Skip to main content
Log in

Occupational risks and lung cancer burden for Chinese men: a population-based case–referent study

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript



We aimed to fill in the gap of knowledge on the lung cancer burden resulting from occupational exposures among Chinese men through a population-based case–referent study.


Detailed information on lifestyle and full occupational histories of 1,208 male lung cancer incident cases and 1,069 age-matched male community referents were obtained through interviews during 2004–2006. The associations between lung cancer risk and exposures to specific or group of agents that were confirmed or suspected occupational carcinogens were analyzed.


After adjustment of smoking and other potential confounding factors, significant odds ratio of lung cancer was observed for workers employed in major industrial divisions of “construction” (1.37, 95% CI: 1.00–1.89) and “financing, insurance, real estate, and business services” (0.48, 95% CI: 0.23–0.97), as well as in the occupational groups of “bricklayers, carpenters, and other construction workers” (1.49, 95% CI: 1.07–2.06). Significantly elevated odds ratios were found for occupational exposures to silica dust (1.75, 95% CI: 1.16–2.62), welding fumes (1.74, 95% CI: 1.13–2.68), diesel exhaust (2.18, 95% CI: 1.23–3.84), and man-made mineral fibers (7.45, 95% CI: 1.63–34.00), while a significantly reduced risk (OR = 0.67, 95% CI: 0.47–0.95) was linked to cotton dust. The population attributable fraction of lung cancer was 3.2% (95% CI: 0.1–7.3%) for construction workers and 9.5% (95% CI: 4.8–15.1%) for the four significant specific exposures.


Our study indicates that previous exposure to occupational carcinogens remains an important determinant of lung cancer burden for Hong Kong Chinese men. However, results obtained from this study should be confirmed by future analyses based on job exposure matrix.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others



Environmental tobacco smoke


International Standard Classification of Occupations


International Standard Industrial Classification of All Economic Activities


Man-made mineral fibers


Odds ratio

95% CI:

95% Confidence interval


Population attributable fraction


International Agency for Research on Cancer


Standardized mortality ratio


  1. International Agency of Research on Cancer (2004) IARC monographs on the evaluation of carcinogenic risks to humans, vol 83 Tobacco smoke and Involuntary smoking. IARC Press, Lyon

    Google Scholar 

  2. Tse LA, Mang OW, Yu ITS et al (2009) Cigarette smoking and changing trends of lung cancer incidence by histological subtype among Chinese male population. Lung Cancer 66:22–27

    Article  PubMed  Google Scholar 

  3. Bardin-Mikolajczak A, Lissowska J, Zaridze D et al (2007) Occupation and risk of lung cancer in Central and Eastern Europe: the IARC multi-center case-control study. Cancer Causes Control 18:645–654

    Article  PubMed  Google Scholar 

  4. Bruske-Hohlfeld I, Mohner M, Pohlabeln H et al (2000) Occupational lung cancer risk for men in Germany: results from a pooled case-control study. Am J Epidemiol 151:384–395

    PubMed  CAS  Google Scholar 

  5. Gustavsson P, Jakobsson R, Nyberg F et al (2000) Occupational exposure and lung cancer risk: a population-based case-referent study in Sweden. Am J Epidemiol 152:32–40

    Article  PubMed  CAS  Google Scholar 

  6. van Loon AJM, Kant IJ, Swaen GMH et al (1997) Occupational exposure to carcinogens and risk of lung cancer: results from the Netherlands cohort study. Occup Environ Med 54:817–824

    Article  PubMed  Google Scholar 

  7. Consonni D, De Matteis S, Lubin JH et al (2010) Lung cancer and occupation in a population-based case-control study. Am J Epidemiol 171:323–333

    Article  PubMed  Google Scholar 

  8. Tse LA, Yu IT, Au JS et al (2009) Environmental tobacco smoke and lung cancer among Chinese nonsmoking males: might adenocarcinoma be the culprit? Am J Epidemiol 169:533–541

    Article  PubMed  Google Scholar 

  9. Ferris BG (1978) Epidemiology standardization project (American Thoracic Society). Am Rev Respir Dis 118:1–20

    PubMed  CAS  Google Scholar 

  10. Simonato L, Agudo A, Ahrens W et al (2001) Lung cancer and cigarette smoking in Europe: an update of risk estimates and an assessment of inter-country heterogeneity. Int J Cancer 91:876–887

    Article  PubMed  CAS  Google Scholar 

  11. International Labour Office (1968) International standard classifications of occupations, 2nd edn. International Labour Office Publications, Geneva

    Google Scholar 

  12. United Nations Publications (1971) International standard industrial classification of all economic activities (ISIC). Publishing Service United Nations, New York

    Google Scholar 

  13. Bruzzi P, Green SB, Byar DP et al (1985) Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol 122:904–914

    PubMed  CAS  Google Scholar 

  14. Yu IT, Tse LA, Leung CC et al (2007) Lung cancer mortality among silicotic workers in Hong Kong—no evidence for a link. Ann Oncol 18:1056–1063

    Article  PubMed  CAS  Google Scholar 

  15. International Agency for Research on Cancer (1997) IARC monographs on the evaluation of carcinogenic risks to human, silica, some silicates, coal dust, and para-aramid fibrils, vol 68. IARC Publications, Lyon

    Google Scholar 

  16. IARC (1990) IARC monographs on the evaluation of carcinogenic risks to humans, vol 49, WELDING (Group 2B). IARC Press, Lyon

    Google Scholar 

  17. IARC (2009) Diesel and gasoline engine exhausts and some nitroarenes, IARC Monographs Volume 46. Accessed 11 Dec 2009

  18. RC IA (1988) IARC monographs on the evaluation on the carcinogenetic risks to humans. vol 43: Man-made mineral fibers and radon. IARC, Lyon

    Google Scholar 

  19. RC IA (1989) IARC monographs on the evaluation of carcinogenic risks to humans Polynuclear aromatic compounds, engine, exhausts and nitroarenes. International Agency for Research on Cancer, Lyon

    Google Scholar 

  20. McDonald C, Cherry N (1999) Crystalline silica and lung cancer: the problem of conflicting evidence. Indoor Built Environ 8:121–126

    CAS  Google Scholar 

  21. Hessel PA, Gamble JF, Gee JBL et al (2000) Silica, silicosis, and lung cancer: a response to a recent working group report. J Occup Environ Med 42:704–720

    Article  PubMed  CAS  Google Scholar 

  22. Checkoway H, Franzblau A (2000) Is silicosis required for silica-associated lung cancer? Am J Ind Med 37:252–259

    Article  PubMed  CAS  Google Scholar 

  23. Pelucchi C, Pira E, Piolatto G et al (2006) Occupational silica exposure and lung cancer risk: a review of epidemiological studies 1996–2005. Ann Oncol 17:1039–1050

    Article  PubMed  CAS  Google Scholar 

  24. Cassidy A, ‘t MA, van Tongeren M et al (2007) Occupational exposure to crystalline silica and risk of lung cancer: a multicenter case-control study in Europe. Epidemiol 18:36–43

    Article  Google Scholar 

  25. Sjogren B, Hansen KS, Kjuus H et al (1994) Exposure to stainless steel welding fumes and lung cancer: a meta-analysis. Occup Environ Med 51:335–336

    Article  PubMed  CAS  Google Scholar 

  26. Moulin JJ (1997) A meta-analysis of epidemiologic studies of lung cancer in welders. Scand J Work Environ Health 23:104–113

    PubMed  CAS  Google Scholar 

  27. Ambroise D, Wild P, Moulin JJ (2006) Update of a meta-analysis on lung cancer and welding. Scand J Work Environ Health 32:22–31

    PubMed  Google Scholar 

  28. Siew SS, Kauppinen T, Kyyrönen P, Heikkilä P, Pukkala E (2008) Exposure to iron and welding fumes and the risk of lung cancer. Scand J Work Environ Health 34(6):444–450

    PubMed  CAS  Google Scholar 

  29. Mohr U, Ernst H, Roller M, Pott F (2006) Pulmonary tumor types induced in Wistar rats of the so-called “19-dust study”. Exp Toxicol Pathol 58(1):13–20

    Article  PubMed  CAS  Google Scholar 

  30. Kagawa J (2002) Health effects of diesel exhaust emissions—a mixture of air pollutants of worldwide concern. Toxicol 181–182:349–353

    Article  Google Scholar 

  31. Merchant JA, Ortmeyer C (1981) Mortality of employees of two cotton mills in North Carolina. Chest 79(4 Suppl):6S–11S

    Article  PubMed  CAS  Google Scholar 

  32. Henderson V, Enterline PE (1973) An unusual mortality experience in cotton textile workers. J Occup Med 15:717–719

    PubMed  CAS  Google Scholar 

  33. Wernli KJ, Ray RM, Gao DL et al (2003) Cancer among women textile workers in Shanghai, China: overall incidence patterns, 1989–1998. Am J Ind Med 44:595–599

    Article  PubMed  Google Scholar 

  34. Astrakianakis G, Seixas NS, Ray R et al (2007) Lung cancer risk among female textile workers exposed to endotoxin. J Natl Cancer Inst 99:357–364

    Article  PubMed  CAS  Google Scholar 

  35. Census Statistics Department Hong Kong Government (2010) 2009 Report on annual earnings and hours survey. [Accessed on 26 November, 2010]

Download references


The work described in this paper was substantially supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China; Project No. CUHK4460/03M. The funding source had no role in the study design, data collection, data analysis, or interpretation of the findings.

Conflict of interest

The authors declared no conflicts of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ignatius Tak-sun Yu.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 30 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tse, L.A., Yu, I.Ts., Qiu, H. et al. Occupational risks and lung cancer burden for Chinese men: a population-based case–referent study. Cancer Causes Control 23, 121–131 (2012).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: