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Occupational exposure to silica and lung cancer risk in the Netherlands

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Author: Preller, L. · Bosch, L.M.C. van den · Brandt, P.A. van den · Kauppinen, T. · Goldbohm, R.A.
Institution: TNO Kwaliteit van Leven
Source:Occupational and Environmental Medicine, 10, 67, 657-663
Identifier: 409805
Keywords: Health · Leefomgeving en gezondheid · asbestos · silicon dioxide · adult · aged · alcohol consumption · article · cancer incidence · cancer risk · clinical assessment · clinical trial · cohort analysis · controlled study · follow up · hazard ratio · high risk population · human · job experience · lifestyle · lung cancer · lung carcinoma · major clinical study · male · multicenter study · Netherlands · occupational exposure · population based case control study · priority journal · risk factor · self report · smoking


Objectives: The lung cancer carcinogenicity of crystalline silica dust remains the subject of discussion. Epidemiological evidence is based on occupational cohort studies and population-based case-control studies. The aim of this study was to assess associations between male lung cancer risk and silica exposure in a population-based cohort study. Methods: The study was conducted among men aged 55-69 years (n=58 279) from the Netherlands Cohort Study, which included self-reported, life-time job histories. Job titles were linked to the occupational groups of the external Finnish Job Exposure Matrix (FINJEM), including probability and level of silica exposure, each for specific time periods. 1667 incident lung cancer cases with known silica exposure status (210 exposed) were available after 11.3 years of follow-up. Risks were estimated based on a case-cohort design, and using Cox proportional hazards models. Results: Adjusted for smoking and other confounders, elevated risks were observed for exposure duration (RR 1.65, 95% CI 1.14 to 2.41 for 26-51 years vs no exposure) and cumulative exposure (RR 1.47, 95% CI 0.93 to 2.33 for ≥3 vs <3 mg/m<sup>3</sup>.year). Associations with average exposure levels were weaker. Associations were stronger for occupations with an exposure probability of ≥90%. Adjustment for asbestos exposure slightly increased the risk. Conclusions: Results from this prospective populationbased cohort study corroborate the classification of crystalline silica as a lung carcinogen. Associations could not be explained by smoking or by asbestos exposure.