© 1992 Oxford University Press
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Occupational and Environmental Hazards Associated with Lung Cancer
* Bremen Institute for Prevention Research and Social Medicine (BIPS) Grünenstrasse 120, D-2800 Bremen 1, Federal Republic of Germany (FRG)
** University of Wuppertal, Dept. of Labour Safety and Environmental Medicine Gaußstr. 20, D–5600 Wuppertal 1, FRG
City of Hamburg, Office of Work, Health and Social Welfare, Dept of Occupational Safety, Division of Occupational Medicine PO Box 76 01 06, D–2000 Hamburg 76, FRG
§ Medical Institute of Environmental Hygiene at the University of Düsseldorf Auf'm Hennekamp 50, D–4000 Düsseldorf 1, FRG
|| University of Bremen, Dept. of Mathematics and Computer Science, Institute of Statistics PO Box 33 04 40, D–2800 Bremen 33, FRG
In a hospital-based case-control study 194 lung cancer cases, 194 hospital controls, and 194 population controls were interviewed for their smoking, occupational, and residential history by trained interviewers, using a standardized questionnaire, In order to include many different environmental exposures, case ascertainment took place in seven different hospitals with catchment areas ranging from rural to highly industrialized.
Lung cancer risk strongly increases with cumulative cigarette dose, reaching an odds ratio (OR) of 16.19 (95% confidence limits (CL) 5.10, 51.33) for male smokers of more than 40 pack-years and an OR of 19.99(95% CL: 4.98, 80.24) for female smokers of more than 20 pack-years.
For the quantification of occupational exposure to known carcinogens of the lung a novel approach was developed which accumulates exposure information obtained by supplemental questionnaires through an automatic procedure. The OR for the highest exposure group in males was 2.7 (95% CL: 1.23, 5.78). Significantly increased risks were observed in the metal industry, particularly in smelter and foundry workers (OR 4.8, 95% CL: 1.15, 20.16) and in turners (OR 2.2, 95% CL: 1.05, 4.75). In the construction industry the risks were particularly high in road construction workers (OR 3.7, 95% CL: 1.06, 13.20) and in unskilled construction workers (OR 2.7, 95% CL: 1.24, 5.761). The risks in these occupational groups increased with duration and with latency.
Quantification of air pollution was done on a county basis by time period. An index based on emission data for sulphur dioxide was compared to a semiquantitative index, which included additional information on ambient air pollution. After adjustment for smoking and occupational exposures an OR of 1.01(95% CL: 0.53, 1.91) for an emission index and of 1.16 (95% CL: 0.64, 2.13) for a semiquantitative index was obtained.
Received 1 October 1991
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