations in Harris County, Texas, 1977–1980. Am J Epidemiol 1988; 127: 65–74.Google Scholar
  6. 6.
    Miller AB. Planning cancer control strategies. In: Chronic Diseases in Canada. Toronto, Ontario: Health and Welfare, 1992; Vol. No. 1.Google Scholar
  7. 7.
    Schoenberg JB, Stemhagen A, Mason TJ, Patterson J, Bill J, Altman R. Occupation and lung cancer risk among New Jersey white males. JNCI 1987; 79: 13–21.Google Scholar
  8. 8.
    Fraumeni JFJr. Respiratory carcinogenesis: an epidemiologic appraisal [Editorial]. JNCI 1975; 55: 1039–46.Google Scholar
  9. 9.
    Radford EP, St. Clair Renard KG. Lung cancer in Swedish iron miners exposed to low doses of radon daughters. N Engl J Med 1984; 310: 1485–94.Google Scholar
  10. 10.
    Samet JM, Kutvirt DM, Waxweiler RJ, Key CR. Uranium mining and lung cancer in Navajo men. N EEngl J Med 1984; 310: 1481–4.Google Scholar
  11. 11.
    Damber L, Larsson L-G. Underground mining, smoking, and lung cancer: a case-control study in the iron ore municipalities in northern Sweden. JNCI 1985; 74: 1207–13.Google Scholar
  12. 12.
    Talcott JA, Thurber WA, Kanto AF, et al. Asbestosassociated diseases in a cohort of cigarette-filter workers. N Engl J Med 1989; 321: 1220–3.Google Scholar
  13. 13.
    Monson RR. Occupational Epidemiology. 2nd Edition. Boca Raton, Florida: CRC Press, Inc., 1990.Google Scholar
  14. 14.
    Hertz-Picciotto I, Smith AH, Holtzman D, Lipsett M, Alexeeff G. Synergism between occupational arsenic exposure and smoking in the induction of lung cancer. Epidemiol 1992; 3: 23–31.Google Scholar
  15. 15.
    Brownson RC, Davis JR, Chang JC, DiLorenzo TM, Keefe TJ, Bagby JRJr. A study of the accuracy of cancer risk factor information reported to a central registry compared with that obtained by interview. Am J Epidemiol 1989; 129: 616–24.Google Scholar
  16. 16.
    World Health Organization. The World Health Organization Histologic Typing of Lung Tumors, 2nd Edition. Am J Clin Pathol 1982; 77: 123–36.Google Scholar
  17. 17.
    Koss LG. Diagnostic Cytology and its Histopathologic Bases. Third Edition. Philadelphia, PA: B Lippincott, Co, 1979.Google Scholar
  18. 18.
    Hatten J. Medicare's common denominator: the covered population. Health Care Finance Rev 1980; 2: 53–64.Google Scholar
  19. 19.
    Breslow NE, Day NE. Statistical Methods in Cancer Research. Volume 1. The Analysis of Case-Control Studies. Lyon, France: International Agency of Research on Cancer, 1980; IARC Sci. Pub. No. 32.Google Scholar
  20. 20.
    Alavanja MCR, Brownson RC, Boice JDJr, Hoch E. Preexisting lung disease and lung cancer among nonsmoking women. Am J Epidemiol 1992; 136: 623–32.Google Scholar
  21. 21.
    Fleiss JL. Statistical Methods for Rates and Proportions. 2nd Edition. New York: John Wiley & Sons, 1981: 64.Google Scholar
  22. 22.
    Saracci R. The interactions of tobacco smoking and other agents in cancer etiology. Epidemiol Rev 1987; 9: 175–93.Google Scholar
  23. 23.
    Wang HH, MacMahon B. Mortality of workers employed in the manufacture of chlordane and heptachlor. Arch Environ Health 1979; 21: 745–8.Google Scholar
  24. 24.
    Morgan DP, Lin LI, Saikaly HH. Morbidity and mortality in workers occupationally exposed to pesticides. Arch Environ Contam Toxicol 1980; 9: 349–82.Google Scholar
  25. 25.
    Blair A, Grauman DJ, Lubin JH, Fraumeni JFJr. Lung cancer and other causes of death among licensed pesticide applicators. JNCI 1983; 71: 31–7.Google Scholar
  26. 26.
    MacMahon B, Monson RR, Wang HH, Zheng T. A second follow-up of mortality in a cohort of pesticide applicators. J Occup Med 1988; 30: 429–32.Google Scholar
  27. 27.
    Sathiakumar N, Delzell E, Austin H, Cole P. A follow-up study of agricultural chemical production workers. Am J Ind Med 1992; 21: 321–30.Google Scholar
  28. 28.
    Shindell S, Ulrich S. Mortality of workers employed in the manufacture of chlordane: an update. J Occup Med 1986; 28: 497–501.Google Scholar
  29. 29.
    Cantor KP, Booze CF. Mortality among aerial pesticide applicators and flight instructors: a reprint. Arch Environ Health 1991; 46: 110–6.Google Scholar
  30. 30.
    International Agency for Research on Cancer. Monographs on the Evaluation of Carcinogenic Risks for Humans. Overall Evaluations of Carcinogenicity: An Updating of IARC Monographs. Volumes 1–42. Lyon, France: International Agency of Research on Cancer; 1987.Google Scholar
  31. 31.
    Blair A, Decoufle P, Grauman D. Cause of death among laundry and dry cleaning workers. Am J Public Health 1979; 69: 508–11.Google Scholar
  32. 32.
    Duh R-W, Asal NR. Mortality among laundry and dry cleaning workers in Oklahoma. Am J Public Health 1984; 74: 1278–80.Google Scholar
  33. 33.
    Blair A, Stewart PA, Tolbert PE, et al. Cancer and other causes of death among a cohort of dry cleaners. Br J Ind Med 1990; 47: 162–8.Google Scholar
  34. 34.
    Katz RM, Jowett D. Female laundry and dry cleaning workers in Wisconsin: a mortality analysis. Am J Public Health 1981; 71: 305–7.Google Scholar
  35. 35.
    Rogot E, Reid D. The validity of data from next-of-kin in studies of mortality among immigrants. Int J Epidemiol 1975; 4: 51–4.Google Scholar
  36. 36.
    Pershagen CT, Axelson O. A validation of questionnaire information on occupational exposure and smoking. Scand J Work Environ Health 1982; 8: 24–8.Google Scholar
  37. 37.
    Damber L, Larsson L-G. Combined effects of mining and smoking in the causation of lung carcinoma. Acta Radiol Oncol 1982; 21: 305–13.Google Scholar
  38. 38.
    Lerchen ML, Samet JM. An assessment of the validity of questionnaire responses provided by a surviving spouse. Am J Epidemiol 1986; 123: 481–9.Google Scholar
  39. 39.
    Zahm SH, Brownson RC, Chang JC, Davis JR. Study of lung cancer histologic types, occupation, and smoking in Missouri. Am J Ind Med 1989; 15: 565–78.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1993

Authors and Affiliations

  • Ross C. Brownson
  • Michael C. R. Alavanja
  • Jian C. Chang

There are no affiliations available

Personalised recommendations