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Poster-discussion: Lung Cancer
Lung cancer risk among cooks and kitchen workers in a pooled analysis of case-control studies in Europe and Canada
  1. Carolina Bigert1,
  2. Ann Olsson2,
  3. Per Gustavsson1,
  4. Thomas Brüning3,
  5. Benjamin Kendzia3,
  6. Beate Pesch3,
  7. Karl-Heinz Jöckel4,
  8. Hermann Pohlabeln5,
  9. Wolfgang Ahrens5,
  10. Isabelle Gross3,
  11. Irene Brüske6,
  12. Heinz-Erich Wichmann6,
  13. Franco Merletti7,
  14. Dario Mirabelli7,
  15. Lorenzo Richiardi7,
  16. David Zaridze8,
  17. Adrian Cassidy9,
  18. Neonila Szeszenia-Dabrowska10,
  19. Peter Rudnai11,
  20. Jolanta Lissowska12,
  21. Isabelle Stücker13,
  22. Eleonora Fabianova14,
  23. Rodica Stanescu Dumitru15,
  24. Vladimir Bencko16,
  25. Lenka Foretova17,
  26. Vladimir Janout18,
  27. Jack Siemiatycki19,
  28. Maria Teresa Landi20,
  29. Neil Caporaso20,
  30. Paul Brennan2,
  31. Simone Benhamou21,
  32. Veronique Benhaim-Luzon2,
  33. Hans Kromhout22,
  34. Roel Vermeulen22,
  35. Susan Peters22,
  36. Dario Consonni23,
  37. Bas Bueno-de-Mesquita24,
  38. Paolo Boffetta25,
  39. Kurt Straif2
  1. 1Karolinska Institutet, Stockholm, Sweden
  2. 2IARC, Lyon, France
  3. 3IPA, Bochum, Germany
  4. 4University of Duisburg-Essen, Essen, Germany
  5. 5Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany
  6. 6Deutsches Forschungszentrum fur Gesundheit und Umwelt, Neuherberg, Germany
  7. 7University of Turin, Turin, Italy
  8. 8Russian Cancer Research Centre, Moscow, Russia
  9. 9Cancer Research Centre, University of Liverpool, Liverpool, UK
  10. 10Nofer Institute, Lodz, Poland
  11. 11National Institute of Environment Health, Budapest, Hungary
  12. 12Cancer Center and Institute of Oncology, Warsaw, Poland
  13. 13INSERM U 754 – IFR69, Villejuif, France
  14. 14Regional Authority of Public Health, Banska Bystrica, Slovakia
  15. 15Institute of Public Health, Bucharest, Romania
  16. 16Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic
  17. 17Masaryk Memorial Cancer Institute, Brno, Czech Republic
  18. 18Palacky University, Olomouc, Czech Republic
  19. 19University of Montreal, Montreal, Canada
  20. 20NCI, Bethesda, USA
  21. 21INSERM U 946, Paris, France
  22. 22Utrecht University, Utrecht, The Netherlands
  23. 23Fondazione IRCCS Ca'Granda – Ospedale Maggiore Policlinico, Milan, Italy
  24. 24NIVM, Bilthoven, The Netherlands
  25. 25Mount Sinai School of Medicine, New York, USA


Objectives Several epidemiologic studies indicate an increased risk of lung cancer among cooks but it is not known whether this is caused by cigarette smoking or by occupational exposure to carcinogens. Emissions from high-temperature frying have been classified by the IARC as probably carcinogenic to humans.

Methods We used data from the SYNERGY project with pooled information on lifetime work histories and tobacco smoking from 13 176 lung cancer cases and 16 129 controls from 11 case-control studies in Europe and Canada. There were 704 persons (405 men, 299 women) who had ever worked as a cook or kitchen worker (based on ISCO-68), among them 340 cases and 364 controls. ORs and 95% CIs were estimated by unconditional logistic regression, adjusted for study, age, sex, smoking, and ever employment in an occupation with established lung cancer risk.

Results Occupation as a cook or kitchen worker was associated with an increased lung cancer risk before (OR 1.20, 95% CI 1.03 to 1.40) but not after (OR 1.01, 95% CI 0.86 to 1.20) controlling for smoking habits. There was no significant exposure-response relationship in terms of work duration, and no significant heterogeneity in lung cancer risk among cooks across studies. It was not possible to separate cooks from other kitchen workers.

Conclusions Working as a cook or kitchen worker was not associated with an increased risk of lung cancer. However, the possible risk by cooking fumes cannot be ruled out. Misclassification of exposure may have biased our results towards the null.

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