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Occupational exposure to metal compounds and lung cancer. Results from a multi-center case–control study in Central/Eastern Europe and UK

Abstract

Purpose

To study the association between occupational exposure to metals including chromium, cadmium, nickel, and arsenic compounds, within a population-based study design, while adjusting for confounding factors.

Methods

A population-based lung cancer case–control study in Central/Eastern Europe and UK was conducted in 1998–2003, including 2,853 cases and 3,104 controls. Exposure to 70 occupational agents was assessed by local expert-teams for all subjects. Odds ratios (OR) for exposure to dust and fumes/mist of chromium, nickel, cadmium, arsenic, as well as inorganic pigment dust and inorganic acid mist, were adjusting for smoking, age, center, sex, and exposure to other occupational agents including the metals under study.

Results

Exposure to arsenic (prevalence = 1.4%) was associated with an increased lung cancer risk ((OR) 1.65, 95% confidence interval (95% CI):1.05–2.58). For chromium dust (prevalence = 4.8%, OR: 1.25, 95% CI: 0.95–1.65), a linear upward trend for duration and cumulative exposure was observed. A weak association was observed for exposure to cadmium fumes (prevalence = 1.8%, OR: 1.19, 95% CI: 0.77–1.82), which was strongest for the highest category of cumulative exposure (OR: 2.04, 95% CI: 1.07–3.90). No increased risk was observed for inorganic acid mist, inorganic pigment dust, or nickel, after adjustment for other metals. An independent effect of nickel cannot be excluded, due to its collinearity with chromium exposure.

Conclusions

Occupational exposure to metals is an important risk factor for lung cancer. Although the strongest risk was observed for arsenic, exposure to chromium dust was most important in terms of attributable risk due to its high prevalence.

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Acknowledgments

The study was partially funded by the European Commission’s Inco-Copernicus Programme (Contract No. IC15-CT96-0313). In Warsaw, the study was supported by a grant from the Polish State Committee for Scientific Research (Grant No. SPUB-M-COPERNICUS/P-05/DZ-30/99/2000). In Liverpool, the work was funded by the Roy Castle Lung Cancer Foundation, UK. Andrea ’t Mannetje and Tony Fletcher worked on this study under the tenure of a Special Training Award and a Visiting Scientist Award from the International Agency for Research on Cancer. Gilles Ferro and Noémie Travier contributed to data management.

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Correspondence to Andrea ’t Mannetje.

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’t Mannetje, A., Bencko, V., Brennan, P. et al. Occupational exposure to metal compounds and lung cancer. Results from a multi-center case–control study in Central/Eastern Europe and UK. Cancer Causes Control 22, 1669 (2011). https://doi.org/10.1007/s10552-011-9843-3

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Keywords

  • Lung neoplasms
  • Occupational exposure
  • Metals
  • Case–control study
  • Confounding