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MS SYNERGY collaboration – occupational factors in lung cancer
Occupational exposure to organic dust increases lung cancer risk in the general population
  1. Susan Peters1,
  2. Hans Kromhout1,
  3. Ann Olsson2,
  4. Heinz-Erich Wuchmann3,
  5. Irene Brüske4,
  6. Dario Consonni5,
  7. Maria Teresa Landi6,
  8. Neil Caporaso6,
  9. Jack Siemiatycki7,
  10. Lorenzo Richiardi8,
  11. Dario Mirabelli8,
  12. Lorenzo Simonato9,
  13. Per Gustavsson10,
  14. Nils Plato10,
  15. Karl-Heinz Jöckel11,
  16. Wolfgang Ahrens12,
  17. Hermann Pohlabeln12,
  18. Paolo Boffetta13,
  19. Paul Brennan2,
  20. David Zaridze14,
  21. Adrian Cassidy15,
  22. Jolanta Lissowska16,
  23. Neonila Szeszenia-Dabrowska17,
  24. Peter Rudnai18,
  25. Eleonora Fabianova19,
  26. Francesco Forastiere20,
  27. Vladimir Bencko21,
  28. Lenka Foretova22,
  29. Vladimir Janout23,
  30. Isabelle Stücker24,
  31. Rodica Stanescu Dumitru25,
  32. Simone Benhamou26,
  33. Bas Bueno-de-Mesquita27,
  34. Benjamin Kendzia28,
  35. Beate Pesch28,
  36. Kurt Straif2,
  37. Thomas Brüning28,
  38. Roel Vermeulen1
  1. 1Utrecht University, Utrecht, The Netherlands
  2. 2IARC, Lyon, France
  3. 3Helmholtz Zentrum, Neuherberg, Germany
  4. 4Ludwig Maximilians University, Munich, Germany
  5. 5Fondacione IRCCS Ca' Granda, Milan, Italy
  6. 6NCI, Bethesda, USA
  7. 7University of Montreal, Montreal, Canada
  8. 8University of Turin, Turin, Italy
  9. 9University of Padova, Padova, Italy
  10. 10Karolinska Institute, Stockholm, Sweden
  11. 11University of Duisberg-Essen, Essen, Germany
  12. 12Institute for Prevention Research and Social Medicine, Bremen, Germany
  13. 13Mount Sinai School of Medicine, New York, USA
  14. 14Cancer Research Centre, Moscow, Russia
  15. 15University of Liverpool, Liverpool, UK
  16. 16Institute of Oncology, Warsaw, Poland
  17. 17Nofer Institute, Lodz, Poland
  18. 18National Institute of Environment and Health, Budapest, Hungary
  19. 19Regional Authority of Public Health, Banska Bystrica, Slovakia
  20. 20Regional Health Service, Rome, Italy
  21. 21Charles University, Prague, Czech Republic
  22. 22Masaryk Memorial Institute, Brno, Czech Republic
  23. 23Palacky University, Olomouc, Czech Republic
  24. 24Inserm U754-IFR69, Villejuif, France
  25. 25Institute of Public Health, Bucharest, Romania
  26. 26Inserm U946, Paris, France
  27. 27RIVM, Bilthoven, The Netherlands
  28. 28IPA, Bochum, Germany


Objectives Organic dust is a mixture of particulate matter from microbial, plant or animal origin. Increased lung cancer risks have been reported for occupations with exposure to animal products (eg, butchers), while exposure to microbial components (eg, endotoxin) has been associated with decreased lung cancer risks. To date there has not been a comprehensive evaluation of the possible association between organic dust exposure and its specific constituents and lung cancer risk in the general population.

Methods The SYNERGY project pooled information on lifetime work histories and smoking from 13 300 lung cancer cases and 16 273 controls from 11 case-control studies conducted in Europe and Canada. A job exposure matrix for exposure to organic dust, endotoxin, and contact with animals or fresh animal products was applied to determine level of exposure. ORs for lung cancer were estimated by logistic regression, adjusted for age, gender, study, cigarette pack-years, time-since-quitting smoking, and ever employment in occupations with established lung cancer risk.

Results Organic dust exposure was associated with increased lung cancer risk. The second to the fourth quartile of cumulative exposure showed significant risk estimates ranging from 1.12 to 1.24 in a dose-dependent manner (p-value <.0001). This association remained after restricting analyses to subjects without a history of COPD or asthma. No association was observed between lung cancer and exposure to endotoxin or contact with animals or animal products.

Conclusions Occupational exposure to organic dust was associated with increased lung cancer risk in the general population.

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