Diesel Engine Exhaust Exposure, Smoking, and Lung Cancer Subtype Risks A Pooled Exposure-Response Analysis of 14 Case-Control Studies

被引：41

作者：

Ge, Calvin ^{[1
]}

Peters, Susan ^{[1
]}

Olsson, Ann ^{[2
]}

Portengen, Lutzen ^{[1
]}

Schuz, Joachim ^{[2
]}

Almansa, Josue ^{[1
]}

Ahrens, Wolfgang ^{[3
]}

Bencko, Vladimir ^{[4
]}

Benhamou, Simone ^{[5
]}

Boffetta, Paolo ^{[6
,7
]}

Bueno-de-Mesquita, Bas ^{[8
]}

Caporaso, Neil ^{[9
]}

Consonni, Dario ^{[10
]}

Demers, Paul ^{[11
]}

Fabianova, Eleonora ^{[12
,13
,15
]}

Fernandez-Tardon, Guillermo ^{[14
]}

Field, John ^{[16
]}

Forastiere, Francesco ^{[17
]}

Foretova, Lenka ^{[18
]}

Guenel, Pascal ^{[19
]}

Gustavsson, Per ^{[20
]}

Janout, Vladimir ^{[21
]}

Jockel, Karl-Heinz ^{[22
]}

Karrasch, Stefan ^{[23
,24
,25
]}

Landi, Maria Teresa ^{[9
]}

Lissowska, Jolanta ^{[26
]}

Luce, Daniele ^{[27
]}

Mates, Dana ^{[28
]}

McLaughlin, John ^{[29
]}

Merletti, Franco ^{[30
,31
]}

Mirabelli, Dario ^{[30
,31
]}

Pandics, Tamas ^{[32
]}

Parent, Marie-Elise ^{[33
]}

Plato, Nils ^{[20
]}

Pohlabeln, Hermann ^{[3
]}

Richiardi, Lorenzo ^{[30
,31
]}

Siemiatycki, Jack ^{[34
]}

Swiatkowska, Beata ^{[35
]}

Tardon, Adonina ^{[14
]}

Wichmann, Heinz-Erich ^{[36
,37
]}

Zaridze, David ^{[38
]}

Straif, Kurt ^{[2
]}

Kromhout, Hans ^{[1
]}

Vermeulen, Roel ^{[1
]}

机构：

[1] Univ Utrecht, Inst Risk Assessment Sci, Yalelaan 2, NL-3584 CM Utrecht, Netherlands

[2] Int Agcy Res Canc IARC WHO, Lyon, France

[3] Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany

[4] Charles Univ Prague, Fac Med 1, Inst Hyg & Epidemiol, Prague, Czech Republic

[5] INSERM, U1018, Villejuif, France

[6] Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA

[7] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[8] Natl Inst Publ Hlth & Environm Protect, Bilthoven, Netherlands

[9] NCI, Bethesda, MD 20892 USA

[10] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Epidemiol Unit, Milan, Italy

[11] Canc Care Ontario, Occupat Canc Res Ctr, Toronto, ON, Canada

[12] Reg Author Publ Hlth, Banska Bystrica, Slovakia

[13] Catholic Univ, Fac Hlth, Ruzomberok, Slovakia

[14] Univ Oviedo, Fdn Invest & Innovac Biomed Principado Asturias, Fac Med, Inst Invest Sanitaria Principado FINBA ISPA, Oviedo, Spain

[15] Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Oviedo, Spain

[16] Univ Liverpool, Canc Res Ctr, Roy Castle Lung Canc Res Programme, Liverpool, Merseyside, England

[17] CNR, Ist Ric & Innovaz Biomed CNR Irib, Palermo, Italy

[18] Masaryk Mem Canc Inst, Brno, Czech Republic

[19] Univ Paris Saclay, Univ Paris Sud, Ctr Res Epidemiol & Populat Hlth CESP, Canc & Environm Team,Inserm,U1018, Villejuif, France

[20] Karolinska Inst, Inst Environm Med, Stockholm, Sweden

[21] Palacky Univ, Fac Hlth Sci, Olomouc, Czech Republic

[22] Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany

[23] Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Inst & Outpatient Clin Occupat Social & Environm, Inner City Clin, Munich, Germany

[24] Helmholtz Zentrum Munchen, Inst Epidemiol, German Res Ctr Environm Hlth, Neuherberg, Germany

[25] German Ctr Lung Res, Comprehens Pneumol Ctr Munich CPC M, Neuherberg, Germany

[26] M Sklodowska Curie Natl Res Inst Oncol, Warsaw, Poland

[27] Univ Rennes, Irset Inst Rech Sante Environm & Travail, UMR S 1085, Ecole Hautes Etud Sante Publ EHESP,Inserm, Pointe A Pitre, Guadeloupe, France

[28] Natl Inst Publ Hlth, Bucharest, Romania

[29] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[30] Univ Turin, Dept Med Sci, Canc Epidemiol Unit, Turin, Italy

[31] Ctr Riferimento Epidemiol & Prevenz Oncol Piemont, Turin, Italy

[32] Natl Publ Hlth Ctr, Budapest, Hungary

[33] Univ Quebec, Inst Natl Rech Sci, Laval, PQ, Canada

[34] Univ Montreal, Univ Montreal Hosp Res Ctr, Montreal, PQ, Canada

[35] Nofer Inst Occupat Med, Lodz, Poland

[36] Ludwig Maximilians Univ Munchen, Inst Med Informat Biometrie Epidemiol, Munich, Germany

[37] Deutsch Forschungszentrum Gesundheit & Umwelt, Inst Epidemiol, Neuherberg, Germany

[38] Russian Canc Res Ctr, Moscow, Russia

来源：

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | 2020年 / 202卷 / 03期

关键词：

occupational exposure; diesel exhaust; lung neoplasms; epidemiology; OCCUPATIONAL-EXPOSURE; TRUCKING INDUSTRY; ELEMENTAL CARBON; MOTOR EXHAUST; EMISSIONS; MORTALITY; MINERS; COHORT;

D O I：

10.1164/rccm.201911-2101OC

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Rationale: Although the carcinogenicity of diesel engine exhaust has been demonstrated in multiple studies, little is known regarding exposure-response relationships associated with different exposure subgroups and different lung cancer subtypes. Objectives: We expanded on a previous pooled case-control analysis on diesel engine exhaust and lung cancer by including three additional studies and quantitative exposure assessment to evaluate lung cancer and subtype risks associated with occupational exposure to diesel exhaust characterized by elemental carbon (EC) concentrations. Methods: We used a quantitative EC job-exposure matrix for exposure assessment. Unconditional logistic regression models were used to calculate lung cancer odds ratios and 95% confidence intervals (CIs) associated with various metrics of EC exposure. Lung cancer excess lifetime risks (ELR) were calculated using life tables accounting for all-cause mortality. Additional stratified analyses by smoking history and lung cancer subtypes were performed in men. Measurements and Main Results: Our study included 16,901 lung cancer cases and 20,965 control subjects. In men, exposure response between EC and lung cancer was observed: odds ratios ranged from 1.09 (95% CI, 1.00-1.18) to 1.41 (95% CI, 1.30-1.52) for the lowest and highest cumulative exposure groups, respectively. EC-exposed men had elevated risks in all lung cancer subtypes investigated; associations were strongest for squamous and small cell carcinomas and weaker for adenocarcinoma. EC lung cancer exposure response was observed in men regardless of smoking history, including in never-smokers. ELR associated with 45 years of EC exposure at 50, 20, and 1 mu g/m(3) were 3.0%, 0.99%, and 0.04%, respectively, for both sexes combined. Conclusions: We observed a consistent exposure-response relationship betweenECexposure and lung cancer in men. Reduction of workplace EC levels to background environmental levels will further reduce lung cancer ELR in exposed workers.

引用

页码：402 / 411

页数：10

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