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Hosseini B, Olsson A, Bouaoun L, Hall A, Hadji M, Rashidian H, Naghibzadeh-Tahami A, Marzban M, Najafi F, Haghdoost AA, Boffetta P, Kamangar F, Pukkala E, Etemadi A, Weiderpass E, Schüz J, Zendehdel K. Lung cancer risk in relation to jobs held in a nationwide case-control study in Iran. Occup Environ Med 2022; 79:831-838. [PMID: 36379677 PMCID: PMC9685687 DOI: 10.1136/oemed-2022-108463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/24/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Globally, lung cancer is the most frequent occupational cancer, but the risk associated with the occupations or occupational environment in Iran is not clear. We aimed to assess occupations with the risk of lung cancer. METHODS We used the IROPICAN nationwide case-control study data including 658 incident lung cancer cases and 3477 controls. We assessed the risk of lung cancer in relation to ever working in major groups of International Standard Classification of Occupations, high-risk occupations for lung cancer and duration of employment and lung cancer subtype among construction workers and farmers while controlling for cigarette smoking and opium consumption. We used unconditional regression logistic models to estimate ORs for the association between increased lung cancer risk and occupations. RESULTS We observed elevated ORs for lung cancer in male construction workers (OR=1.4; 95% CI: 1.0 to 1.8), petroleum industry workers (OR=3.2; 95% CI: 1.1 to 9.8), female farmers (OR=2.6; 95% CI: 1.3 to 5.3) and female bakers (OR=5.5; 95% CI: 1.0 to 29.8). A positive trend by the duration of employment was observed for male construction workers (p< 0.001). Increased risk of squamous cell carcinoma was observed in male construction workers (OR=1.9; 95% CI: 1.2 to 3.0) and female farmers (OR=4.3; 95% CI: 1.1 to 17.2), who also experienced an increased risk of adenocarcinoma (OR=3.8; 95% CI: 1.4 to 9.9). DISCUSSION Although we observed associations between some occupations and lung cancer consistent with the literature, further studies with larger samples focusing on exposures are needed to better understand the occupational lung cancer burden in Iran.
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Affiliation(s)
- Bayan Hosseini
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
- Cancer Research Center, Cancer Institute of the Islamic Republic of Iran, Tehran, The Islamic Republic of Iran
| | - Ann Olsson
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Liacine Bouaoun
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Amy Hall
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Maryam Hadji
- Cancer Research Center, Cancer Institute of the Islamic Republic of Iran, Tehran, The Islamic Republic of Iran
- Health Sciences Unit, Faculty of Social Sciences, University of Tampere Faculty of Social Sciences, Tampere, Finland
| | - Hamideh Rashidian
- Cancer Research Center, Cancer Institute of the Islamic Republic of Iran, Tehran, The Islamic Republic of Iran
| | - Ahmad Naghibzadeh-Tahami
- Department of Epidemiology and Biostatistics, Kerman University of Medical Sciences, Kerman, The Islamic Republic of Iran
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, The Islamic Republic of Iran
| | - Maryam Marzban
- Clinical Research Development Center, The Persian Gulf Martyrs, Boushehr University of Medical Sciences, Bushehr, The Islamic Republic of Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, The Islamic Republic of Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, The Islamic Republic of Iran
| | - Ali Akbar Haghdoost
- Kerman University of Medical Sciences Department of Epidemiology and Biostatistics, Kerman, The Islamic Republic of Iran
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Farin Kamangar
- Department of Biology, Morgan State University School of Computer Mathematical and Natural Sciences, Baltimore, Maryland, USA
| | - Eero Pukkala
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry, Cancer Society of Finland Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Arash Etemadi
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Elisabete Weiderpass
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of the Islamic Republic of Iran, Tehran, The Islamic Republic of Iran
- Cancer Biology Research Center, Cancer Institute of the Islamic Republic of Iran, Tehran, The Islamic Republic of Iran
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Abstract
Background: In Indonesia, many occupations and industries involve a variety of hazardous and toxic materials. The ILO estimates that about 21.1% of the tracheal, bronchial, and lung cancer deaths among men were attributable to workplace hazardous substances. This study investigated the relationship between occupations or workplace exposure and the risk of lung cancer in the country. The results will help determine how Indonesia can best mitigate the risk for its workers. Objectives: This case-control study utilizes the Indonesian Standard of Industrial Classification (IndSIC) 2015 with the aim of exploring the risk of lung cancer among Indonesian workers. Methods: The study included patients aged 35 years old or older receiving thoracic CT at the radiology department of Persahabatan Hospital. The cases were histological-confirmed primary lung cancers, while the controls were negative thoracic CT scan for lung cancer. The subjects’ job titles and industries were classified according to IndSIC 2015 and blind to the patient’s grouping as a case or control. Logistic regression was used to determine the odds ratios for lung cancer among all sections and some divisions or groups of IndSIC 2015. Findings: The mean age was 58.1 (±10.23) years for lung cancer patients and 54.5 (±10.23) years for controls. The majority of subjects (19.6%) worked in Section G (Wholesale and retail trade; repair of motor vehicles and motorcycle). After adjusting for age, gender, level of education, and smoking habit, the risk of lung cancer was nearly three-times higher (OR = 2.8, 95% CI = 1.11–7.02) in workers of Division A01 (crop, animal production, and hunting) and two-times higher (OR = 1.9, 95% CI = 1.05–3.46) in workers of Section F (construction) compared to the workers in other sections or divisions. Conclusions: The excess risk of lung cancer among certain categories of workers confirms the need for improved policy, monitoring, and control of occupational exposure for primary cancer prevention and workers’ compensation purposes.
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