1
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Park RM. Risk assessment for conventional diesel exhaust (before 1990) and lung cancer in a cohort of miners. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:1413-1429. [PMID: 37876044 DOI: 10.1111/risa.14231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/22/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023]
Abstract
Diesel exhaust in the latter half of the 20th century has been found to be a lung carcinogen. Conventional diesel emissions continue in the transportation, mining, construction, and farming industries. From the Diesel Exhaust in Miners Study, a public-use dataset was used to calculate the excess lifetime risk of lung cancer associated with diesel exposure (1947-1997). Excess rates of lung cancer mortality associated with respirable elemental carbon (REC) and possible other mining exposures (e.g., oil mists, explosives emissions) were investigated using Poisson regression methods. Lung cancer mortality declined with increasing employment duration while increasing with cumulative REC and non-diesel exposures, suggesting a strong worker survivor effect. Attenuation of the REC effect was observed with increasing cumulative exposure. After adjustment for employment duration, the excess rate ratio for lung cancer mortality was 0.67 (95% CI = 0.35-0.99) for a 10-year lagged exposure to 200 μg/m3 REC, a typical below-ground exposure in the study mines. At exposures of 200, 10, and 1 μg/m3 REC, the estimated excess lifetime risks, respectively, were 119, 43, and 8.7 per thousand. Analysis of an inception cohort hired after dieselization commenced produced smaller and less certain estimates of lifetime risk. From exposures to conventional diesel engine exhaust common in occupational groups in the past, the excess lifetime risk of lung cancer was more than 5%. Ambient REC exposures in the general population were estimated to confer lifetime risks of 0.14 to 14 per thousand, depending on assumptions made.
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Romero Starke K, Bolm-Audorff U, Reissig D, Seidler A. Dose-response-relationship between occupational exposure to diesel engine emissions and lung cancer risk: A systematic review and meta-analysis. Int J Hyg Environ Health 2024; 256:114299. [PMID: 38194821 DOI: 10.1016/j.ijheh.2023.114299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND In 2012, the International Agency for Research on Cancer (IARC) concluded that diesel engine emissions (DEE) emissions cause cancer in humans. However, there is still controversy surrounding this conclusion, due to several studies since the IARC decision citing a lack of evidence of a dose-response relationship. OBJECTIVES Through a systematic review, we aimed to evaluate all evidence on the association between occupational DEE and lung cancer to investigate whether there is an increased risk of lung cancer for workers exposed to DEE and if so, to describe the dose-response relationship. METHODS We registered the review protocol with PROSPERO and searched for observational studies in relevant literature databases. Two independent reviewers screened the studies' titles/abstracts and full texts, and extracted and assessed their quality. Studies with no direct DEE measurement but with information on length of exposure for high-risk occupations were assigned exposure values based on the DEE Job-Exposure-Matrix (DEE-JEM). After assessing quality and informativeness, we selected appropriate studies for the dose-response meta-analysis. RESULTS Sixty-five reports (from thirty-seven studies) were included in the review; one had a low risk of bias (RoB) (RR per 10 μg/m3-years: 1.014 [95%CI 1.007-1.021]). There was an increased, statistically significant risk of lung cancer with increasing DEE exposure for all studies (RR per 10 μg/m3-years = 1.013 [95%CI 1.004-1.021]) as well as for studies with a low RoB in the exposure category (RR per 10 μg/m3-years = 1.008 [95% CI1.001-1.015]). We obtained a doubling dose of 555 μg/m3-years for all studies and 880 μg/m3-years for studies with high quality in the exposure assessment. DISCUSSION We found a linear positive dose-response relationship for studies with high quality in the exposure domain, even though all studies had an overall high risk of bias. Current threshold levels for DEE exposure at the workplace should be reconsidered.
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Affiliation(s)
- Karla Romero Starke
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Ulrich Bolm-Audorff
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - David Reissig
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Wagner GR, Michaels D. Invited Perspective: Diesel Exhaust and Lung Cancer-Delayed Findings Confirmed, but Consequences Continue. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:81301. [PMID: 37549096 PMCID: PMC10406172 DOI: 10.1289/ehp13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/24/2023] [Accepted: 06/26/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Gregory R. Wagner
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - David Michaels
- Milken Institute School of Public Heath, George Washington University, Washington, District of Columbia, USA
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Liu C, Nie W, Luo C, Hua Y, Yu F, Niu W, Zhang X, Zhang S, Xue Q, Sun N, Jiang C. Numerical study on temporal and spatial distribution of particulate matter under multi-vehicle working conditions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 862:160710. [PMID: 36496015 DOI: 10.1016/j.scitotenv.2022.160710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
The high growth in the use of underground diesel vehicles has led to a large number of exhaust pollutants, especially particulate matter (PM), which is a serious threat to the lives and health of underground personnel. In this paper, based on numerical simulations and field measurements, the temporal and spatial distribution of PM in the exhaust of two vehicles and the impact on the health of underground personnel was analyzed. The results showed that in both conditions, the airflow velocity between two vehicles showed a zonal distribution, and there was an airflow vortex in the chamber under the interaction of the wind. When the vehicles were running in the same direction into the wind, PM with a concentration range of 15.79-26.32 mg/m3 could reach the height of the human respiratory belt and was mainly distributed on the east side of the roadway. Therefore, underground personnel should avoid approaching the right area of the vehicle body. In addition, PM concentration around the driver position of the vehicle was still higher than the human contact limit, so the drivers of the vehicle would need personal protection. When the vehicles were running in the same direction with the wind, compared with the airflow inlet side, the amount of PM on the airflow outlet side increased more obviously with time, especially for PM with a concentration range of 21.05-31.58 mg/m3. Also, partial PM flowed into the chamber with the airflow, such that personnel should avoid being located on the downwind side of the vehicle, and personnel in the chamber should also have personal protection.
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Affiliation(s)
- Chengyi Liu
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Wen Nie
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China.
| | - Chongyang Luo
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Yun Hua
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Fengning Yu
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Wenjin Niu
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Xu Zhang
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Shaobo Zhang
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Qianqian Xue
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Ning Sun
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
| | - Chenwang Jiang
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong Province, China; State Key Laboratory of Mining Disaster Prevention and Control Co-found by Shandong Province and the Ministry of Science and Technology, Shandong University of Science and Technology, Qingdao 266590, China
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Vermeulen R, Portengen L, Lubin J, Stewart P, Blair A, Attfield MD, Silverman DT. The impact of alternative historical extrapolations of diesel exhaust exposure and radon in the Diesel Exhaust in Miners Study (DEMS). Int J Epidemiol 2021; 49:459-466. [PMID: 31539056 PMCID: PMC7266543 DOI: 10.1093/ije/dyz189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 11/28/2022] Open
Abstract
Background Previous results from the Diesel Exhaust in Miners Study (DEMS) demonstrated a positive exposure–response relation between lung cancer and respirable elemental carbon (REC), a key surrogate for diesel exhaust exposure. Two issues have been raised regarding DEMS: (i) the use of historical carbon monoxide (CO) measurements to calibrate models used for estimating historical exposures to REC in the DEMS exposure assessment; and (ii) potential confounding by radon. Methods We developed alternative REC estimates using models that did not rely on CO for calibration, but instead relied on estimated use of diesel equipment, mine ventilation rates and changes in diesel engine emission rates over time. These new REC estimates were used to quantify cumulative REC exposure for each subject in the nested case-control study. We conducted conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals for lung cancer. To evaluate the impact of including radon as a potential confounder, we estimated ORs for average REC intensity adjusted for cumulative radon exposure in underground miners. Results Validation of the new REC exposure estimates indicated that they overestimated historical REC by 200–400%, compared with only 10% for the original estimates. Effect estimates for lung cancer using these alternative REC exposures or adjusting for radon typically changed by <10% when compared with the original estimates. Conclusions These results emphasize the robustness of the DEMS findings, support the use of CO for model calibration and confirm that radon did not confound the DEMS estimates of the effect of diesel exposure on lung cancer mortality.
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Affiliation(s)
- Roel Vermeulen
- Formerly, National Cancer Institute, Rockville, MD, USA.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jay Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Patricia Stewart
- Formerly, National Cancer Institute, Rockville, MD, USA.,Stewart Exposure Assessments, LLC, Arlington, VA, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Michael D Attfield
- Formerly, National Institute for Occupational Safety and Health, Morgantown, WA, USA
| | - Debra T Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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6
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Duyx B, Urlings MJE, Swaen GMH, Bouter LM, Zeegers MP. Determinants of citation in the literature on diesel exhaust exposure and lung cancer: a citation analysis. BMJ Open 2020; 10:e033967. [PMID: 33033008 PMCID: PMC7542959 DOI: 10.1136/bmjopen-2019-033967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Epidemiological research on the association between diesel exhaust exposure and lung cancer risk has some methodological challenges that give rise to different conclusions and intense debates. This raises the question about the role of selective citation and of citation bias in particular. Our aim was to investigate the occurrence and prevalence of selective citation in this field. DESIGN Citation analysis. SETTING Web of Science Core Collection. PARTICIPANTS We identified 96 publications in this network, with 4317 potential citations. For each publication, we extracted characteristics such as study conclusion and funding source. Some of these characteristics are related to the study content: study design, sample size, method of diesel exposure assessment, type of diesel technology under investigation, and whether smoking had been adjusted for. PRIMARY AND SECONDARY OUTCOME MEASURES Whether a citation occurs or not, measured and analysed according to the preregistered protocol. Exploratively we analysed the association between funding source and study conclusion. RESULTS Methodological content of a study was clearly related to citation, studies using more sophisticated methods were more likely to be cited. There was some evidence for citation bias: supportive publications had a higher chance of being cited than non-supportive ones, but after adjustment for study quality, this effect decreased substantially (adjusted OR 1.3, 95% CI 1.0 to 1.7). Explorative analyses indicated that three quarters of non-profit funded publications had a supportive study conclusion against only one quarter of the industry-funded publications. CONCLUSIONS There is evidence for selective citation within this field, but the evidence for citation bias was weak. It seems that factors related to the methodology had more impact on citation than the conclusion of a study. Interestingly, publications that were funded by industry were more skeptical about a causal relationship between diesel exhaust and lung cancer compared to non-profit-funded publications.
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Affiliation(s)
- Bram Duyx
- CAPHRI School for Public Health and Primary Care, Department of Genetics and Cell Biology, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Miriam J E Urlings
- CAPHRI School for Public Health and Primary Care, Department of Genetics and Cell Biology, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Gerard M H Swaen
- CAPHRI School for Public Health and Primary Care, Department of Genetics and Cell Biology, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Lex M Bouter
- Department of Epidemiology and Biostatistic, Amsterdam University Medical Centres, Location VUmc, Amsterdam, Noord-Holland, The Netherlands
| | - Maurice P Zeegers
- CAPHRI School for Public Health and Primary Care, Department of Genetics and Cell Biology, Maastricht University, Maastricht, Limburg, The Netherlands
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7
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Diesel engine emissions: are they no longer tolerable? Arch Toxicol 2019; 93:2483-2490. [PMID: 31410529 DOI: 10.1007/s00204-019-02531-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
Emissions from diesel engines contain several hundred chemical compounds, which are emitted partly as gas and partly as particles. The composition of diesel exhaust and its concentrations in air has changed significantly over time, to the extent that now there is a distinction between "traditional" and "new technology" diesel emissions. New technology diesel engines comply with emissions from EURO 3 vehicles and higher. Starting with EURO 5, a significant further reduction of particle emissions has been achieved by increased temperature, which, however, lead to increased emissions of NOx and exceeded the NO2 emission limit. To overcome this problem, some car manufacturers installed illegal software that detected the vehicle test bench operation, resulting in low emissions during the test cycle. Detection of such devices in 2015 led to the "Diesel scandal". In 2017 the worldwide harmonized light vehicles test procedure (WLTP) was introduced for new cars, which simulates emissions under different driving conditions. It became mandatory for certification of all new vehicles by September 2018. In addition, fleet CO2 emissions have been introduced for all cars, requiring that by 2020 95% of each manufacturer's passenger car must meet the CO2 emission target of 95 mg/km, and by 2021 100% of the fleet. All these regulations significantly reduced the emissions of diesel- and gasoline-driven cars, which since the introduction of the EURO 6 regulation in 2014 are almost similar for both. Since the energy efficiency of diesel motors is up to 20% higher than that of gasoline-driven cars resulting in up to 20% lower CO2 emission, there is no reason to question the future use of diesel engines. These regulations apply for new cars. However, air concentrations at sampling points close to streets with high traffic still exceed the limit values especially for NO2. In several cities this led to restrictions for passenger cars of EURO 5 and below. Since concentrations close to streets are not relevant to evaluate the long-term exposure of the population, these measures are highly debatable.
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8
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Silverman DT. THE AUTHOR REPLIES. Am J Epidemiol 2019; 188:491-492. [PMID: 30192912 PMCID: PMC6357805 DOI: 10.1093/aje/kwy178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/08/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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9
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Chang ET, Lau EC, Van Landingham C, Crump KS, McClellan RO, Moolgavkar SH. CHANG ET AL. REPLY. Am J Epidemiol 2019; 188:485-486. [PMID: 30124745 DOI: 10.1093/aje/kwy167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/11/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ellen T Chang
- Center for Health Sciences, Exponent, Inc., Menlo Park, CA
- Stanford Cancer Institute, Stanford, CA
| | - Edmund C Lau
- Center for Health Sciences, Exponent, Inc., Menlo Park, CA
| | | | | | | | - Suresh H Moolgavkar
- Center for Health Sciences, Exponent, Inc., Bellevue, WA
- Fred Hutchinson Cancer Research Center, Seattle, WA
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10
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Chang ET, Lau EC, Van Landingham C, Crump KS, McClellan RO, Moolgavkar SH. RE: "DIESEL EXHAUST AND LUNG CANCER-AFTERMATH OF BECOMING AN IARC GROUP 1 CARCINOGEN". Am J Epidemiol 2019; 188:489-491. [PMID: 30192919 DOI: 10.1093/aje/kwy176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 05/23/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ellen T Chang
- Center for Health Sciences, Exponent, Inc., Menlo Park, CA
- Stanford Cancer Institute, Stanford, CA
| | - Edmund C Lau
- Center for Health Sciences, Exponent, Inc., Menlo Park, CA
| | | | | | | | - Suresh H Moolgavkar
- Center for Health Sciences, Exponent, Inc., Bellevue, WA
- Fred Hutchinson Cancer Research Center, Seattle, WA
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11
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Möhner M. The Diesel Exhaust in Miners Study provides no evidence for an increase in risk for lung cancer in miners exposed to diesel engine emissions. Eur J Epidemiol 2018; 33:1251-1254. [PMID: 30382498 PMCID: PMC6290853 DOI: 10.1007/s10654-018-0455-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/21/2018] [Indexed: 01/21/2023]
Abstract
The Diesel Exhaust in Miners Study is unquestionably the most suitable data material to date to examine a possible link between diesel engine emissions and lung cancer risk. But the results do not appear to be consistent in themselves. The crucial methodological problem in this study, however, has yet to be discovered, to which the lack of any description of age related information (year of birth, year of hire, year of first exposure, year of death) for the cohort as well as for the cases might have contributed. This information is important to understand the flaws in the analysis. It turns out that the year of birth is associated with the exposure, i.e. with the chance to be exposed over a certain period of time as well as with the chance to be an ever-smoker. A further important issue for the interpretation of the results is the validity of the data on smoking, which are mainly obtained from next of kin for decedents up to 50 years after death. Taking all these aspects into account, it can be concluded that only the SMR-analysis can be considered from all published results.
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Affiliation(s)
- Matthias Möhner
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany.
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12
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Chang ET, Lau EC, Van Landingham C, Crump KS, McClellan RO, Moolgavkar SH. Reanalysis of Diesel Engine Exhaust and Lung Cancer Mortality in the Diesel Exhaust in Miners Study Cohort Using Alternative Exposure Estimates and Radon Adjustment. Am J Epidemiol 2018. [PMID: 29522073 PMCID: PMC5982729 DOI: 10.1093/aje/kwy038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The Diesel Exhaust in Miners Study (DEMS) (United States, 1947–1997) reported positive associations between diesel engine exhaust exposure, estimated as respirable elemental carbon (REC), and lung cancer mortality. This reanalysis of the DEMS cohort used an alternative estimate of REC exposure incorporating historical data on diesel equipment, engine horsepower, ventilation rates, and declines in particulate matter emissions per horsepower. Associations with cumulative REC and average REC intensity using the alternative REC estimate and other exposure estimates were generally attenuated compared with original DEMS REC estimates. Most findings were statistically nonsignificant; control for radon exposure substantially weakened associations with the original and alternative REC estimates. No association with original or alternative REC estimates was detected among miners who worked exclusively underground. Positive associations were detected among limestone workers, whereas no association with REC or radon was found among workers in the other 7 mines. The differences in results based on alternative exposure estimates, control for radon, and stratification by worker location or mine type highlight areas of uncertainty in the DEMS data.
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Affiliation(s)
- Ellen T Chang
- Center for Health Sciences, Exponent, Inc., Menlo Park, California
- Stanford Cancer Institute, Stanford, California
| | - Edmund C Lau
- Center for Health Sciences, Exponent, Inc., Menlo Park, California
| | | | | | | | - Suresh H Moolgavkar
- Center for Health Sciences, Exponent, Inc., Bellevue, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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13
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Silverman DT. Diesel Exhaust and Lung Cancer-Aftermath of Becoming an IARC Group 1 Carcinogen. Am J Epidemiol 2018. [PMID: 29522191 DOI: 10.1093/aje/kwy036] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The International Agency for Research on Cancer reclassified diesel exhaust from Group 2A (probably carcinogenic to humans) to Group 1 (carcinogenic to humans) in 2012. Since then, reevaluation and reanalysis of 2 major studies (Diesel Exhaust in Miners Study and Trucking Industry Particle Study) that were influential to the International Agency for Research on Cancer evaluation have replicated the original findings and demonstrated the suitability of these epidemiologic data for the quantitative risk assessment needed to set safe exposure limits in occupational and outdoor ambient environments. The challenge now is to protect the workers and general populations in urban areas from the carcinogenicity of diesel exhaust.
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Affiliation(s)
- Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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14
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Challenges and Opportunities for Occupational Epidemiology in the Twenty-first Century. Curr Environ Health Rep 2018; 4:319-324. [PMID: 28803393 DOI: 10.1007/s40572-017-0154-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW There are many opportunities and challenges for conducting occupational epidemiologic studies today. In this paper, we summarize the discussion of a symposium held at the Epidemiology in Occupational Health (EPICOH) conference, Chicago 2014, on challenges for occupational epidemiology in the twenty-first century. RECENT FINDINGS The increasing number of publications and attendance at our conferences suggests that worldwide interest in occupational epidemiology has been growing. There are clearly abundant opportunities for new research in occupational epidemiology. Areas ripe for further work include developing improved methods for exposure assessment, statistical analysis, studying migrant workers and other vulnerable populations, the use of biomarkers, and new hazards. Several major challenges are also discussed such as the rapidly changing nature and location of work, lack of funding, and political/legal conflicts. As long as work exists there will be occupational diseases that demand our attention, and a need for epidemiologic studies designed to characterize these risks and to support the development of preventive strategies. Despite the challenges and given the important past contribution in this field, we are optimistic about the importance and continued vitality of the research field of occupational epidemiology.
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15
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McGartland A, Revesz R, Axelrad DA, Dockins C, Sutton P, Woodruff TJ. Estimating the health benefits of environmental regulations. Science 2018; 357:457-458. [PMID: 28774918 DOI: 10.1126/science.aam8204] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Al McGartland
- U.S. Environmental Protection Agency, Washington, DC 20460, USA
| | | | | | - Chris Dockins
- U.S. Environmental Protection Agency, Washington, DC 20460, USA
| | - Patrice Sutton
- University of California San Francisco (UCSF), San Francisco, CA 94143, USA
| | - Tracey J Woodruff
- University of California San Francisco (UCSF), San Francisco, CA 94143, USA.
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16
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Möhner M, Wendt A. A critical review of the relationship between occupational exposure to diesel emissions and lung cancer risk. Crit Rev Toxicol 2017; 47:185-224. [PMID: 28322628 DOI: 10.1080/10408444.2016.1266598] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In 2012, a working group of the International Agency for Research on Cancer classified diesel exhaust (DE) as a human carcinogen (Group 1). This decision was primarily based on the findings of the Diesel Exhaust in Miners Study (DEMS). The disparity between the results of various methodological approaches applied to the DEMS led to several critical commentaries. An expert panel was subsequently set up by the Health Effects Institute to evaluate the DEMS results, together with a large study in the trucking industry. The panel concluded that both studies provided a useful basis for quantitative risk assessments (QRAs) of DE exposure. However, the results of both studies were non-definitive as the studies suffer from several methodological shortcomings. We conducted a critical review of the studies used by the International Agency for Research on Cancer (IARC) working group to evaluate the relationship between DE and lung cancer. The aim was to assess whether the available studies support the statement of a causal relationship and, secondarily if they could be used for QRA. Our review highlights several methodological flaws in the studies, amongst them overadjustment bias, selection bias, and confounding bias. The conclusion from our review is that the currently published studies provide little evidence for a definite causal link between DE exposure and lung cancer risk. Based on two studies in miners, the DEMS and the German Potash Miners study, QRA may be conducted. However, the DEMS data should be reanalyzed in advance to avoid bias that affects the presently published risk estimates.
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Affiliation(s)
- Matthias Möhner
- a Division Work and Health , Federal Institute for Occupational Safety and Health , Berlin , Germany
| | - Andrea Wendt
- a Division Work and Health , Federal Institute for Occupational Safety and Health , Berlin , Germany
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