Objectives Lung cancer is the 4th most common malignancy in South Africa. Although smoking is a well established risk factor, the role of occupational exposures in the local setting is not clear. We estimated the lung cancer risk attributable to occupations.
Method Data from on-going Johannesburg Cancer Case-Control Study of black African adult cancer patients (2001–2008) was used. Information from 579 lung cancer cases and 1120 frequency matched controls was analysed. Controls were randomly selected from cancers not known to be associated with the effects of tobacco, matched by sex and age (±5years). Usual occupation stated at interview were used as an indicator of occupational exposure. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression and attributable fraction (AF) by Miettinen’s formula, adjusted for smoking pack years, HIV status and domestic fuel type use.
Results The mean age of cases and controls was 56.0 and 57.1. Among men, adjusted OR for lung cancer was 3.0 (95% CI 1.4–6.4) in miners and 1.7 (95% CI 1.3–3.2) in transport occupations. In women, the adjusted OR in domestic workers was 7.3 (95% CI 1.7–11.3) whereas working in the food and beverage industry was 4.9 (95% CI 1.4–26.8). Occupation resulted in an AF of 14% in men and 26% in women.
Conclusions Occupational risk factors for lung cancer in South Africa are gender-specific, having more impact in women than in men. Further studies are needed to assess possible specific exposures in the mining and transport industries for men, and food industry and private homes for women.
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