Objectives Despite the compelling association between wood dust and sinonasal cancer, there has been little systematic and rigorous study of the relationship between wood dust and lung cancer. We investigated whether a history of wood dust exposure through occupational and hobby-related activities was associated with increased lung cancer risk.

Methods We conducted a population-based case-control study, with 440 cases and 845 age-matched controls. Using detailed work and personal histories, quantitative estimates of cumulative exposure to wood dust (thought to be primarily from softwood) were calculated for each participant. Using unconditional logistic regression adjusted for age and smoking status, risk of lung cancer was examined in relation to employment in wood-related occupations, working with wood as a hobby, as well as cumulative wood dust exposure that took into account both occupational and hobby-related sources.

Results While we observed an increased risk of lung cancer associated with working in a sawmill (OR=1.5; 95% CI: 1.1, 2.1), we found no evidence of increased risks with other occupations, working with wood as a hobby or with estimated cumulative exposure to wood dust. Contrary to our hypothesis, we observed modest decreased risks with exposure to wood dust, although no dose-response relationship was apparent.

Conclusions This study provided somewhat reassuring evidence that softwood dust does not increase the risk of lung cancer, but future studies should evaluate exposure to hardwood dusts. Suggestive evidence for an inverse association may be attributable to the presence of endotoxin in the wood dust, but the lack of a dose-response relationship suggests a non-causal relationship.