Occupational and Environmental Medicine 2008;65:249-254
ORIGINAL ARTICLES
Occupational lung cancer risk among men in the Netherlands
1 Department of Food and Chemical Risk Analysis, TNO Quality of Life, Zeist, the Netherlands
2 Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
Liesbeth Preller, Department of Food and Chemical Risk Analysis, TNO Quality of Life, PO Box 360, 3700 AJ Zeist, the Netherlands; Liesbeth.Preller{at}tno.nl
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.
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