Background Lung cancer incidence in Central and Eastern Europe (CEE) is among the highest in the world, and the role of occupational exposures has not been adequately studied in these countries.
Objectives To investigate the contribution of occupational exposure to polycyclic aromatic hydrocarbons (PAH) to lung cancer in CEE.
Methods A case–control study was conducted in the Czech Republic, Hungary, Poland, Romania, Russia and Slovakia, as well as the United Kingdom (UK) between 1998 and 2002. Occupational and socio-demographic information was collected through interviews from 2861 newly diagnosed lung cancer cases and 2936 population or hospital controls. Industrial hygiene experts in each country evaluated exposure to 70 occupational agents, whereof 15 mixtures containing PAH. ORs of lung cancer were calculated after adjusting for other occupational exposures and tobacco smoking.
Results The OR for ever exposure to PAH in the CEE countries was 0.93 (95% CI 0.77 to 1.14). The ORs for the highest category of cumulative exposure, duration of exposure and intensity of exposure were 1.13 (95% CI 0.80 to 1.58), 1.02 (95% CI 0.66 to 1.57) and 1.11 (95% CI 0.60 to 2.05), respectively. The OR for ever PAH exposure in the UK was 1.97 (95% CI 1.16 to 3.35).
Conclusion Occupational PAH exposure does not appear to substantially contribute to the burden of lung cancer in CEE. The apparently stronger effect observed in the UK may be due to high exposure levels and a joint effect with asbestos.
- Lung neoplasms
- polycyclic hydrocarbons
- occupational exposure
- case-control studies
- epidemiology, cancer
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Funding This work was supported by a grant from the European Commission's INCO-COPERNICUS program (contract no. IC15-CT96-0313). In Warsaw, the study was supported by a grant from the Polish State Committee for Scientific Research, grant no. SPUB-M-COPERNICUS/P-05/DZ-30/99/2000. In Liverpool, the work was funded by the Roy Castle Foundation as part of the Liverpool Lung Project.
Competing interests None.
Ethics approval Ethics approvals were obtained from the relevant ethics review committees in each country, and subsequently by the IARC ethical review committee on 19 March 1999.
Provenance and peer review Not commissioned; externally peer reviewed.