Occupational exposure to diesel motor exhaust and risk of lung cancer by histological subtype: a population-based case-control study in Swedish men

• Published in: European journal of epidemiology 2017-08, Vol.32 (8), p.711-719
• Main Authors: Ilar, Anna, Plato, Nils, Lewné, Marie, Pershagen, Göran, Gustavsson, Per
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adult; Aged; Air Pollutants, Occupational - adverse effects; Air pollution; Alveoli; Asbestos; Cancer; Carcinoma, Large Cell - chemically induced; Carcinoma, Large Cell - epidemiology; Carcinoma, Squamous Cell - chemically induced; Carcinoma, Squamous Cell - epidemiology; Cardiology; Case studies; Case-Control Studies; Combustion products; Diesel; Diesel engines; ENVIRONMENTAL EPIDEMIOLOGY; Epidemiology; Exposure; Female; Health risk assessment; Health risks; Humans; Infectious Diseases; Inhalation Exposure - adverse effects; Inhalation Exposure - statistics & numerical data; Lung cancer; Lung Neoplasms - chemically induced; Lung Neoplasms - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Motor task performance; Occupational Diseases - chemically induced; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Occupational exposure; Occupational Exposure - adverse effects; Occupational Exposure - statistics & numerical data; Occupational hazards; Occupational health; Odds Ratio; Oncology; Population studies; Population Surveillance; Population-based studies; Public Health; Quartiles; Radon; Regression analysis; Risk; Risk Factors; Smoking; Squamous cell carcinoma; Sweden - epidemiology; Vehicle Emissions
• ISSN: 0393-2990; 1573-7284
• DOI: 10.1007/s10654-017-0268-5

We investigated occupational exposure to diesel motor exhaust (DME) and the risk of lung cancer by histological subtype among men, using elemental carbon (EC) as a marker of DME exposure. 993 cases and 2359 controls frequency-matched on age and year of study inclusion were analyzed by unconditional logistic regression in this Swedish case-control study. Work and smoking histories were collected by a questionnaire and telephone interviews. DME was assessed by a job-exposure matrix. We adjusted for age, year of study inclusion, smoking, occupational exposure to asbestos and combustion products (other than motor exhaust), residential exposure to radon and exposure to air pollution from road traffic. The OR for lung cancer for ever vs. never exposure to DME was 1.15 (95% CI 0.94-1.41). The risk was higher for squamous and large cell, anaplastic or mixed cell carcinoma than for alveolar cell cancer, adenocarcinoma and small cell carcinoma. The OR in the highest quartile of exposure duration (≥34 years) vs. never exposed was 1.66 (95% CI 1.08-2.56; p for trend over all quartiles: 0.027) for lung cancer overall, 1.73 (95% CI 1.00-3.00; p: 0.040) for squamous cell carcinoma and 2.89 (95% CI 1.37-6.11; p: 0.005) for the group of undifferentiated, large cell, anaplastic and mixed cell carcinomas. We found no convincing association between exposure intensity and lung cancer risk. Long-term DME exposure was associated with an increased risk of lung cancer, particularly to squamous cell carcinoma and the group of undifferentiated, large cell, anaplastic or mixed carcinomas.