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Occupational exposure to nickel and hexavalent chromium and the risk of lung cancer in a pooled analysis of case-control studies (SYNERGY) |
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| Authors: | Thomas Behrens Calvin Ge Roel Vermeulen Benjamin Kendzia Ann Olsson Joachim Schüz Hans Kromhout Beate Pesch Susan Peters Lützen Portengen Per Gustavsson Dario Mirabelli Pascal Guénel Danièle Luce Dario Consonni Neil E Caporaso Maria Teresa Landi John K Field Stefan Karrasch Heinz-Erich Wichmann Jack Siemiatycki Marie-Elise Parent Lorenzo Richiardi Lorenzo Simonato Karl-Heinz Jöckel Wolfgang Ahrens Hermann Pohlabeln Guillermo Fernández-Tardón David Zaridze John R McLaughlin Paul A Demers Beata ?wi?tkowska Jolanta Lissowska Tamás Pándics Eleonora Fabianova Dana Mates Vladimir Bencko Lenka Foretova Vladimír Janout Paolo Boffetta Bas Bueno-de-Mesquita Francesco Forastiere Kurt Straif Thomas Brüning |
| Affiliation: | 1. Institute for Prevention and Occupational Medicine of the German Social Accident Insurance—Institute of the Ruhr-University Bochum (IPA), Germany;2. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands;3. International Agency for Research on Cancer (IARC/WHO), Lyon, France;4. The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden;5. Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy;6. Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, University Paris-Saclay, Institut Gustave Roussy, Villejuif, France;7. Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Pointe-à-Pitre, France;8. Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy;9. National Cancer Institute, Bethesda, Maryland, USA;10. Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, The University of Liverpool, Liverpool, UK;11. Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital LMU Munich;12. Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany;13. Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany;14. University of Montreal Hospital Research Center (CRCHUM), Montreal, Canada;15. Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Laval, Quebec, Canada;16. Department of Cardiovascular Sciences and Public Health, University of Padova, Padova, Italy;17. Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany;18. Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany;19. Health Research Institute of Asturias, University of Oviedo, ISPA and CIBERESP, Spain;20. Department of Epidemiology and Prevention, N.N. Blokhin National Medical Research Centre of Oncology, Moscow, Russia;21. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;22. Occupational Cancer Research Centre, Ontario Health, Toronto, Canada;23. The Nofer Institute of Occupational Medicine, Lodz, Poland;24. Department of Cancer Epidemiology and Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland;25. National Public Health Center, Budapest, Hungary;26. Regional Authority of Public Health, Banska Bystrica, Slovakia;27. National Institute of Public Health, Bucharest, Romania;28. Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic;29. Masaryk Memorial Cancer Institute, Brno, Czech Republic;30. Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic;31. Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy;32. Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands Sadly, Bas Bueno-de-Mesquita passed away during the submission process.;33. Environmental Research Group, School of Public Health, Imperial College, London, UK, and National Research Council (CNR-Irib), Palermo, Italy;34. ISGlobal, Barcelona, Spain Boston College, Chestnut Hill, Massachusetts, USA |
| Abstract: | There is limited evidence regarding the exposure-effect relationship between lung-cancer risk and hexavalent chromium (Cr(VI)) or nickel. We estimated lung-cancer risks in relation to quantitative indices of occupational exposure to Cr(VI) and nickel and their interaction with smoking habits. We pooled 14 case-control studies from Europe and Canada, including 16 901 lung-cancer cases and 20 965 control subjects. A measurement-based job-exposure-matrix estimated job-year-region specific exposure levels to Cr(VI) and nickel, which were linked to the subjects' occupational histories. Odds ratios (OR) and associated 95% confidence intervals (CI) were calculated by unconditional logistic regression, adjusting for study, age group, smoking habits and exposure to other occupational lung carcinogens. Due to their high correlation, we refrained from mutually adjusting for Cr(VI) and nickel independently. In men, ORs for the highest quartile of cumulative exposure to CR(VI) were 1.32 (95% CI 1.19-1.47) and 1.29 (95% CI 1.15-1.45) in relation to nickel. Analogous results among women were: 1.04 (95% CI 0.48-2.24) and 1.29 (95% CI 0.60-2.86), respectively. In men, excess lung-cancer risks due to occupational Cr(VI) and nickel exposure were also observed in each stratum of never, former and current smokers. Joint effects of Cr(VI) and nickel with smoking were in general greater than additive, but not different from multiplicative. In summary, relatively low cumulative levels of occupational exposure to Cr(VI) and nickel were associated with increased ORs for lung cancer, particularly in men. However, we cannot rule out a combined classical measurement and Berkson-type of error structure, which may cause differential bias of risk estimates. |
| Keywords: | metals pulmonary cancer smoking SYNERGY welders |
