Occupational lung cancer risk among men in The Netherlands

Liesbeth Preller ^1*, Helena F Balder ¹, Erik Tielemans ¹, Piet A Van den Brandt ² and R Alexandra Goldbohm ¹

¹ Netherlands Organisation for Applied Scientific Research (TNO), Netherlands
² Nutrition and Toxicology Research Institute Maastricht, Netherlands

^* To whom correspondence should be addressed. E-mail: liesbeth.preller{at}tno.nl.

Accepted 12 September 2007

Abstract

Objectives: The aim of the study was 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 industry sectors. Methods: Associations were studied among the male population (n=58,279) of the prospective Netherlands Cohort Study (NLCS), which was initiated in 1986 with a self-administered questionnaire on risk factors for cancer among subjects aged 55-69 years. After 11.3 years of follow-up 1920 incident lung cancer cases were available. Based on a case-cohort design, and using Cox proportional hazards models, risks were estimated for blue collar workers in 26 industrial sectors. Associations were adjusted for different sets of potential confounders using individual information on lifestyle factors. 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 15 yrs in blue collar jobs in the electronics and optical instruments industry (Rate Ratio (RR): 1.99; 95%CI: 1.18-3.35), construction and homebuilding business (RR: 1.64; 95%CI: 1.21-2.22), and railway company (RR: 2.40; 95%CI: 1.00-5.73). The attributable fraction for working 15 years in these three industries was 5%. In three other sectors there was a statistically non-significant elevated RR of over 1.5. Conclusions: Male lung cancer risk is increased in several industrial sectors. Taking into account limitations of the data, about 2000 lung cancer cases that have occurred in the Netherlands between 1986 and 1997 in the same age group as the NLCS may be attributable to working for 15 years in the three sectors with increased risk. Results also suggest that estimates for occupational lung cancer risks for sectors can be biased if no individual information is available on smoking habits, but several other lifestyle factors do not appear to be strong confounders.

Keywords: cohort study, industrial sectors, lung cancer

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