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Occupational lung cancer risk among men in the Netherlands

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Author: Preller, L. · Balder, H.F. · Tielemans, E. · Brandt, P.A. van den · Goldbohm, R.A.
Institution: TNO Kwaliteit van Leven
Source:Occupational and Environmental Medicine, 4, 65, 249-254
Identifier: 240734
doi: doi:10.1136/oem.2006.030353
Keywords: Health · Food and Chemical Risk Analysis · adult · aged · alcohol consumption · article · blue collar worker · building industry · cancer risk · cohort analysis · confidence interval · electronics industry · employment · follow up · food intake · fruit · human · incidence · industry · lifestyle · lung cancer · major clinical study · male · Netherlands · occupational lung disease · optical instrumentation · priority journal · proportional hazards model · prospective study · railway employee · risk assessment · risk factor · smoking habit · statistical significance · vegetable · Aged · Alcohol Drinking · Epidemiologic Methods · Food Habits · Fruit · Humans · Industry · Lung Neoplasms · Male · Middle Aged · Netherlands · Occupational Diseases · Occupational Exposure · Smoking · Time Factors · Vegetables


Objectives: To assess male lung cancer risks for industrial sectors in the Netherlands and to estimate the proportion of lung cancer attributed to working in specific industrial sectors. Methods: Associations were studied among men aged 55-69 years (n = 58 279) from the prospective Netherlands Cohort Study. 1920 incident lung cancer cases were available after 11.3 years of follow-up. Based on a case-cohort design, and using Cox proportional hazards models, risks were estimated for blue collar workers in 26 industrial sectors. Results: Adjustment for individual smoking habits affected risk estimates for some sectors, but adjustment for fruit/vegetables and alcohol intake did not. Adjusted for confounders, an increased risk of lung cancer was observed for employment for ≥15 years in blue collar jobs in the "electronics and optical instruments" industry (rate ratio (RR) 1.99; 95% CI 1.18 to 3.35), "construction and homebuilding business" (RR 1.64; 95% CI 1.21 to 2.22) and "railway company" (RR 2.40; 95% CI 1.00 to 5.73). The attributable fraction for working for ≥15 years in these three industries was 5%. In three other sectors there was a statistically non-significant elevated RR of >1.5. Conclusions: Male lung cancer risk is increased in several industrial sectors. Approximately 2000 lung cancer cases between 1986 and 1997 in the 55-69-year-old age group in the Netherlands may be attributable to working for ≥15 years in the three sectors with increased risk. In addition, estimates for occupational lung cancer risks for sectors may be biased if no individual information is available on smoking habits.