Lung Cancer Risks Associated with Occupational Exposure to Pairs of Five Lung Carcinogens: Results from a Pooled Analysis of Case-Control Studies (SYNERGY)
Year: 2024
Type: article
Abstract: BACKGROUND: While much research has been done to identify individual workplace lung carcinogens, little is known about joint effects on risk when workers are exposed to multiple agents. OBJECTIVES: We investigated the pairwise joint effects of occupational exposures to asbestos, respirable crystalline silica, metals (i.e., nickel, chromium-VI), and polycyclic aromatic hydrocarbons (PAH) on lung cancer risk, overall and by major histologic subtype, while accounting for cigarette smoking. METHODS: In the international 14-center SYNERGY project, occupational exposures were assigned to 16,901 lung cancer cases and 20,965 control subjects using a quantitative job-exposure matrix (SYN-JEM). Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for ever vs. never exposure using logistic regression models stratified by sex and adjusted for study center, age, and smoking habits. Joint effects among pairs of agents were assessed on multiplicative and additive scales, the latter by calculating the relative excess risk due to interaction (RERI). RESULTS: = 0.05). In women, several pairwise joint effects were observed for small cell lung cancer including exposure to PAH/silica (OR = 5.12; CI: 1.77, 8.48), and to asbestos/silica (OR = 4.32; CI: 1.35, 7.29), where exposure to PAH/silica resulted in a synergistic effect (RERI: 3.45; CI: 0.10, 6.8). DISCUSSION: Small or no deviation from additive or multiplicative effects was observed, but co-exposure to the selected lung carcinogens resulted generally in higher risk than exposure to individual agents, highlighting the importance to reduce and control exposure to carcinogens in workplaces and the general environment. https://doi.org/10.1289/EHP13380.
DOI: 10.1289/ehp13380
Authors: Ann Olsson, Liacine Bouaoun, Joachim Schüz, Roel Vermeulen, Thomas Behrens, Calvin Ge, Hans Kromhout, Jack Siemiatycki, Per Gustavsson, Paolo Boffetta, Benjamin Kendzia, Loredana Radoi, Christine Barul, Stefan Karrasch, Heinz-Erich Wichmann, Dario Consonni, Maria Teresa Landi, Neil E. Caporaso, Franco Merletti, Enrica Migliore, Lorenzo Richiardi, Karl-Heinz Jöckel, Wolfgang Ahrens, Hermann Pohlabeln, Guillermo Fernández-Tardón, David Zaridze, John K. Field, Jolanta Lissowska, Beata Świątkowska, John R. McLaughlin, Paul A. Demers, Miriam Schejbalova, Lenka Foretova, Vladimir Janout, Tamás Pándics, Eleonora Fabianova, Dana Mates, Francesco Forastiere, Kurt Straif, Thomas Brüning, Jelle Vlaanderen, Susan Peters
Institutions: Centre international de recherche sur le cancer, Utrecht University, Institute for Prevention and Occupational Medicine, Université de Montréal, Karolinska Institutet, Stony Brook University, University of Bologna, Inserm, Université Paris Cité, Université Paris-Saclay, Centre de recherche en Epidémiologie et Santé des Populations, École des Hautes Études en Santé Publique, Institut de Recherche en Santé, Environnement et Travail, Université de Rennes, Helmholtz Munich, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Ludwig-Maximilians-Universität München, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Cancer Epidemiology and Genetics, University of Turin, Institut für Medizinische Informatik, Biometrie und Epidemiologie, Essen University Hospital, University of Bremen, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Investigación Sanitaria del Principado de Asturias, Russian Cancer Research Center NN Blokhin, University of Liverpool, The Maria Sklodowska-Curie National Research Institute of Oncology, Nofer Institute of Occupational Medicine, University of Toronto, Occupational Cancer Research Centre, Ontario Health, Charles University, Masaryk Memorial Cancer Institute, Palacký University Olomouc, Public Health Authority of the Slovak Republic, Catholic University in Ruzomberok, Institutul National de Sanatate Publica, ASL Roma, Boston College, Barcelona Institute for Global Health
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,500
Funders: World Health Organization, Compagnia di San Paolo, European Commission, Deutsche Gesetzliche Unfallversicherung, Fondation de France, Ruhr-Universität Bochum, Universidad de Oviedo, Istituto Nazionale per l'Assicurazione Contro Gli Infortuni sul Lavoro, Regione Lombardia, Ministry of Labour and Social Protection of the Russian Federation, National Institutes of Health, Canadian Institutes of Health Research, Rijksinstituut voor Volksgezondheid en Milieu, European Regional Development Fund, National Cancer Institute, Division of Cancer Epidemiology and Genetics, National Cancer Institute
Awards: G6485533901, G7762133158, G858645475
OpenAlex ID: W4390973071