Objectives To investigate the associations between occupational exposure to refractory ceramic fibres (RCF) and the risk of lung and head and neck cancer.

Methods We used data from ICARE, a population based case-control study conducted in France. Detailed lifetime tobacco and alcohol consumptions as well as complete occupational history were collected. Analyses were restricted to men and included 1867 cases of head and neck squamous cell carcinomas, 2276 lung cancer cases and 2780 controls. Occupational exposure to RCF was assessed through a specific job-exposure matrix. We estimated odds ratios (ORs) and 95% confidence intervals (CI), adjusted for age, residence area, tobacco smoking, alcohol drinking and cumulative exposure to asbestos with logistic models.

Results Exposure to RCF was not associated with the risk of lung (OR = 0.9, CI = 0.7–1.2) or head and neck cancer overall (OR = 0.8, CI = 0.6–1.1) or for any of the cancer sites. There was no suggestion of a dose-response relationship with cumulative exposure. When we excluded subjects with the lowest probability of exposure, a non-significantly elevated risk was observed for lung cancer only (OR = 1.3, CI = 0.8–2.2). Co-exposure to asbestos and RCF did not increase the risk of respiratory cancer. For men exposed to both asbestos and RCF, the ORs were 1.8 (CI = 1.4–2.3) for lung cancer and 1.6 (1.2–2.0) for head and neck cancer, compared to respectively 1.7 (CI = 1.5–2.0) and 1.8 (CI = 1.5–2.1) for men exposed to asbestos alone. Since nearly all subjects exposed to RCF were also exposed to asbestos, an independent role of exposure to RCF could not be evaluated.

Conclusion Even if a small excess risk cannot be excluded, our results do not provide evidence that exposure to RCF increases the risk of respiratory cancer.