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MS SYNERGY collaboration – occupational factors in lung cancer
Exposure-response relation for occupational exposure to respirable quartz and lung cancer risk: performance of a quantitative vs a semi-quantitative job-exposure matrix
  1. Susan Peters1,
  2. Roel Vermeulen1,
  3. Lutzen Portengen1,
  4. Ann Olsson2,
  5. Heinz-Erich Wichmann3,
  6. Irene Brüske3,
  7. Dario Consonni4,
  8. Andrea Cattaneo4,
  9. Pier Alberto Bertazzi4,
  10. Jack Siemiatycki5,
  11. Lorenzo Richiardi6,
  12. Dario Mirabelli6,
  13. Lorenzo Simonato7,
  14. Per Gustavsson8,
  15. Karl-Heinz Jöckel9,
  16. Wolfgang Ahrens10,
  17. Hermann Pohlabeln10,
  18. Paolo Boffetta11,
  19. Paul Brennan2,
  20. Francesco Forastiere12,
  21. Isabelle Stücker13,
  22. Simone Benhamou14,
  23. Bas Bueno-de-Mesquita15,
  24. Nils Plato8,
  25. Jérôme Lavoué5,
  26. Dirk Dahmann16,
  27. Joelle Fevotte17,
  28. Benjamin Kendzia18,
  29. Raymond Vincent19,
  30. Barbara Savary19,
  31. Domenico Cavallo20,
  32. Beate Pesch18,
  33. Thomas Brüning18,
  34. Kurt Straif2,
  35. Hans Kromhout1
  1. 1IRAS, Utrecht, The Netherlands
  2. 2IARC, Lyon, France
  3. 3Institut für Epidemiologie, Neuherberg, Germany
  4. 4University of Milan, Milan, Italy
  5. 5University of Montreal, Montreal, Canada
  6. 6University of Turin, Turin, Italy
  7. 7University of Padova, Padova, Italy
  8. 8Karolinska Institutet, Stockholm, Sweden
  9. 9University of Duisburg-Essen, Duisburg-Essen, Germany
  10. 10Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany
  11. 11The Tisch Cancer Institute, New York, France
  12. 12Department of Epidemiology, Rome, Italy
  13. 13INSERM, Villejuif, France
  14. 14INSERM, Paris, France
  15. 15RIVM, Bilthoven, The Netherlands
  16. 16IGF-BG, Bochum, Germany
  17. 17InVS, St Maurice, France
  18. 18IPA, Bochum, Germany
  19. 19INRS, Nancy, France
  20. 20Università degli Studi dell'Insubria, Como, Italy


Objectives In order to estimate the exposure-response relation of respirable quartz and lung cancer risk, we developed a quantitative time/job/region specific job-exposure matrix (JEM) based on statistical modelling of historical exposure data. We compared the performance of this quantitative JEM (SYN-JEM) with an already available semi-quantitative general population JEM (DOM-JEM) within a study of pooled community-based lung cancer case-control studies (SYNERGY).

Methods Detailed lifetime occupational and smoking history was available for 13 259 cases and 16 232 controls from 11 case-control studies from 12 European countries and Canada. Occupational histories were linked with SYN-JEM and DOM-JEM to derive estimates of cumulative exposure. ORs for lung cancer were estimated using unconditional logistic regression adjusted for age, gender, study, cigarette pack-years, time-since-quitting smoking, and ever occupational exposure to five other known lung carcinogens.

Results Exposure to respirable quartz was associated with a monotonic increase in risk of lung cancer. Cumulative exposure estimates based on the quantitative SYN-JEM ranged from 0.005 to 104 mg/m3-years. Quartiles of cumulative exposure (categorised using the exposure distribution among exposed controls) showed significant elevated risks ranging from 1.16 to 1.40. SYN-JEM did not perform better than the ordinal DOM-JEM which provided similar ORs.

Conclusions We found a positive exposure-response association between occupational exposure to respirable quartz and lung cancer in a large pooled community-based case-control study. A semi-quantitative approach showed similar results as the quantitative exposure assessment approach except that with the latter risk can be expressed in terms of mg/m3 quartz years, which would facilitate quantitative risk-assessment.

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