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Risk of lung cancer in relation to contiguous windows of endotoxin exposure among female textile workers in Shanghai

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Abstract

Objective

Exposure to endotoxin has been consistently associated with a reduced risk of lung cancer. However, there is a paucity of information regarding temporal aspects of this relationship. The objective of this study was to investigate the associations between contiguous windows of endotoxin exposure and risk of lung cancer.

Methods

Data were reanalyzed from a case-cohort study (602 cases, 3,038 subcohort) of female textile workers in Shanghai, China. Cumulative endotoxin exposure was partitioned into two windows: ≥20 and <20 years before risk. Exposure–response relations were examined using categorical and non-linear (semi-parametric) models, accounting for confounding by previous exposure windows.

Results

There was an inverse trend of decreasing risk of lung cancer associated with increasing levels of endotoxin exposure ≥20 years before risk (p trend = 0.02). Women in the highest two categories of cumulative exposures had hazard ratios of 0.78 (95% CI 0.60–1.03) and 0.77 (95% CI 0.58–1.02) for lung cancer, respectively, in comparison with unexposed textile workers. There was, however, a weaker association and not statistically significant between lung cancer and endotoxin exposure accumulated in the more recent window (<20 years before risk).

Conclusion

Results provide further evidence that endotoxin exposure that occurred 20 years or more before risk confers the strongest protection against lung cancer, indicating a possible early anti-carcinogenic effect. Further studies are needed to better understand the underlying biological mechanisms for this effect.

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Acknowledgments

This research was supported by grant R01-CA80180 from the US National Cancer Institute. Ilir Agalliu was supported by funds from the Albert Einstein College of Medicine. George Astrakianakis is supported by the Michael Smith Foundation for Health Research. Katie Applebaum was supported by K01-OH009390 from CDC-NIOSH. The authors are grateful to women workers included in the study, and to the Shanghai field staff, and give special thanks to project manager Wenwan Wang, and industrial hygienists Helian Dai, Zhuming Wang, A-Zhen Chi, Xiaming Wang, Weiping Xiang, and Yufang Li for their dedication and efforts.

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Correspondence to Ilir Agalliu.

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Agalliu, I., Costello, S., Applebaum, K.M. et al. Risk of lung cancer in relation to contiguous windows of endotoxin exposure among female textile workers in Shanghai. Cancer Causes Control 22, 1397–1404 (2011). https://doi.org/10.1007/s10552-011-9812-x

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  • DOI: https://doi.org/10.1007/s10552-011-9812-x

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