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MS SYNERGY collaboration – occupational factors in lung cancer
Lung cancer risk among men by occupation and industry in SYNERGY – pooled analysis of case-control studies on the joint effects of occupational carcinogens in the development of lung cancer
  1. Dario Mirabelli1,
  2. Franco Merletti1,
  3. Lorenzo Richiardi1,
  4. Marine Corbin1,
  5. Iván Marín Franch1,
  6. Ann Olsson2,
  7. Per Gustavsson3,
  8. Hans Kromhout4,
  9. Susan Peters4,
  10. Roel Vermeulen4,
  11. Irene Brüske5,
  12. Beate Pesch6,
  13. Thomas Brüning6,
  14. Isabelle Gross6,
  15. Jack Siemiatycki7,
  16. Javier Pintos7,
  17. Heinz-Erich Wichmann5,
  18. Dario Consonni8,
  19. Nils Plato3,
  20. Wolfgang Ahrens9,
  21. Hermann Pohlabeln9,
  22. Jolanta Lissowska10,
  23. Neonila Szeszenia-Dabrowska11,
  24. Adrian Cassidy12,
  25. David Zaridze13,
  26. Isabelle Stücker14,
  27. Simone Benhamou15,
  28. Vladimir Bencko16,
  29. Lenka Foretova17,
  30. Vladimir Janout18,
  31. Peter Rudnai19,
  32. Eleonora Fabianova20,
  33. Dana Mates21,
  34. Bas Bueno-de-Mesquita22,
  35. Paolo Boffetta23,
  36. Kurt Straif2
  1. 1University of Turin, Turin, Italy
  2. 2IARC, Lyon, France
  3. 3Karolinska Institutet, Stockholm, Sweden
  4. 4Utrecht University, Utrecht, The Netherlands
  5. 5Institute for Epidemiology, Neuherberg, Germany
  6. 6Institute for Prevention and Occupational Medicine, Bochum, Germany
  7. 7University of Montreal, Montreal, Canada
  8. 8Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy
  9. 9Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany
  10. 10M Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland
  11. 11Nofer Institute of Occupational Medicine, Lodz, Poland
  12. 12University of Liverpool, Liverpool, UK
  13. 13Russian Cancer Research Centre, Moscow, Russia
  14. 14INSERM U 754 - IFR69, Villejuif, France
  15. 15INSERM U 946, Paris, France
  16. 16Charles University, Prague, Czech Republic
  17. 17Masaryk Memorial Cancer Institute, Brno, Czech Republic
  18. 18Palacky University, Olomouc, Czech Republic
  19. 19National Institute of Environment Health, Budapest, Hungary
  20. 20Regional Authority of Public Health, Banska Bystrica, Slovakia
  21. 21Institut of Public Health, Bucharest, Romania
  22. 22National Institute for Public Health and Environmental Protection, Bilthoven, The Netherlands
  23. 23Mount Sinai School of Medicine, New York, USA


Objectives Exploratory analyses by occupation or industry are commonly conducted in case-control studies. However, cancer risks limited to certain jobs within an industry, or to a job within a given industry, become undetectable in the overall industry or job odds-ratio. Using the SYNERGY dataset we conducted an analysis based on occupations and industries combined.

Methods Data included 10 917 male cases and 13 154 male controls. Industries and jobs were coded according to ISIC Revision 2 and ISCO 1968, respectively. Odds-ratios were computed for ISCO-ISIC combinations with ≥10 study subjects, adjusting for study, age, and smoking. To allow for multiple comparisons we applied a semi-Bayes approach, shrinking towards a group mean the estimate for each ISCO-ISIC combination, previously classified as: occupation known or suspected to entail lung cancer risk, other manual workers, other non-manual workers.

Results Out of 1187 evaluated ISCO-ISIC combinations, 50 had an increased odds-ratio (p<0.05). For 26 combinations the risk remained elevated after semi-Bayes shrinkage. As an example, painters in car repair, but not in other industries like car building, had an increased risk (odds-ratio after shrinkage: 1.79, 95% CI 1.04 to 3.07). Likewise, only 8 jobs had increased risk among 63 analysed within the construction industry: miners (2.05, 1.18 to 3.55), bricklayers (1.57, 1.37 to 1.80), welders (1.57, 1.08 to 2.28), earth-moving operators (1.36, 1.05 to 1.76), carpenters (1.30, 1.08 to 1.57), other workers (1.24, 1.06 to 1.44), plumbers (1.23, 1.02 to 1.49) and labourers (1.20, 1.05 to 1.36).

Conclusions The use of ISCO-SIC combinations and a semi-Bayes approach identified specific jobs within specific industries with an increased lung cancer risk.

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