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Korbecki J, Bosiacki M, Szatkowska I, Kupnicka P, Chlubek D, Baranowska-Bosiacka I. The Clinical Significance and Involvement in Molecular Cancer Processes of Chemokine CXCL1 in Selected Tumors. Int J Mol Sci 2024; 25:4365. [PMID: 38673949 PMCID: PMC11050300 DOI: 10.3390/ijms25084365] [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: 01/29/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Chemokines play a key role in cancer processes, with CXCL1 being a well-studied example. Due to the lack of a complete summary of CXCL1's role in cancer in the literature, in this study, we examine the significance of CXCL1 in various cancers such as bladder, glioblastoma, hemangioendothelioma, leukemias, Kaposi's sarcoma, lung, osteosarcoma, renal, and skin cancers (malignant melanoma, basal cell carcinoma, and squamous cell carcinoma), along with thyroid cancer. We focus on understanding how CXCL1 is involved in the cancer processes of these specific types of tumors. We look at how CXCL1 affects cancer cells, including their proliferation, migration, EMT, and metastasis. We also explore how CXCL1 influences other cells connected to tumors, like promoting angiogenesis, recruiting neutrophils, and affecting immune cell functions. Additionally, we discuss the clinical aspects by exploring how CXCL1 levels relate to cancer staging, lymph node metastasis, patient outcomes, chemoresistance, and radioresistance.
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Affiliation(s)
- Jan Korbecki
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (J.K.); (M.B.); (D.C.)
- Department of Anatomy and Histology, Collegium Medicum, University of Zielona Góra, Zyty 28, 65-046 Zielona Góra, Poland
| | - Mateusz Bosiacki
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (J.K.); (M.B.); (D.C.)
| | - Iwona Szatkowska
- Department of Ruminants Science, Faculty of Biotechnology and Animal Husbandry, West Pomeranian University of Technology, Klemensa Janickiego 29 St., 71-270 Szczecin, Poland;
| | - Patrycja Kupnicka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (J.K.); (M.B.); (D.C.)
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (J.K.); (M.B.); (D.C.)
| | - Irena Baranowska-Bosiacka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (J.K.); (M.B.); (D.C.)
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Sassano M, Collatuzzo G, Teglia F, Boffetta P. Occupational exposure to diesel exhausts and liver and pancreatic cancers: a systematic review and meta-analysis. Eur J Epidemiol 2024; 39:241-255. [PMID: 38289519 PMCID: PMC10995068 DOI: 10.1007/s10654-024-01099-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/09/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Diesel exhaust (DE) is human carcinogen with sufficient evidence only for lung cancer. Systematic evidence on other cancer types is scarce, thus we aimed to systematically review current literature on the association between occupational DE exposure and risk of liver and pancreatic cancers. METHODS We performed a systematic literature review to identify cohort studies on occupational DE exposure and risk of cancers other than lung. We computed pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) for liver and pancreatic cancers using DerSimonian and Laird random-effects model. RESULTS Fifteen studies reporting results on pancreatic cancer and fourteen on liver cancer were included. We found a weakly increased risk of pancreatic cancer in workers exposed to DE (RR: 1.07, 95% CI: 1.00, 1.14), mainly driven by results on incidence (RR: 1.11, 95% CI: 1.02, 1.22). As for liver cancer, results were suggestive of a positive association (RR: 1.09; 95% CI: 0.99, 1.19), although a significant estimate was present in studies published before 2000 (RR: 1.41; 95% CI: 1.09, 1.82). We found no compelling evidence of publication bias. CONCLUSIONS Our findings suggest an association between occupational DE exposure and liver and pancreatic cancer. Further studies with detailed exposure assessment, environmental monitoring data, and appropriate control for confounders are warranted.
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Affiliation(s)
- Michele Sassano
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Federica Teglia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
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Collatuzzo G, Turati F, Malvezzi M, Negri E, La Vecchia C, Boffetta P. Attributable Fraction of Cancer Related to Occupational Exposure in Italy. Cancers (Basel) 2023; 15:cancers15082234. [PMID: 37190163 DOI: 10.3390/cancers15082234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Exposure to occupational carcinogens is an important and avoidable cause of cancer. We aimed to provide an evidence-based estimate of the burden of occupation-related cancers in Italy. METHODS The attributable fraction (AF) was calculated based on the counterfactual scenario of no occupational exposure to carcinogens. We included exposures classified as IARC group 1 and with reliable evidence of exposure in Italy. Relative risk estimates for selected cancers and prevalences of exposure were derived from large-scale studies. Except for mesothelioma, a 15-20-year latency period between exposure and cancer was considered. The data on cancer incidence in 2020 and mortality in 2017 in Italy were obtained from the Italian Association of Cancer Registries. RESULTS The most prevalent exposures were UV radiation (5.8%), diesel exhaust (4.3%), wood dust (2.3%) and silica dust (2.1%). Mesothelioma had the largest AF to occupational carcinogens (86.6%), followed by sinonasal cancer (11.8%) and lung cancer (3.8%). We estimated that 0.9% of cancer cases (N~3500) and 1.6% of cancer deaths (N~2800) were attributable to occupational carcinogens in Italy. Of these, about 60% were attributable to asbestos, 17.5% to diesel exhaust, followed by chromium and silica dust (7% and 5%). CONCLUSIONS Our estimates provide up-to-date quantification of the low, but persistent, burden of occupational cancers in Italy.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Federica Turati
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy
| | - Matteo Malvezzi
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, 20122 Milan, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
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Thind PS, Kumar D, Singh S, Chohan JS, Kumar R, Sharma S, Li C, Di Bona G, Forcina A, Silvestri L. Impact of Unsustainable Environmental Conditions Due to Vehicular Emissions on Associated Lifetime Cancer Risk in India: A Novel Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116459. [PMID: 35682044 PMCID: PMC9180477 DOI: 10.3390/ijerph19116459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 12/10/2022]
Abstract
The Indian Western Himalayas (IWHs) are a world famous tourist spot, and every year millions of tourists visit this area in fossil fuel-driven vehicles. Emissions from these vehicles persistently deteriorate the pristine environment of the IWHs. Therefore, in the current study, efforts were made to assess the compromised environmental conditions of Manali, Himachal Pradesh, India that resulted from the inflow of tourists and the activities undertaken by them. This study revealed that Manali could sustainably accommodate only 0.305 M tourists/month, and this threshold was reported to be crossed in the months of April, May and June. Furthermore, to augment these findings, water and ambient air samples were collected and analyzed for the presence of elemental carbon (EC) from one of the medium tourism potential regions of Manali, i.e., the Hamta glacier. The tributary receiving water from the Hamta glacier and the ambient air of the area was observed to be contaminated with 42 ± 12 ppb and 880 ± 43 µg m−3 of EC, respectively. It was observed that the inhalation and ingestion of EC-contaminated air and water could jeopardize human health due to a high lifetime cancer risk. However, without the intervention of eco-tourism in the study area, higher environmental health effects were also speculated. The observations made in this study are expected to trigger the interests of the researchers, international scientific community and regional authorities working towards the unsustainable development of the IWHs and deteriorating environmental conditions.
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Affiliation(s)
- Parteek Singh Thind
- Department of Civil Engineering, Punjab Engineering College, Chandigarh 160012, India;
| | - Deepak Kumar
- Department of Geography, Kurukshetra University, Kurukshetra 136119, India;
| | - Sandeep Singh
- Department of Civil Engineering, University Centre for Research & Development, Chandigarh University, Mohali 140413, India;
| | - Jasgurpreet Singh Chohan
- Department of Mechanical Engineering, University Centre for Research & Development, Chandigarh University, Mohali 140413, India; (J.S.C.); (R.K.)
| | - Raman Kumar
- Department of Mechanical Engineering, University Centre for Research & Development, Chandigarh University, Mohali 140413, India; (J.S.C.); (R.K.)
| | - Shubham Sharma
- Department of Mechanical Engineering, University Centre for Research & Development, Chandigarh University, Mohali 140413, India; (J.S.C.); (R.K.)
- Department of Mechanical Engineering, IK Gujral Punjab Technical University, Main Campus, Kapurthala 144603, India
- Correspondence: or (S.S.); (G.D.B.); Tel.: +91-700-923-9473 (S.S.)
| | - Changhe Li
- School of Mechanical and Automotive Engineering, Qingdao University of Technology, Qingdao 266520, China;
| | - Gianpaolo Di Bona
- Department of Civil and Industrial Engineering, University of Cassino and Southern Lazio, 03043 Cassino, Italy
- Correspondence: or (S.S.); (G.D.B.); Tel.: +91-700-923-9473 (S.S.)
| | - Antonio Forcina
- Department of Engineering, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Luca Silvestri
- Department of Engineering, University of Rome “Niccolo Cusano”, 00166 Rome, Italy;
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Guimarães RM, Dutra VGP, Ayres ARG, Garbin HBDR, Martins TCDF, Meira KC. Exposição ocupacional e câncer: uma revisão guarda-chuva. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2022. [DOI: 10.1590/2317-6369/37620pt2022v47e14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: fornecer uma visão geral das associações entre exposição ocupacional e risco da ocorrência ou morte por câncer. Métodos: esta revisão guarda-chuva da literatura utilizou as bases Medline e Web of Science. A partir de protocolo de busca, foram incluídas metanálises para diversas circunstâncias ocupacionais e cânceres selecionados que possuíssem algum nível de evidência para associação com ocupação. Resultados: foram incluídas 37 metanálises, abrangendo 18 localizações de câncer. Considerando a avaliação da heterogeneidade dos estudos, da qualidade da evidência e da força de associação, obteve-se evidências altamente sugestivas de associações entre exposição a solvente e mieloma múltiplo; amianto e câncer de pulmão; hidrocarbonetos e câncer de trato aerodigestivo superior; e estresse ocupacional e câncer colorretal. Conclusão: há evidências robustas para associar exposições ocupacionais e tipos de câncer não previstos, inicialmente, nas orientações de vigilância do câncer relacionado ao trabalho no Brasil. Permanecem lacunas sobre exposições de grande relevância, que carecem de metanálises mais consistentes, por exemplo, exposição a poeiras inorgânicas e câncer de pulmão e mesotelioma; exposição a solventes e tumores hematológicos. Evidências de câncer em outras regiões anatômicas foram menos robustas, apresentando indícios de incerteza ou viés.
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Guimarães RM, Dutra VGP, Ayres ARG, Garbin HBDR, Martins TCDF, Meira KC. Occupational exposure and cancer: an umbrella review. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2022. [DOI: 10.1590/2317-6369/37620en2022v47e14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to provide an overview of the associations between occupational exposure and risk of occurrence or death from cancer. Methods: this umbrella review used the Medline and Web of Science databases. Based on the search protocol, meta-analysis was included for several occupational circumstances and selected cancers that had some level of evidence associated with the occupation. Results: 37 meta-analysis were included, covering 18 cancer locations. By assessing the heterogeneity of studies, quality of evidence, and strength of association, results highly indicated associations between solvent exposure and multiple myeloma, asbestos and lung cancer, hydrocarbons and upper aerodigestive tract cancer, occupational stress and colorectal cancer. Conclusion: robust evidence shows an association between occupational exposures and types of cancer not initially foreseen in the guidelines for work-related cancer surveillance in Brazil. Gaps in relevant exposures require further research and more consistent meta-analysis, including: exposure to inorganic dust and lung cancer and mesothelioma; solvents and hematological tumors. Evidence of cancer in other anatomical regions was less robust, showing signs of uncertainty or bias.
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Torp-Pedersen C, Goette A, Nielsen PB, Potpara T, Fauchier L, John Camm A, Arbelo E, Boriani G, Skjoeth F, Rumsfeld J, Masoudi F, Guo Y, Joung B, Refaat MM, Kim YH, Albert CM, Piccini J, Avezum A, Lip GYH. 'Real-world' observational studies in arrhythmia research: data sources, methodology, and interpretation. A position document from European Heart Rhythm Association (EHRA), endorsed by Heart Rhythm Society (HRS), Asia-Pacific HRS (APHRS), and Latin America HRS (LAHRS). Europace 2021; 22:831-832. [PMID: 31725156 DOI: 10.1093/europace/euz210] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/24/2019] [Indexed: 02/07/2023] Open
Abstract
The field of observational studies or "real world studies" is in rapid development with many new techniques introduced and increased understanding of traditional methods. For this reason the current paper provides an overview of current methods with focus on new techniques. Some highlights can be emphasized: We provide an overview of sources of data for observational studies. There is an overview of sources of bias and confounding. Next There is an overview of causal inference techniques that are increasingly used. The most commonly used techniques for statistical modelling are reviewed with focus on the important distinction of risk versus prediction. The final section provides examples of common problems with reporting observational data.
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Affiliation(s)
| | | | | | - Tatjana Potpara
- School of Medicine, Belgrade University, Belgrade, Serbia.,Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Université de Tours, Faculté de Médecine, Tours, France
| | - Alan John Camm
- St. George's, University of London, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK
| | - Elena Arbelo
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,IDIBAPS, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Flemming Skjoeth
- Aalborg University, Health Science and Technology, Aalborg, Denmark
| | - John Rumsfeld
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Frederick Masoudi
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Yutao Guo
- Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Boyoung Joung
- Cardiology Department, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Marwan M Refaat
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Young-Hoon Kim
- Cardiology Department, Korea University Medical Center, Seoul, Republic of Korea
| | | | - Jonathan Piccini
- Duke Center for Atrial Fibrillation, Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA
| | - Alvaro Avezum
- Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital, Liverpool, UK.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Zheng F, Gonçalves FM, Abiko Y, Li H, Kumagai Y, Aschner M. Redox toxicology of environmental chemicals causing oxidative stress. Redox Biol 2020; 34:101475. [PMID: 32336668 PMCID: PMC7327986 DOI: 10.1016/j.redox.2020.101475] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 12/17/2022] Open
Abstract
Living organisms are surrounded with heavy metals such as methylmercury, manganese, cobalt, cadmium, arsenic, as well as pesticides such as deltamethrin and paraquat, or atmospheric pollutants such as quinone. Extensive studies have demonstrated a strong link between environmental pollutants and human health. Redox toxicity is proposed as one of the main mechanisms of chemical-induced pathology in humans. Acting as both a sensor of oxidative stress and a positive regulator of antioxidants, the nuclear factor erythroid 2-related factor 2 (NRF2) has attracted recent attention. However, the role NRF2 plays in environmental pollutant-induced toxicity has not been systematically addressed. Here, we characterize NRF2 function in response to various pollutants, such as metals, pesticides and atmospheric quinones. NRF2 related signaling pathways and epigenetic regulations are also reviewed.
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Affiliation(s)
- Fuli Zheng
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, China; Department of Molecular Pharmacology, Albert Einstein College of Medicine, Forchheimer 209, 1300 Morris Park Avenue, Bronx, NY, 10461, United States.
| | - Filipe Marques Gonçalves
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Forchheimer 209, 1300 Morris Park Avenue, Bronx, NY, 10461, United States
| | - Yumi Abiko
- Environmental Biology Laboratory, Faculty of Medicine, University of Tsukuba, Tsukuba, 305-8575, Japan
| | - Huangyuan Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, China.
| | - Yoshito Kumagai
- Environmental Biology Laboratory, Faculty of Medicine, University of Tsukuba, Tsukuba, 305-8575, Japan.
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Forchheimer 209, 1300 Morris Park Avenue, Bronx, NY, 10461, United States.
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Hagan DH, Kroll JH. Assessing the accuracy of low-cost optical particle sensors using a physics-based approach. ATMOSPHERIC MEASUREMENT TECHNIQUES 2020; 13:6343-6355. [PMID: 33777248 PMCID: PMC7995643 DOI: 10.5194/amt-13-6343-2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Low-cost sensors for measuring particulate matter (PM) offer the ability to understand human exposure to air pollution at spatiotemporal scales that have previously been impractical. However, such low-cost PM sensors tend to be poorly characterized, and their measurements of mass concentration can be subject to considerable error. Recent studies have investigated how individual factors can contribute to this error, but these studies are largely based on empirical comparisons and generally do not examine the role of multiple factors simultaneously. Here, we present a new physics-based framework and open-source software package (opcsim) for evaluating the ability of low-cost optical particle sensors (optical particle counters and nephelometers) to accurately characterize the size distribution and/or mass loading of aerosol particles. This framework, which uses Mie theory to calculate the response of a given sensor to a given particle population, is used to estimate the fractional error in mass loading for different sensor types given variations in relative humidity, aerosol optical properties, and the underlying particle size distribution. Results indicate that such error, which can be substantial, is dependent on the sensor technology (nephelometer vs. optical particle counter), the specific parameters of the individual sensor, and differences between the aerosol used to calibrate the sensor and the aerosol being measured. We conclude with a summary of likely sources of error for different sensor types, environmental conditions, and particle classes and offer general recommendations for the choice of calibrant under different measurement scenarios.
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Affiliation(s)
- David H. Hagan
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- QuantAQ, Inc., Somerville, MA 02143, USA
| | - Jesse H. Kroll
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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Weng CF, Chen LJ, Lin CW, Chen HM, Lee HHC, Ling TY, Hsiao FY. Association between the risk of lung cancer and influenza: A population-based nested case-control study. Int J Infect Dis 2019; 88:8-13. [PMID: 31374345 DOI: 10.1016/j.ijid.2019.07.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous animal studies have shown that certain respiratory oncoviruses can lead to tumorigenesis, especially influenza virus. However, no clinical studies other than animal studies have been conducted to test this hypothesis. OBJECTIVE To investigate the association between influenza and the risk of lung cancer using the Taiwan Cancer Registry Database (TCRD) and Taiwan's National Health Insurance Research Database (NHIRD). METHODS We identified a study cohort consisting of patients aged 40 years or above who were enrolled in the NHIRD between 1 January 2012 and 31 December 2014. Among them, we identified patients with lung cancer (cases) and their matched controls (matched by age, sex, and disease risk score (DRS) at a ratio of 1:10). Multivariate conditional logistic regression models were used to evaluate the association between exposure to influenza (timing and cumulative number) and risk of lung cancer. RESULTS We identified 32,063 cases and 320,627 matched controls. Influenza was associated with a 1.09-fold increased risk of lung cancer (aOR 1.09, 95% CI 1.04-1.14, p<0.0001). The risk of lung cancer increased slightly with cumulative exposure to influenza (1-2 exposures: aOR 1.05, 95% CI 1.00-1.11; 3-4 exposures: aOR 1.12, 95% CI 1.00-1.25; 5+ exposures: aOR 1.25, 95% CI 1.13-1.39). CONCLUSION Exposure to influenza was associated with an increased risk of lung cancer and the risk increased with cumulative exposure to influenza. However, the lack of valid information on smoking could lead to confounding, and future studies collecting patients' smoking histories are warranted to validate the association between influenza and lung cancer.
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Affiliation(s)
- Ching-Fu Weng
- Division of Pulmonary Medicine, Department of Internal Medicine, Hsinchu Cathay General Hospital, Hsinchu, Taiwan; Department and Graduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Ju Chen
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
| | - Chih-Wan Lin
- Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan
| | - Ho-Min Chen
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
| | - Henry Hsin-Chung Lee
- Department of Surgery, Hsinchu Cathay General Hospital, Hsinchu, Taiwan; Graduate Institute of Translational and Interdisciplinary Medicine, College of Health Sciences and Technology, National Central University, Taoyuan, Taiwan
| | - Thai-Yen Ling
- Department and Graduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan; School of Pharmacy, National Taiwan University, Taipei, Taiwan.
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12
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Abdul Wahab S, Hassan A, Latif MT, Vadiveel Y, Jeyabalan T, Soo CI, Abdul Hamid F, Yu-Lin AB, Hassan T. Cluster Analysis Evaluating PM2.5, Occupation Risk and Mode of Transportation as Surrogates for Air-pollution and the Impact on Lung Cancer Diagnosis and 1-Year Mortality. Asian Pac J Cancer Prev 2019; 20:1959-1965. [PMID: 31350951 PMCID: PMC6745199 DOI: 10.31557/apjcp.2019.20.7.1959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Indexed: 12/18/2022] Open
Abstract
Objective: Epidemiological studies have reported the close relationship between risk for lung cancers and air pollution in particular, for non-smoking related lung cancers. However, most studies used residential address as proxies which may not estimate accurately an individual’s air pollution exposure. Therefore, the aim of this study was to identify risk factors such as occupation and mode of transportation associated with lung cancer diagnosis and death. Methods: Subjects with lung cancer (n=514) were evaluated both by chart reviews for clinical data and interviews to determine residential address for ten years, main occupation and main mode of transportation. Annual particulate matter with diameter size less than 2.5 micrometre (PM2.5) concentration were calculated based on particulate matter with diameter size less than 10 micrometre (PM10) data recorded by Malaysian Department of Environment. Logistic regression analysis, cluster analysis and the Cox regression analysis were performed to the studied variables. Results: This study concurred with previous studies that lung adenocarcinoma were diagnosed in predominantly younger, female non-smokers compared to the other types of lung cancers. Lung adenocarcinoma subjects had annual PM2.5 that was almost twice higher than squamous cell carcinoma, small cell carcinoma and other histological subtypes (p=0.024). Independent of smoking, the κ -means cluster analysis revealed two clusters in which the high risk cluster involves occupation risk with air pollution of more than four hours per day, main transportation involving motorcycle and trucks and mean annual PM2.5 concentration of more than 30 based on residential address for more than ten years. The increased risk for the high-risk cluster was more than five times for the diagnosis of lung adenocarcinoma (OR=5.69, 95% CI=3.14-7.21, p<0.001). The hazard ratio for the high-risk cluster was 3.89 (95% CI=2.12-4.56, p=0.02) for lung adenocarcinoma mortality at 1 year. Conclusion: High-risk cluster including PM2.5, occupation risk and mode of transportation as surrogates for air-pollution exposure was identified and highly associated with lung adenocarcinoma diagnosis and 1-year mortality.
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Affiliation(s)
- Sopian Abdul Wahab
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia.
| | - Astrid Hassan
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia. ,Department of Clinical Oncology, University Technology MARA, 40450 Shah Alam, Malaysia
| | - Mohd Talib Latif
- School of Environmental and Natural Resource Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia.,Institute for Environment and Development (Lestari), Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Yasheeny Vadiveel
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia.
| | - Tamyenthini Jeyabalan
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia.
| | - Chun Ian Soo
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia.
| | - Faisal Abdul Hamid
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia.
| | - Andrea Ban Yu-Lin
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia.
| | - Tidi Hassan
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, Cheras, Malaysia.
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13
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Salhab HA, Fares MY, Khachfe HH, Khachfe HM. Epidemiological Study of Lung Cancer Incidence in Lebanon. ACTA ACUST UNITED AC 2019; 55:medicina55060217. [PMID: 31141934 PMCID: PMC6631477 DOI: 10.3390/medicina55060217] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/10/2019] [Accepted: 05/22/2019] [Indexed: 01/06/2023]
Abstract
Background and Objectives: Lung cancer (LC) is the most common cancer in the world. Developing countries in the Middle East and North Africa (MENA) region, including Lebanon, have witnessed a great increase in the incidence rates of this disease. The aim of our study is to investigate the incidence rates of lung cancer in Lebanon from 2005 to 2015 and to compare these rates to other countries from the MENA region and other regions of the world. Material and Methods: Lung cancer data for the years 2005-2015 were collected from the National Cancer Registry of Lebanon and stratified by gender and age group. Age-specific and age-standardized incidence rates were calculated and analyzed using joinpoint regression. Age-standardized incidence rates to the world population (ASR(w)) for other countries were obtained from two online databases. Results: Lung cancer ranked as the second most common cancer in Lebanon and accounted for 9.2% of all newly diagnosed cancers. Lung cancer ASR(w) showed a significantly increasing trend over the period studied for males and females. Lung cancer ASR(w) among males in Lebanon came second after Malta when compared to other MENA countries, but it was among the lowest when compared to non-MENA countries. For females, Lebanon ranked first when compared to other MENA countries but was among the lowest when compared to countries in other regions of the world. The lung cancer incidence rate increased with age in both sexes and 89.2% of patients were 50 years of age or older. Conclusion: Lebanon has the highest incidence of LC in females and the second highest for males in the MENA region. The lung cancer incidence rate is on the rise and older age groups are much more burdened by this disease than the young ones. Several risk factors, particularly smoking, play a role in increased LC incidence among the Lebanese population.
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Affiliation(s)
- Hamza A Salhab
- Faculty of Medicine, American University of Beirut, Beirut 1107, Lebanon.
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut 6573, Lebanon.
| | - Mohamad Y Fares
- Faculty of Medicine, American University of Beirut, Beirut 1107, Lebanon.
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut 6573, Lebanon.
| | - Hussein H Khachfe
- Faculty of Medicine, American University of Beirut, Beirut 1107, Lebanon.
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut 6573, Lebanon.
| | - Hassan M Khachfe
- School of Arts and Sciences, and the Lebanese Institute for Biomedical Research and Application (LIBRA), Lebanese International University (LIU), Beirut 1105, Lebanon.
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14
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Shankar A, Dubey A, Saini D, Singh M, Prasad CP, Roy S, Bharati SJ, Rinki M, Singh N, Seth T, Khanna M, Sethi N, Kumar S, Sirohi B, Mohan A, Guleria R, Rath GK. Environmental and occupational determinants of lung cancer. Transl Lung Cancer Res 2019; 8:S31-S49. [PMID: 31211104 PMCID: PMC6546634 DOI: 10.21037/tlcr.2019.03.05] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 03/11/2019] [Indexed: 12/24/2022]
Abstract
Lung cancer has become a global problem, from a rare disease to an emerging public health issue. The current data of GLOBOCAN 2018, indicates that this disease has recorded highest mortality among all types of cancer. The etiological factors of lung cancer have become more multiplex because of increasing industrialization and environmental pollution around the world, especially in India. There is a rise in incidence of lung cancer among non-smokers and this can be attributed to environmental and occupational exposure to various kinds of hazardous substances. Target mutations are high in Lung cancer among non-smokers when compared to smokers. Some developed countries have guidelines and policies for prevention and control of risk factors focusing on these issues. Intervention aiming for primary prevention can be an important and cost-effective tool in developing countries to deal with increasing incidence of lung cancer. There is a need to define high risk group among non-smokers after taking into account environmental and occupational determinants as important risk factors. Research on etiology of lung cancer and prevention provides evidence to work on global incidence and prevalence of lung cancer, and for designing cost effective lung cancer prevention strategies. Research in the area of lung cancer prevention should be considered to recognize the areas where action is required to prevent environment and occupation related lung cancer. The government and occupational health and safety organizations have taken many steps in the last few years that can help to protect workers from these exposures. But the dangers are still there, so there is a need to do more to limit these exposures around workplace. This whole situation guides us to advocate population-based intervention along with policy implementation.
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Affiliation(s)
- Abhishek Shankar
- Preventive Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Anusha Dubey
- Indian Society of Clinical Oncology, Delhi, India
| | - Deepak Saini
- Indian Society of Clinical Oncology, Delhi, India
| | - Mayank Singh
- Medical Oncology (Lab), Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Chandra Prakash Prasad
- Medical Oncology (Lab), Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Shubham Roy
- Indian Society of Clinical Oncology, Delhi, India
| | - Sachidanand Jee Bharati
- Oncoanaesthesia and Palliative Medicine, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Minakshi Rinki
- Microbiology, Swami Shraddhanand College, Delhi University, Delhi, India
| | - Navneet Singh
- Pulmonary Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Tulika Seth
- Clinical Hematology, All India Institute of Medical Sciences, Delhi, India
| | | | | | - Sunil Kumar
- Surgical Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Bhawna Sirohi
- Medical Oncology, Max Institute of Cancer Care, Delhi, India
| | - Anant Mohan
- Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, Delhi, India
| | - Randeep Guleria
- Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, Delhi, India
| | - Goura Kishor Rath
- Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
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15
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Carey RN, Fritschi L, Driscoll TR, Peters S, Glass DC, Benke G, Reid A. Interventions to Reduce Future Cancer Incidence from Diesel Engine Exhaust: What Might Work? Cancer Prev Res (Phila) 2018; 12:13-20. [PMID: 30352840 DOI: 10.1158/1940-6207.capr-18-0274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/10/2018] [Accepted: 10/15/2018] [Indexed: 11/16/2022]
Abstract
Exposure to diesel engine exhaust (DEE) contributes appreciably to the burden of occupational cancer. This study aims to estimate the potential impact of a range of interventions on the future burden of cancer from occupational exposure to DEE in Australia. The future excess fraction method, a novel method based on the lifetime risk approach, was used to model changes in the future burden of cancer among the Australian working age population exposed to DEE at work in 2012 under various intervention strategies. The interventions modeled were based on the widely accepted hierarchy of control model. At baseline, 600 (0.4%) future bladder and 4,450 (0.6%) future lung cancer cases over the lifetime of the cohort were estimated to be attributable to occupational exposure to DEE in those exposed in 2012. Up to 2,000 of these cases were estimated to be avoidable through the use of various interventions. Exhaust hoses (engineering controls) were estimated to be particularly effective. This study provides an indication of which intervention strategies may be most useful in reducing the future burden of cancer associated with occupational DEE exposure. These results show the potential effect of changing current exposure, rather than focusing on past exposures, and thus provide relevant information for policy planning.
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Affiliation(s)
- Renee N Carey
- School of Public Health, Curtin University, Bentley, Australia.
| | - Lin Fritschi
- School of Public Health, Curtin University, Bentley, Australia
| | - Timothy R Driscoll
- School of Public Health, University of Sydney, New South Wales, Australia
| | - Susan Peters
- School of Global and Population Health, University of Western Australia, Nedlands, Australia.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Deborah C Glass
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Geza Benke
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Bentley, Australia
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16
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Thomas GW, Sousan S, Tatum M, Liu X, Zuidema C, Fitzpatrick M, Koehler KA, Peters TM. Low-Cost, Distributed Environmental Monitors for Factory Worker Health. SENSORS (BASEL, SWITZERLAND) 2018; 18:E1411. [PMID: 29751534 PMCID: PMC5982698 DOI: 10.3390/s18051411] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/17/2022]
Abstract
An integrated network of environmental monitors was developed to continuously measure several airborne hazards in a manufacturing facility. The monitors integrated low-cost sensors to measure particulate matter, carbon monoxide, ozone and nitrogen dioxide, noise, temperature and humidity. The monitors were developed and tested in situ for three months in several overlapping deployments, before a full cohort of 40 was deployed in a heavy vehicle manufacturing facility for a year of data collection. The monitors collect data from each sensor and report them to a central database every 5 min. The work includes an experimental validation of the particle, gas and noise monitors. The R² for the particle sensor ranges between 0.98 and 0.99 for particle mass densities up to 300 μg/m³. The R² for the carbon monoxide sensor is 0.99 for concentrations up to 15 ppm. The R² for the oxidizing gas sensor is 0.98 over the sensitive range from 20 to 180 ppb. The noise monitor is precise within 1% between 65 and 95 dBA. This work demonstrates the capability of distributed monitoring as a means to examine exposure variability in both space and time, building an important preliminary step towards a new approach for workplace hazard monitoring.
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Affiliation(s)
- Geb W Thomas
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242, USA.
| | - Sinan Sousan
- Department of Occupational and Environmental Health, The University of Iowa, Iowa City, IA 52242, USA.
| | - Marcus Tatum
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242, USA.
| | - Xiaoxing Liu
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242, USA.
- Department of Mathematics and Computer Science, Adelphi University, New York, NY 11530, USA.
| | - Christopher Zuidema
- Department of Environmental Health & Engineering, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Mitchell Fitzpatrick
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, IA 52242, USA.
| | - Kirsten A Koehler
- Department of Environmental Health & Engineering, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Thomas M Peters
- Department of Occupational and Environmental Health, The University of Iowa, Iowa City, IA 52242, USA.
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17
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Serrier H, Sultan-Taïeb H, Luce D, Béjean S. [Respiratory cancers attributable to occupational exposures: what is the cost to society in France]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2017; 29:509-524. [PMID: 29034666 DOI: 10.3917/spub.174.0509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To estimate the social cost of respiratory cancers attributable to occupational risk factors in France in 2010. METHODS We estimated the number of cases of respiratory cancers attributable to each identified occupational risk factor according to the attributable fractions method. We also estimated direct (costs of hospital stays, drugs, outpatient care) and indirect costs (production losses) related to morbidity (absenteeism and presenteeism) and mortality (years of lost production). Production losses for paid work and unpaid domestic activities were taken into account. RESULTS The social cost of respiratory cancers (lung, larynx, sinonasal, pleural mesothelioma) attributable to exposure to asbestos, chromium, diesel engine exhaust, polycyclic aromatic hydrocarbons, painting occupations (unidentified carcinogen), crystalline silica, wood and leather dust in France in 2010 was estimated to be between €960 and 1,866 million. The cost of lung cancer represents between €804 and 1,617 million. The three risk factors with the greatest impact are asbestos (€530 to 890 million), diesel engine exhaust (€227 to 394 million), and crystalline silica (€116 to 268 million). CONCLUSION These results provide a conservative estimate of the public health and economic burden of respiratory cancers attributable to occupational risk factors from a societal perspective.
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18
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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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19
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Facteurs de risque professionnels du cancer bronchopulmonaire. Rev Mal Respir 2016; 33:444-59. [DOI: 10.1016/j.rmr.2015.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 09/22/2015] [Indexed: 11/21/2022]
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20
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Tual S, Silverman DT, Koutros S, Blair A, Sandler DP, Lebailly P, Andreotti G, Hoppin JA, Freeman LEB. Use of Dieselized Farm Equipment and Incident Lung Cancer: Findings from the Agricultural Health Study Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:611-8. [PMID: 26452295 PMCID: PMC4858397 DOI: 10.1289/ehp.1409238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 10/05/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND Diesel exhaust is a known lung carcinogen. Farmers use a variety of dieselized equipment and thus may be at increased risk of lung cancer, but farm exposures such as endotoxins may also be protective for lung cancer. OBJECTIVES We evaluated the relative risk of incident lung cancer, including histological subtype, from enrollment (1993-1997) to 2010-2011 in relation to farm equipment use in the Agricultural Health Study (AHS), a prospective cohort study of pesticide applicators and spouses in Iowa and North Carolina, USA. METHODS Farm equipment use was reported by 21,273 farmers and 29,840 spouses. Rate ratios (RRs) were estimated separately for farmers and spouses with Poisson regression models adjusted for smoking and other confounders. We conducted stratified analyses by exposure to animals or stored grain, a surrogate for endotoxin exposure. RESULTS Daily diesel tractor use (vs. no use) was positively associated with lung cancer in farmers (RR = 1.48; 95% CI: 0.87, 2.50; 35 exposed, 32 unexposed cases), particularly adenocarcinoma (RR = 3.39; 95% CI: 1.23, 9.33; 12 exposed, 7 unexposed cases). The association of adenocarcinoma with daily (vs. low/no) use of diesel tractors was stronger for farmers with no animal or stored grain exposures (RR = 6.23; 95% CI: 2.25, 17.25; 5 exposed, 18 unexposed cases) than among farmers with these exposures (RR = 1.19; 95% CI: 0.51, 2.79; 7 exposed, 27 unexposed cases) (p-interaction = 0.05). CONCLUSIONS This study provides preliminary evidence of an increased risk of lung adenocarcinoma among daily drivers of diesel tractors and suggests that exposure to endotoxins may modify the impact of diesel exposure on lung cancer risk. Confirmation of these findings with more exposed cases and more detailed exposure information is warranted. CITATION Tual S, Silverman DT, Koutros S, Blair A, Sandler DP, Lebailly P, Andreotti G, Hoppin JA, Beane Freeman LE. 2016. Use of dieselized farm equipment and incident lung cancer: findings from the Agricultural Health Study Cohort. Environ Health Perspect 124:611-618; http://dx.doi.org/10.1289/ehp.1409238.
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Affiliation(s)
- Séverine Tual
- INSERM, UMR 1086 Cancers et Préventions, Caen, France
- Université de Caen, Normandie, Caen, France
- Centre de Lutte Contre le Cancer François Baclesse, Caen, France
| | - Debra T. Silverman
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle, North Carolina, USA
| | - Pierre Lebailly
- INSERM, UMR 1086 Cancers et Préventions, Caen, France
- Université de Caen, Normandie, Caen, France
- Centre de Lutte Contre le Cancer François Baclesse, Caen, France
| | - Gabriella Andreotti
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Jane A. Hoppin
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Laura E. Beane Freeman
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
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21
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Van Maele-Fabry G, Lombaert N, Lison D. Dietary exposure to cadmium and risk of breast cancer in postmenopausal women: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2016; 86:1-13. [PMID: 26479829 DOI: 10.1016/j.envint.2015.10.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND With tobacco smoking, diet is the main source of cadmium (Cd) exposure in the general population. The carcinogenic and estrogenic activities of Cd make it a contaminant of potential concern for hormone-dependent cancers including breast cancer. Postmenopausal women represent the most appropriate population to investigate the possible impact of exogenous factors with potential estrogenic activity on breast cancer as, after menopause, their estrogenic influence is predominant. OBJECTIVES We systematically reviewed available studies on the association between dietary exposure to Cd and breast cancer focusing on postmenopausal women. A meta-analysis combining the risk estimators was performed and potential sources of between studies heterogeneity were traced. METHODS Studies were searched from MEDLINE through 31 January 2015 and from the reference lists of relevant publications. Six eligible studies published between 2012 and 2014 were identified and relative risk estimates were extracted. Meta-rate ratio estimates (mRR) were calculated according to fixed and random-effect models. Meta-analyses were performed on the whole set of data and separate analyses were conducted after stratification for study design, geographic location, use of hormone replacement therapy (HRT), tumor estrogen receptor status (ER+ or ER-), progesterone receptor status (PGR+ or PGR-), body mass index (BMI), smoker status, zinc or iron intake. RESULTS No statistically significant increased risk of breast cancer was observed when all studies were combined (mRR=1.03; 95% confidence interval [CI]: 0.89-1.19). Several sources of heterogeneity and inconsistency were identified, including smoker status, HRT use, BMI, zinc and iron intake. Inconsistency was also strongly reduced when only considering ER-, PGR-, tumors subgroups from USA and from Japan. The risks were, however, not substantially modified after stratifications. No evidence of publication bias was found. CONCLUSION The present study does not provide support for the hypothesis that dietary exposure to Cd increases the risk of breast cancer in postmenopausal women. Misclassification in dietary Cd assessment in primary studies could have biased the results towards a finding of no association.
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Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, SSS/IREC/LTAP (Louvain Center for Toxicology and Applied Pharmacology), Avenue E. Mounier 53, bte B1.52.12, B-1200 Brussels, Belgium.
| | - Noömi Lombaert
- International Zinc/Cadmium Association, Avenue de Tervueren 168/Box 4, B-1150 Brussels, Belgium.
| | - Dominique Lison
- Université catholique de Louvain, SSS/IREC/LTAP (Louvain Center for Toxicology and Applied Pharmacology), Avenue E. Mounier 53, bte B1.52.12, B-1200 Brussels, Belgium.
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22
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Sousan S, Koehler K, Thomas G, Park JH, Hillman M, Halterman A, Peters TM. Inter-comparison of Low-cost Sensors for Measuring the Mass Concentration of Occupational Aerosols. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2016; 50:462-473. [PMID: 28867868 PMCID: PMC5580827 DOI: 10.1080/02786826.2016.1162901] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Low-cost sensors are effective for measuring the mass concentration of ambient aerosols and secondhand smoke in homes, but their use at concentrations relevant to occupational settings has not been demonstrated. We measured the concentrations of four aerosols (salt, Arizona road dust, welding fume, and diesel exhaust) with three types of low-cost sensors (a DC1700 from Dylos and two commodity sensors from Sharp), an aerosol photometer, and reference instruments at concentrations up to 6500 μg/m3. Raw output was used to assess sensor precision and develop equations to compute mass concentrations. EPA and NIOSH protocols were used to assess the mass concentrations estimated with low-cost sensors compared to reference instruments. The detection efficiency of the DC1700 ranged from 0.04% at 0.1 μm to 108% at 5 μm, as expected, although misclassification of fine and coarse particles was observed. The raw output of the DC1700 had higher precision (lower coefficient of variation, CV = 7.4%) than that of the two sharp devices (CV = 25% and 17%), a finding attributed to differences in manufacturer calibration. Aerosol type strongly influenced sensor response, indicating the need for on-site calibration to convert sensor output to mass concentration. Once calibrated, however, the mass concentration estimated with low-cost sensors was highly correlated with that of reference instruments (R2=0.99). These results suggest that the DC1700 and Sharp sensors are useful in estimating aerosol mass concentration for aerosols at concentrations relevant to the workplace.
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Affiliation(s)
- Sinan Sousan
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, USA
| | - Kirsten Koehler
- Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Geb Thomas
- Department of Mechanical and Industrial Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Jae Hong Park
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, USA
| | - Michael Hillman
- Department of Mechanical and Industrial Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Andrew Halterman
- Department of Chemical and Biochemical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Thomas M. Peters
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, USA
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Morphology, chemical composition and nanostructure of single carbon-rich particles studied by transmission electron microscopy: source apportionment in workroom air of aluminium smelters. Anal Bioanal Chem 2015; 408:1151-8. [DOI: 10.1007/s00216-015-9217-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/17/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
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Occupational Exposure to Diesel Motor Exhaust and Lung Cancer: A Dose-Response Relationship Hidden by Asbestos Exposure Adjustment? The ICARE Study. J Cancer Epidemiol 2015; 2015:879302. [PMID: 26425123 PMCID: PMC4573883 DOI: 10.1155/2015/879302] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/13/2015] [Accepted: 05/14/2015] [Indexed: 01/09/2023] Open
Abstract
Background. In a French large population-based case-control study we investigated the dose-response relationship between lung cancer and occupational exposure to diesel motor exhaust (DME), taking into account asbestos exposure. Methods. Exposure to DME was assessed by questionnaire. Asbestos was taken into account through a global indicator of exposure to occupational carcinogens or by a specific JEM. Results. We found a crude dose response relationship with most of the indicators of DME exposure, including with the cumulative exposure index. All results were affected by adjustment for asbestos exposure. The dose response relationships between DME and lung cancer were observed among subjects never exposed to asbestos. Conclusions. Exposure to DME and to asbestos is frequently found among the same subjects, which may explain why dose-response relationships in previous studies that adjusted for asbestos exposure were inconsistent.
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Winters N, Goldberg MS, Hystad P, Villeneuve PJ, Johnson KC. Exposure to ambient air pollution in Canada and the risk of adult leukemia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 526:153-176. [PMID: 25955692 DOI: 10.1016/j.scitotenv.2015.03.149] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/13/2015] [Accepted: 03/23/2015] [Indexed: 06/04/2023]
Abstract
There is a paucity of studies investigating adult leukemia and air pollution. To address this gap, we analyzed data from a Canadian population-based case-control study conducted in 1994-1997. Cases were 1064 adults with incident leukemia and controls were 5039 healthy adults. We used data from satellites and fixed-site monitoring stations to estimate residential concentrations of NO2 and fine particulate matter (PM2.5) for the period prior to diagnosis, starting in 1975 and ending in 1994. We modeled the average annual exposure of each subject. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated using logistic regression, adjusted for age, gender, province, smoking, education, body mass index, income, and self-reported exposures to ionizing radiation and benzene. We found an 'n-shaped' response function between exposure to NO2 and all forms of leukemia: from the tenth percentile to the median (4.51 to 14.66 ppb), the OR was 1.20; 95% CI: 0.97-1.48 and from the 75th percentile to the 90th (22.75 to 29.7 ppb), the OR was 0.79; 95% CI 0.68-0.93. For PM2.5 we found a response function consistent with a linear model, with an OR per 10 μg/m(3) of 0.97 (95% CI 0.75-1.26). For chronic lymphocytic leukemia we found response functions that were consistent with a simple linear model, with an OR per 5 ppb of NO2 of 0.93 (95% CI 0.86-1.00) and an OR per 10 μg/m(3) of PM2.5 of 0.62 (95% CI 0.42-0.93). In summary, for chronic lymphocytic leukemia we found no evidence of an association with air pollution and with all forms of leukemia we found weak evidence of an association only at low concentrations of NO2. It is possible that these inconsistent results may have arisen because of unaccounted urban/rural differences or possibly from a selection effect, especially among controls.
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Affiliation(s)
- Nicholas Winters
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Ave. W., R4.29, Montreal, Quebec H3A 1A1, Canada.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Kenneth C Johnson
- Science Integration Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Koh DH, Kong HJ, Oh CM, Jung KW, Park D, Won YJ. Lung cancer risk in professional drivers in Korea: A population-based proportionate cancer incidence ratio study. J Occup Health 2015; 57:324-30. [PMID: 25891350 DOI: 10.1539/joh.14-0222-oa] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Professional drivers are exposed to diesel engine exhaust and outdoor air pollution while driving. Diesel engine exhaust and outdoor air pollution are known carcinogens causing lung cancer. However, previous epidemiological studies examining lung cancer risk in professional drivers have not shown a consistent association. In the present study, we evaluated lung cancer risk among Korean professional drivers. METHODS Subjects consisted of male drivers aged 30-59 registered in the Korea Central Cancer Registry for lung cancer between 1999 and 2011. Proportionate cancer incidence ratios (PCIRs) for lung cancer were calculated and indirectly age standardized with the male general population. Additional PCIRs were calculated by indirectly adjusting for the effect of cigarette smoking. RESULTS The PCIR for lung cancer in professional drivers during the study period increased significantly (1.20, 95% CI: 1.13-1.26). The increased risk was generally consistent throughout study years and age categories. Adjusting for the effect of cigarette smoking did not change the significance of the associations (1.09, 95% CI: 1.03-1.15). CONCLUSIONS Our findings support an association between lung cancer and driver jobs in the Korean male population. However, the association should be further evaluated in a study with a longitudinal design and a quantitative exposure assessment.
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Affiliation(s)
- Dong-Hee Koh
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University
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Claxton LD. The history, genotoxicity, and carcinogenicity of carbon-based fuels and their emissions. Part 3: Diesel and gasoline. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2015; 763:30-85. [DOI: 10.1016/j.mrrev.2014.09.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/10/2014] [Accepted: 09/12/2014] [Indexed: 11/26/2022]
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Habert C, Garnier R. [Health effects of diesel exhaust: a state of the art]. Rev Mal Respir 2014; 32:138-54. [PMID: 25765120 DOI: 10.1016/j.rmr.2014.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 07/25/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This review presents the state of knowledge regarding the acute and chronic toxicity of diesel engine exhaust in humans. STATE OF ART The health effects of diesel engine exhaust, which is a complex mixture of gas and particulate matter (ultrafine and fine particles), are mainly irritation of the respiratory tract and carcinogenicity. They may also facilitate the development of respiratory allergies. A recent reassessment by the International Agency for Research on Cancer concluded that there is sufficient evidence of a causal association between exposure to diesel engine exhaust and lung cancer. PERSPECTIVES The epidemiologic data collected during the last two decades also show limited evidence of increased risks of bladder cancer, as well as of chronic obstructive pulmonary disease in diesel engine exhaust exposed workers. Both experimental and epidemiological studies have involved the effect of emissions from traditional diesel engine technology. Major developments in this technology have occurred recently and the toxicity of emissions from these new engines is still to be characterized. CONCLUSION Further studies are needed to explore the link between diesel engine exhaust exposure and the risks of bladder cancer, as well as of chronic obstructive pulmonary disease and respiratory allergies. Research is also needed to get more information about the toxicity of the new diesel technology emissions.
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Affiliation(s)
- C Habert
- Société nationale des chemins de fer, cellule de toxicologie, département prévention et santé, 44, rue de Rome, 75008 Paris, France.
| | - R Garnier
- Société nationale des chemins de fer, cellule de toxicologie, département prévention et santé, 44, rue de Rome, 75008 Paris, France; Centre antipoison de Paris, groupe hospitalier Lariboisière-Saint Louis, Assistance publique-Hôpitaux de Paris, Paris, France
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Van Maele-Fabry G, Hoet P, Lison D. Parental occupational exposure to pesticides as risk factor for brain tumors in children and young adults: a systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2013; 56:19-31. [PMID: 23567326 DOI: 10.1016/j.envint.2013.02.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 02/19/2013] [Accepted: 02/22/2013] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To examine the potential association between parental occupational exposure to pesticides and the occurrence of brain tumors in children and young adults. METHODS Studies identified from a MEDLINE search through 15 January 2013 and from the reference lists of identified publications were submitted to a systematic review and meta-analysis. Relative risk estimates were extracted from 20 studies published between 1974 and 2010. Most of the retrieved studies involved farm/agricultural jobs. Summary ratio estimates (SR) were calculated according to fixed and random-effect meta-analysis models. Separate analyses were conducted after stratification for study design, exposure parameters, disease definition, geographic location and age at diagnosis. RESULTS Statistically significant associations were observed for parents potentially exposed to pesticides in occupational settings and the occurrence of brain tumor in their offspring after combining all case-control studies (summary odds ratio [SOR]: 1.30; 95%: 1.11, 1.53) or all cohort studies (summary rate ratio [SRR]: 1.53; 95% CI: 1.20, 1.95). Significantly increased risks were seen for prenatal exposure windows, for either exposed parent, for exposure defined as to pesticides as well as by occupational/industry title, for astroglial brain tumors and after combining case-control studies from North America or cohort studies from Europe. CONCLUSIONS This meta-analysis supports an association between parental occupational exposure to pesticides and brain tumors in children and young adults, and adds to the evidence leading to the recommendation of minimizing (parental) occupational exposure to pesticides. These results must, however, be interpreted with caution because the impact of work-related factors others than pesticide exposure is not known.
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Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, SSS/IREC/LTAP Louvain Center for Toxicology and Applied Pharmacology, Avenue E. Mounier 52, bte B1.52.12, B-1200 Brussels, Belgium.
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Salvilla SA, Thusu S, Panesar SS. Analysing the benefits of laparoscopic hernia repair compared to open repair: A meta-analysis of observational studies. J Minim Access Surg 2012; 8:111-7. [PMID: 23248436 PMCID: PMC3523446 DOI: 10.4103/0972-9941.103107] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 11/21/2010] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The purpose of this study is to compare the difference of incidence of post-operative complications, operative time, length of stay and recurrence of patients undergoing laparoscopic or open repair of their ventral/incisional hernia a meta-analytic technique for observational studies. MATERIALS AND METHODS A literature search was performed using Medline, PubMed, Embase and Cochrane databases for studies reported between 1998 and 2009 comparing laparoscopic and open surgery for the treatment of ventral (incisional) hernia. This meta-analysis of all the observational studies compared the post-operative complications recurrence rate and length of stay. The random effects model was used. Sensitivity and heterogeneity were analysed. RESULTS Analysis of 15 observational studies comprising 2452 patients qualified for meta-analysis according to the study's inclusion criteria. Laparoscopic surgery was attempted in 1067 out of 2452. The results showed that the length of stay (odds ratio [OR], - 1.00; 95% confidence interval [CI], - 1.09 to - 0.91; P < 0.00001) and operative time (OR, 59.33; 95% CI, 58.55 to 60.11; P < 0.00001) was significantly lower in the laparoscopic group. The results also showed that there was a significant reduction in the formation of abscesses (OR, 0.38; 95% CI, 0.16 to 0.92; P = 0.03) and wound infections (OR, 0.49; 95% CI, 0.29 to 0.82; P = 0.007) post-operatively. There is a trend which indicates that the recurrence of the hernia using laparoscopic repair versus open repair was overall lower with the laparoscopic repair (OR, 0.48; 95% CI, 0.22 to 1.04; P = 0.06), however, this was not significant. CONCLUSION Laparoscopic incisional hernia repair was associated with a reduced length of stay, operative time and lower incidence of abscess and wound infection post-operatively. This study also highlights the benefit of using observational studies as a form of research and its value as a tool in answering questions where large sample sizes of patient groups would be impossible to accumulate in a reasonable length of time.
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Affiliation(s)
- Sarah A Salvilla
- Department of General Surgery, Charing Cross Hospital, Imperial College NHS Trust, London, Fulham Palace Road, London, W6 8RF, United Kingdom
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Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C, Buchbinder R, Bull F, Burnett RT, Byers TE, Calabria B, Carapetis J, Carnahan E, Chafe Z, Charlson F, Chen H, Chen JS, Cheng ATA, Child JC, Cohen A, Colson KE, Cowie BC, Darby S, Darling S, Davis A, Degenhardt L, Dentener F, Des Jarlais DC, Devries K, Dherani M, Ding EL, Dorsey ER, Driscoll T, Edmond K, Ali SE, Engell RE, Erwin PJ, Fahimi S, Falder G, Farzadfar F, Ferrari A, Finucane MM, Flaxman S, Fowkes FGR, Freedman G, Freeman MK, Gakidou E, Ghosh S, Giovannucci E, Gmel G, Graham K, Grainger R, Grant B, Gunnell D, Gutierrez HR, Hall W, Hoek HW, Hogan A, Hosgood HD, Hoy D, Hu H, Hubbell BJ, Hutchings SJ, Ibeanusi SE, Jacklyn GL, Jasrasaria R, Jonas JB, Kan H, Kanis JA, Kassebaum N, Kawakami N, Khang YH, Khatibzadeh S, Khoo JP, Kok C, Laden F, Lalloo R, Lan Q, Lathlean T, Leasher JL, Leigh J, Li Y, Lin JK, Lipshultz SE, London S, Lozano R, Lu Y, Mak J, Malekzadeh R, Mallinger L, Marcenes W, March L, Marks R, Martin R, McGale P, McGrath J, Mehta S, Mensah GA, Merriman TR, Micha R, Michaud C, Mishra V, Mohd Hanafiah K, Mokdad AA, Morawska L, Mozaffarian D, Murphy T, Naghavi M, Neal B, Nelson PK, Nolla JM, Norman R, Olives C, Omer SB, Orchard J, Osborne R, Ostro B, Page A, Pandey KD, Parry CDH, Passmore E, Patra J, Pearce N, Pelizzari PM, Petzold M, Phillips MR, Pope D, Pope CA, Powles J, Rao M, Razavi H, Rehfuess EA, Rehm JT, Ritz B, Rivara FP, Roberts T, Robinson C, Rodriguez-Portales JA, Romieu I, Room R, Rosenfeld LC, Roy A, Rushton L, Salomon JA, Sampson U, Sanchez-Riera L, Sanman E, Sapkota A, Seedat S, Shi P, Shield K, Shivakoti R, Singh GM, Sleet DA, Smith E, Smith KR, Stapelberg NJC, Steenland K, Stöckl H, Stovner LJ, Straif K, Straney L, Thurston GD, Tran JH, Van Dingenen R, van Donkelaar A, Veerman JL, Vijayakumar L, Weintraub R, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams W, Wilson N, Woolf AD, Yip P, Zielinski JM, Lopez AD, Murray CJL, Ezzati M, AlMazroa MA, Memish ZA. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2224-60. [PMID: 23245609 PMCID: PMC4156511 DOI: 10.1016/s0140-6736(12)61766-8] [Citation(s) in RCA: 7224] [Impact Index Per Article: 602.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4-1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Stephen S Lim
- Institute for Health Metrics and Evaluation, Seattle, WA 98121, USA.
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Garshick E, Laden F, Hart JE, Davis ME, Eisen EA, Smith TJ. Lung cancer and elemental carbon exposure in trucking industry workers. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1301-6. [PMID: 22739103 PMCID: PMC3440130 DOI: 10.1289/ehp.1204989] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 05/31/2012] [Indexed: 05/06/2023]
Abstract
BACKGROUND Diesel exhaust has been considered to be a probable lung carcinogen based on studies of occupationally exposed workers. Efforts to define lung cancer risk in these studies have been limited in part by lack of quantitative exposure estimates. OBJECTIVE We conducted a retrospective cohort study to assess lung cancer mortality risk among U.S. trucking industry workers. Elemental carbon (EC) was used as a surrogate of exposure to engine exhaust from diesel vehicles, traffic, and loading dock operations. METHODS Work records were available for 31,135 male workers employed in the unionized U.S. trucking industry in 1985. A statistical model based on a national exposure assessment was used to estimate historical work-related exposures to EC. Lung cancer mortality was ascertained through the year 2000, and associations with cumulative and average EC were estimated using proportional hazards models. RESULTS Duration of employment was inversely associated with lung cancer risk consistent with a healthy worker survivor effect and a cohort composed of prevalent hires. After adjusting for employment duration, we noted a suggestion of a linear exposure-response relationship. For each 1,000-µg/m³ months of cumulative EC, based on a 5-year exposure lag, the hazard ratio (HR) was 1.07 [95% confidence interval (CI): 0.99, 1.15] with a similar association for a 10-year exposure lag [HR = 1.09 (95% CI: 0.99, 1.20)]. Average exposure was not associated with relative risk. CONCLUSIONS Lung cancer mortality in trucking industry workers increased in association with cumulative exposure to EC after adjusting for negative confounding by employment duration.
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Affiliation(s)
- Eric Garshick
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA 02132, USA.
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Lightfoot NE, Berriault CJ. Mortality and cancer incidence in a copper-zinc cohort. Workplace Health Saf 2012; 60:223-33. [PMID: 22587698 DOI: 10.1177/216507991206000506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 11/07/2011] [Indexed: 11/16/2022]
Abstract
Previous studies of copper-zinc workers have primarily observed significant increases in lung and other respiratory cancers. This study concurrently examined cancer incidence and cause-specific mortality for a cohort of workers at a copper-zinc producer in Ontario, Canada, from 1964 to 2005. Significant elevations in lung cancer incidence were observed for males in the overall cohort (standardized incidence ratio [SIR] = 124, 95% confidence interval [CI] = 102-150) and for surface mine (SIR = 272, 95% CI = 124-517), concentrator (SIR = 191, 95% CI = 102-327), and central maintenance (SIR = 214, 95% CI = 125-343) employees. Significant elevations of non-Hodgkin's lymphoma incidence were observed for male underground mine employees (SIR = 232, 95% CI = 111-426). Occupational etiology cannot be ascertained with the current exploratory study design. Future studies could (1) incorporate exposure assessment for subgroups within the existing cohort and (2) determine the efficacy of wellness programs in partnership with the local health unit.
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Affiliation(s)
- Nancy E Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.
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Brown T, Darnton A, Fortunato L, Rushton L. Occupational cancer in Britain. Respiratory cancer sites: larynx, lung and mesothelioma. Br J Cancer 2012; 107 Suppl 1:S56-70. [PMID: 22710680 PMCID: PMC3384016 DOI: 10.1038/bjc.2012.119] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Terry Brown
- Institute of Environment and Health, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
| | - Andy Darnton
- Health and Safety Executive, Epidemiology Unit, Redgrave Court, Merton Road Bootle L20 7HS
| | - Lea Fortunato
- Department of Epidemiology and Biostatistics, School of Public Health and MRC-HPA Centre for Environment and Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 3PG, UK
| | - Lesley Rushton
- Department of Epidemiology and Biostatistics, School of Public Health and MRC-HPA Centre for Environment and Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 3PG, UK
| | - with the British Occupational Cancer Burden Study Group
- Institute of Environment and Health, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
- Health and Safety Executive, Epidemiology Unit, Redgrave Court, Merton Road Bootle L20 7HS
- Department of Epidemiology and Biostatistics, School of Public Health and MRC-HPA Centre for Environment and Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 3PG, UK
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Abstract
Although only a relatively small proportion of cancer is attributable to occupational exposure to carcinogenic agents, the estimated number of deaths due to occupational cancer is high when compared to other deaths due to work-related ill health and injury. However, risk from occupational exposure to carcinogens can be minimised through proportionate but effective risk management. The Health and Safety Executive (HSE) is the regulator of workplace health and safety in Great Britain. As part of its aim to reduce ill health arising from failures to control properly exposure to hazards at work, HSE commissioned the research presented elsewhere in this supplement to enable it to identify priorities for preventing occupational cancer. The research has shown that occupational cancer remains a key health issue and that low-level exposure of a large number of workers to carcinogens is important. The finding that a small number of carcinogens have been responsible for the majority of the burden of occupational cancer provides key evidence in the development of priorities for significant reduction of occupational cancer. Although the research presented in this supplement reflects the consequences of past exposures to carcinogens, occupational cancer remains a problem. The potential for exposure to the agents considered in this research is still present in the workplace and the findings are relevant to prevention of future disease. In this article, the principle approaches for risk reduction are described. It provides supporting information on some of the initiatives already being undertaken, or those being put in place, to reduce occupational cancer in Great Britain. The need also for systematic collection of exposure information and the importance of raising awareness and changing behaviours are discussed.
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Affiliation(s)
- Yiqun Chen
- Corporate Health Science and Specialists Division, Chief Scientific Adviser's Group, Health and Safety Executive, Redgrave Court, Merton Road, Bootle, Merseyside L20 7HS, UK.
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Attfield MD, Schleiff PL, Lubin JH, Blair A, Stewart PA, Vermeulen R, Coble JB, Silverman DT. The Diesel Exhaust in Miners study: a cohort mortality study with emphasis on lung cancer. J Natl Cancer Inst 2012; 104:869-83. [PMID: 22393207 PMCID: PMC3373218 DOI: 10.1093/jnci/djs035] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 10/12/2011] [Accepted: 10/21/2011] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Current information points to an association between diesel exhaust exposure and lung cancer and other mortality outcomes, but uncertainties remain. METHODS We undertook a cohort mortality study of 12 315 workers exposed to diesel exhaust at eight US non-metal mining facilities. Historical measurements and surrogate exposure data, along with study industrial hygiene measurements, were used to derive retrospective quantitative estimates of respirable elemental carbon (REC) exposure for each worker. Standardized mortality ratios and internally adjusted Cox proportional hazard models were used to evaluate REC exposure-associated risk. Analyses were both unlagged and lagged to exclude recent exposure such as that occurring in the 15 years directly before the date of death. RESULTS Standardized mortality ratios for lung cancer (1.26, 95% confidence interval [CI] = 1.09 to 1.44), esophageal cancer (1.83, 95% CI = 1.16 to 2.75), and pneumoconiosis (12.20, 95% CI = 6.82 to 20.12) were elevated in the complete cohort compared with state-based mortality rates, but all-cause, bladder cancer, heart disease, and chronic obstructive pulmonary disease mortality were not. Differences in risk by worker location (ever-underground vs surface only) initially obscured a positive diesel exhaust exposure-response relationship with lung cancer in the complete cohort, although it became apparent after adjustment for worker location. The hazard ratios (HRs) for lung cancer mortality increased with increasing 15-year lagged cumulative REC exposure for ever-underground workers with 5 or more years of tenure to a maximum in the 640 to less than 1280 μg/m(3)-y category compared with the reference category (0 to <20 μg/m(3)-y; 30 deaths compared with eight deaths of the total of 93; HR = 5.01, 95% CI = 1.97 to 12.76) but declined at higher exposures. Average REC intensity hazard ratios rose to a plateau around 32 μg/m(3). Elevated hazard ratios and evidence of exposure-response were also seen for surface workers. The association between diesel exhaust exposure and lung cancer risk remained after inclusion of other work-related potentially confounding exposures in the models and were robust to alternative approaches to exposure derivation. CONCLUSIONS The study findings provide further evidence that exposure to diesel exhaust increases risk of mortality from lung cancer and have important public health implications.
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Hesterberg TW, Long CM, Bunn WB, Lapin CA, McClellan RO, Valberg PA. Health effects research and regulation of diesel exhaust: an historical overview focused on lung cancer risk. Inhal Toxicol 2012; 24 Suppl 1:1-45. [PMID: 22663144 PMCID: PMC3423304 DOI: 10.3109/08958378.2012.691913] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 05/02/2012] [Accepted: 05/03/2012] [Indexed: 11/13/2022]
Abstract
The mutagenicity of organic solvent extracts from diesel exhaust particulate (DEP), first noted more than 55 years ago, initiated an avalanche of diesel exhaust (DE) health effects research that now totals more than 6000 published studies. Despite an extensive body of results, scientific debate continues regarding the nature of the lung cancer risk posed by inhalation of occupational and environmental DE, with much of the debate focused on DEP. Decades of scientific scrutiny and increasingly stringent regulation have resulted in major advances in diesel engine technologies. The changed particulate matter (PM) emissions in "New Technology Diesel Exhaust (NTDE)" from today's modern low-emission, advanced-technology on-road heavy-duty diesel engines now resemble the PM emissions in contemporary gasoline engine exhaust (GEE) and compressed natural gas engine exhaust more than those in the "traditional diesel exhaust" (TDE) characteristic of older diesel engines. Even with the continued publication of epidemiologic analyses of TDE-exposed populations, this database remains characterized by findings of small increased lung cancer risks and inconsistent evidence of exposure-response trends, both within occupational cohorts and across occupational groups considered to have markedly different exposures (e.g. truckers versus railroad shopworkers versus underground miners). The recently published National Institute for Occupational Safety and Health (NIOSH)-National Cancer Institute (NCI) epidemiologic studies of miners provide some of the strongest findings to date regarding a DE-lung cancer association, but some inconsistent exposure-response findings and possible effects of bias and exposure misclassification raise questions regarding their interpretation. Laboratory animal studies are negative for lung tumors in all species, except for rats under lifetime TDE-exposure conditions with durations and concentrations that lead to "lung overload." The species specificity of the rat lung response to overload, and its occurrence with other particle types, is now well-understood. It is thus generally accepted that the rat bioassay for inhaled particles under conditions of lung overload is not predictive of human lung cancer hazard. Overall, despite an abundance of epidemiologic and experimental data, there remain questions as to whether TDE exposure causes increased lung cancers in humans. An abundance of emissions characterization data, as well as preliminary toxicological data, support NTDE as being toxicologically distinct from TDE. Currently, neither epidemiologic data nor animal bioassay data yet exist that directly bear on NTDE carcinogenic potential. A chronic bioassay of NTDE currently in progress will provide data on whether NTDE poses a carcinogenic hazard, but based on the significant reductions in PM mass emissions and the major changes in PM composition, it has been hypothesized that NTDE has a low carcinogenic potential. When the International Agency for Research on Cancer (IARC) reevaluates DE (along with GEE and nitroarenes) in June 2012, it will be the first authoritative body to assess DE carcinogenic health hazards since the emergence of NTDE and the accumulation of data differentiating NTDE from TDE.
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Abstract
Previous studies of copper-zinc workers have primarily observed significant increases in lung and other respiratory cancers. This study concurrently examined cancer incidence and cause-specific mortality for a cohort of workers at a copper-zinc producer in Ontario, Canada, from 1964 to 2005. Significant elevations in lung cancer incidence were observed for males in the overall cohort (standardized incidence ratio [SIR] = 124, 95% confidence interval [CI] = 102-150) and for surface mine (SIR = 272, 95% CI = 124-517), concentrator (SIR = 191, 95% CI = 102-327), and central maintenance (SIR = 214, 95% CI = 125-343) employees. Significant elevations of non-Hodgkin's lymphoma incidence were observed for male underground mine employees (SIR = 232, 95% CI = 111-426). Occupational etiology cannot be ascertained with the current exploratory study design. Future studies could (1) incorporate exposure assessment for subgroups within the existing cohort and (2) determine the efficacy of wellness programs in partnership with the local health unit.
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Affiliation(s)
- Nancy E Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.
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De Matteis S, Consonni D, Lubin JH, Tucker M, Peters S, Vermeulen RC, Kromhout H, Bertazzi PA, Caporaso NE, Pesatori AC, Wacholder S, Landi MT. Impact of occupational carcinogens on lung cancer risk in a general population. Int J Epidemiol 2012; 41:711-21. [PMID: 22467291 DOI: 10.1093/ije/dys042] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Exposure to occupational carcinogens is an important preventable cause of lung cancer. Most of the previous studies were in highly exposed industrial cohorts. Our aim was to quantify lung cancer burden attributable to occupational carcinogens in a general population. METHODS We applied a new job-exposure matrix (JEM) to translate lifetime work histories, collected by personal interview and coded into standard job titles, into never, low and high exposure levels for six known/suspected occupational lung carcinogens in the Environment and Genetics in Lung cancer Etiology (EAGLE) population-based case-control study, conducted in Lombardy region, Italy, in 2002-05. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in men (1537 cases and 1617 controls), by logistic regression adjusted for potential confounders, including smoking and co-exposure to JEM carcinogens. The population attributable fraction (PAF) was estimated as impact measure. RESULTS Men showed an increased lung cancer risk even at low exposure to asbestos (OR: 1.76; 95% CI: 1.42-2.18), crystalline silica (OR: 1.31; 95% CI: 1.00-1.71) and nickel-chromium (OR: 1.18; 95% CI: 0.90-1.53); risk increased with exposure level. For polycyclic aromatic hydrocarbons, an increased risk (OR: 1.64; 95% CI: 0.99-2.70) was found only for high exposures. The PAFs for any exposure to asbestos, silica and nickel-chromium were 18.1, 5.7 and 7.0%, respectively, equivalent to an overall PAF of 22.5% (95% CI: 14.1-30.0). This corresponds to about 1016 (95% CI: 637-1355) male lung cancer cases/year in Lombardy. CONCLUSIONS These findings support the substantial role of selected occupational carcinogens on lung cancer burden, even at low exposures, in a general population.
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Affiliation(s)
- Sara De Matteis
- Unit of Epidemiology, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and EPOCA Research Centre, Department of Occupational and Environmental Health, Università degli Studi di Milano, Milan, Italy
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Silverman DT, Samanic CM, Lubin JH, Blair AE, Stewart PA, Vermeulen R, Coble JB, Rothman N, Schleiff PL, Travis WD, Ziegler RG, Wacholder S, Attfield MD. The Diesel Exhaust in Miners study: a nested case-control study of lung cancer and diesel exhaust. J Natl Cancer Inst 2012; 104:855-68. [PMID: 22393209 PMCID: PMC3369553 DOI: 10.1093/jnci/djs034] [Citation(s) in RCA: 236] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Most studies of the association between diesel exhaust exposure and lung cancer suggest
a modest, but consistent, increased risk. However, to our knowledge, no study to date
has had quantitative data on historical diesel exposure coupled with adequate sample
size to evaluate the exposure–response relationship between diesel exhaust and
lung cancer. Our purpose was to evaluate the relationship between quantitative estimates
of exposure to diesel exhaust and lung cancer mortality after adjustment for smoking and
other potential confounders. Methods We conducted a nested case–control study in a cohort of 12 315 workers in
eight non-metal mining facilities, which included 198 lung cancer deaths and 562
incidence density–sampled control subjects. For each case subject, we selected up
to four control subjects, individually matched on mining facility, sex, race/ethnicity,
and birth year (within 5 years), from all workers who were alive before the day the case
subject died. We estimated diesel exhaust exposure, represented by respirable elemental
carbon (REC), by job and year, for each subject, based on an extensive retrospective
exposure assessment at each mining facility. We conducted both categorical and
continuous regression analyses adjusted for cigarette smoking and other potential
confounding variables (eg, history of employment in high-risk occupations for lung
cancer and a history of respiratory disease) to estimate odds ratios (ORs) and 95%
confidence intervals (CIs). Analyses were both unlagged and lagged to exclude recent
exposure such as that occurring in the 15 years directly before the date of death (case
subjects)/reference date (control subjects). All statistical tests were two-sided. Results We observed statistically significant increasing trends in lung cancer risk with
increasing cumulative REC and average REC intensity. Cumulative REC, lagged 15 years,
yielded a statistically significant positive gradient in lung cancer risk overall
(Ptrend = .001); among heavily exposed workers (ie, above the median of
the top quartile [REC ≥ 1005 μg/m3-y]), risk was approximately three
times greater (OR = 3.20, 95% CI = 1.33 to 7.69) than that among workers
in the lowest quartile of exposure. Among never smokers, odd ratios were 1.0, 1.47 (95%
CI = 0.29 to 7.50), and 7.30 (95% CI = 1.46 to 36.57) for workers with
15-year lagged cumulative REC tertiles of less than 8, 8 to less than 304, and 304
μg/m3-y or more, respectively. We also observed an interaction between
smoking and 15-year lagged cumulative REC (Pinteraction = .086) such that the effect of each of these exposures
was attenuated in the presence of high levels of the other. Conclusion Our findings provide further evidence that diesel exhaust exposure may cause lung
cancer in humans and may represent a potential public health burden.
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Affiliation(s)
- Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20816, USA.
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Risk of lung cancer and occupational history: results of a French population-based case-control study, the ICARE study. J Occup Environ Med 2012; 53:1068-77. [PMID: 21866050 DOI: 10.1097/jom.0b013e318229ab2e] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To assess the risk of lung cancer associated with occupations and industries. METHODS A French population-based case-control study included 2923 cases and 3555 controls. Lifelong occupational history was collected. Two lists of occupations known (A) or suspected (B) to be associated with lung cancer were used. Occupations and industries not included in these lists were also explored. RESULTS Among men, the smoking-adjusted odds ratio was 1.97 for list A (attributable fraction: 12.3%), 1.4 for list B (due especially to carpenters/joiners and transport workers). Among unlisted occupations, excess risks were found for welders, plumbers, and several construction crafts. Odds ratios among women were elevated for list A, list B (due especially to launderers/dry cleaners), cleaners and hairdressers. CONCLUSIONS These results confirm the role of known occupations and give insight into new occupational risk factors among men and women.
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Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med 2011. [PMID: 22054876 DOI: 10.1016/j.ccm.2011.09.001.lung] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Lung cancer is the leading cause of cancer death in the United States and around the world. A vast majority of lung cancer deaths are attributable to cigarette smoking, and curbing the rates of cigarette smoking is imperative. Understanding the epidemiology and causal factors of lung cancer can provide additional foundation for disease prevention. This article focuses on modifiable risk factors, including tobacco smoking, occupational carcinogens, diet, and ionizing radiation. It also discusses briefly the molecular and genetic aspects of lung carcinogenesis.
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Affiliation(s)
- Charles S Dela Cruz
- Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, TAC S441-C, New Haven, CT 06519, USA.
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Abstract
Lung cancer is the leading cause of cancer death in the United States and around the world. A vast majority of lung cancer deaths are attributable to cigarette smoking, and curbing the rates of cigarette smoking is imperative. Understanding the epidemiology and causal factors of lung cancer can provide additional foundation for disease prevention. This article focuses on modifiable risk factors, including tobacco smoking, occupational carcinogens, diet, and ionizing radiation. It also discusses briefly the molecular and genetic aspects of lung carcinogenesis.
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Affiliation(s)
- Charles S Dela Cruz
- Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, TAC S441-C, New Haven, CT 06519, USA.
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Villeneuve PJ, Parent MÉ, Sahni V, Johnson KC. Occupational exposure to diesel and gasoline emissions and lung cancer in Canadian men. ENVIRONMENTAL RESEARCH 2011; 111:727-35. [PMID: 21536265 DOI: 10.1016/j.envres.2011.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/28/2011] [Accepted: 04/04/2011] [Indexed: 05/03/2023]
Abstract
The International Agency for Research on Cancer classifies diesel exhaust as a probable human carcinogen; this decision is based largely from lung cancer evidence. Gasoline exhaust is classified as a possible carcinogen. Epidemiological studies are needed that improve upon some of the limitations of previous research with respect to the characterization of exposure, and the control for the potential confounding influence of smoking and other occupational exposures. Our objective was to investigate associations between occupational exposure to diesel and gasoline engine emissions and lung cancer. We used a case-control study design that involved men 40 years of age and older at the time of interview. Analyses are based on 1681 incident cases of lung cancer and 2,053 population controls. A self-reported questionnaire elicited a lifetime occupational history, including general tasks, and information on other potential risk factors. Occupational exposures to diesel and gasoline emissions, crystalline silica, and asbestos were assigned to each job held by study subjects by industrial hygienists who were blind to case-control status. Exposure metrics for diesel and gasoline emissions that were modeled included: ever exposure, cumulative exposure, and concentration of exposure. We found a dose-response relationship between cumulative occupational exposure to diesel engine emissions and lung cancer. This association was more pronounced for the squamous and large cell subtypes with adjusted odds ratios across the three increasing tertiles of cumulative lifetime exposure relative to those with no exposure of 0.99, 1.25, and 1.32 (p=0.04) for squamous cell carcinoma, and 1.06, 1.19, 1.68 (p=0.02) for large cell carcinoma. While the association with cumulative exposure to gasoline was weakly positive, it was not statistically significant. Our findings suggest that exposure to diesel engine emissions increases the risk of lung cancer particularly for squamous and large cell carcinoma subtypes.
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Affiliation(s)
- Paul J Villeneuve
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada.
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Raaschou-Nielsen O, Andersen ZJ, Hvidberg M, Jensen SS, Ketzel M, Sørensen M, Loft S, Overvad K, Tjønneland A. Lung cancer incidence and long-term exposure to air pollution from traffic. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:860-5. [PMID: 21227886 PMCID: PMC3114823 DOI: 10.1289/ehp.1002353] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 01/12/2011] [Indexed: 05/03/2023]
Abstract
BACKGROUND Previous studies have shown associations between air pollution and risk for lung cancer. OBJECTIVE We investigated whether traffic and the concentration of nitrogen oxides (NOx) at the residence are associated with risk for lung cancer. METHODS We identified 592 lung cancer cases in the Danish Cancer Registry among 52,970 members of the Diet, Cancer and Health cohort and traced residential addresses from 1 January 1971 in the Central Population Registry. We calculated the NOx concentration at each address by dispersion models and calculated the time-weighted average concentration for all addresses for each person. We used Cox models to estimate incidence rate ratios (IRRs) after adjustment for smoking (status, duration, and intensity), environmental tobacco smoke, length of school attendance, occupation, and dietary intake of fruit. RESULTS For the highest compared with the lowest quartile of NOx concentration at the residence, we found an IRR for lung cancer of 1.30 [95% confidence interval (CI), 1.05-1.61], and the IRR for lung cancer in association with living within 50 m of a major road (>10,000 vehicles/day) was 1.21 (95% CI, 0.95-1.55). The results showed tendencies of stronger associations among nonsmokers, among those with a relatively low fruit intake, and among those with a longer school attendance; only length of school attendance modified the effect significantly. CONCLUSIONS This study supports that risk for lung cancer is associated with different markers of air pollution from traffic near the residence.
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Trédaniel J, Durand C, Teixeira L, Staudacher L, Beuzelin C, Jagot JL, Stucker I, Robert J, Salmeron S. La pollution atmosphérique, cause de cancer bronchique ? ARCH MAL PROF ENVIRO 2011. [DOI: 10.1016/j.admp.2011.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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In vitro genotoxicity data of nanomaterials compared to carcinogenic potency of inorganic substances after inhalational exposure. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2011; 727:72-85. [DOI: 10.1016/j.mrrev.2011.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 03/22/2011] [Accepted: 03/22/2011] [Indexed: 11/18/2022]
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Pedeli X, Hoek G, Katsouyanni K. Risk assessment of diesel exhaust and lung cancer: combining human and animal studies after adjustment for biases in epidemiological studies. Environ Health 2011; 10:30. [PMID: 21481231 PMCID: PMC3090323 DOI: 10.1186/1476-069x-10-30] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 04/11/2011] [Indexed: 05/06/2023]
Abstract
BACKGROUND Risk assessment requires dose-response data for the evaluation of the relationship between exposure to an environmental stressor and the probability of developing an adverse health effect. Information from human studies is usually limited and additional results from animal studies are often needed for the assessment of risks in humans. Combination of risk estimates requires an assessment and correction of the important biases in the two types of studies. In this paper we aim to illustrate a quantitative approach to combining data from human and animal studies after adjusting for bias in human studies. For our purpose we use the example of the association between exposure to diesel exhaust and occurrence of lung cancer. METHODS Firstly, we identify and adjust for the main sources of systematic error in selected human studies of the association between occupational exposure to diesel exhaust and occurrence of lung cancer. Evidence from selected animal studies is also accounted for by extrapolating to average ambient, occupational exposure concentrations of diesel exhaust. In a second stage, the bias adjusted effect estimates are combined in a common effect measure through meta-analysis. RESULTS The random-effects pooled estimate (RR) for exposure to diesel exhaust vs. non-exposure was found 1.37 (95% C.I.: 1.08-1.65) in animal studies and 1.59 (95% C.I.: 1.09-2.10) in human studies, whilst the overall was found equal to 1.49 (95% C.I.: 1.21-1.78) with a greater contribution from human studies. Without bias adjustment in human studies, the pooled effect estimate was 1.59 (95% C.I.: 1.28-1.89). CONCLUSIONS Adjustment for the main sources of uncertainty produced lower risk estimates showing that ignoring bias leads to risk estimates potentially biased upwards.
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Affiliation(s)
- Xanthi Pedeli
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, University of Utrecht, Utrecht, The Netherlands
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece
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Wang Y, Yang H, Li L, Wang H, Xia X, Zhang C. Biomarkers of chromosomal damage in peripheral blood lymphocytes induced by polycyclic aromatic hydrocarbons: a meta-analysis. Int Arch Occup Environ Health 2011; 85:13-25. [DOI: 10.1007/s00420-011-0629-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Accepted: 02/25/2011] [Indexed: 11/24/2022]
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Olsson AC, Gustavsson P, Kromhout H, Peters S, Vermeulen R, Brüske I, Pesch B, Siemiatycki J, Pintos J, Brüning T, Cassidy A, Wichmann HE, Consonni D, Landi MT, Caporaso N, Plato N, Merletti F, Mirabelli D, Richiardi L, Jöckel KH, Ahrens W, Pohlabeln H, Lissowska J, Szeszenia-Dabrowska N, Zaridze D, Stücker I, Benhamou S, Bencko V, Foretova L, Janout V, Rudnai P, Fabianova E, Dumitru RS, Gross IM, Kendzia B, Forastiere F, Bueno-de-Mesquita B, Brennan P, Boffetta P, Straif K. Exposure to diesel motor exhaust and lung cancer risk in a pooled analysis from case-control studies in Europe and Canada. Am J Respir Crit Care Med 2011; 183:941-8. [PMID: 21037020 PMCID: PMC7259806 DOI: 10.1164/rccm.201006-0940oc] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 10/28/2010] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Diesel motor exhaust is classified by the International Agency for Research on Cancer as probably carcinogenic to humans. The epidemiologic evidence is evaluated as limited because most studies lack adequate control for potential confounders and only a few studies have reported on exposure-response relationships. OBJECTIVES Investigate lung cancer risk associated with occupational exposure to diesel motor exhaust, while controlling for potential confounders. METHODS The SYNERGY project pooled information on lifetime work histories and tobacco smoking from 13,304 cases and 16,282 controls from 11 case-control studies conducted in Europe and Canada. A general population job exposure matrix based on ISCO-68 occupational codes, assigning no, low, or high exposure to diesel motor exhaust, was applied to determine level of exposure. MEASUREMENTS AND MAIN RESULTS Odds ratios of lung cancer and 95% confidence intervals were estimated by unconditional logistic regression, adjusted for age, sex, study, ever-employment in an occupation with established lung cancer risk, cigarette pack-years, and time-since-quitting smoking. Cumulative diesel exposure was associated with an increased lung cancer risk highest quartile versus unexposed (odds ratio 1.31; 95% confidence interval, 1.19-1.43), and a significant exposure-response relationship (P value < 0.01). Corresponding effect estimates were similar in workers never employed in occupations with established lung cancer risk, and in women and never-smokers, although not statistically significant. CONCLUSIONS Our results show a consistent association between occupational exposure to diesel motor exhaust and increased risk of lung cancer. This association is unlikely explained by bias or confounding, which we addressed by adjusted models and subgroup analyses.
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