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MS SYNERGY collaboration – occupational factors in lung cancer
Lung cancer risk in painters: results from the SYNERGY pooled analysis
  1. Neela Guha1,
  2. Ann Olsson1,
  3. Hans Kromhout2,
  4. Roel Vermeulen2,
  5. Thomas Brüning3,
  6. Beate Pesch3,
  7. Benjamin Kendzia3,
  8. Heinz-Erich Wichmann4,
  9. Irene Brüske4,
  10. Isabelle Stücker5,
  11. Sara De Matteis6,
  12. Maria Teresa Landi7,
  13. Neil Caporaso7,
  14. Jack Siemiatycki8,
  15. Per Gustavsson9,
  16. Nils Plato9,
  17. Franco Merletti10,
  18. Dario Mirabelli10,
  19. Lorenzo Richiardi10,
  20. Wolfgang Ahrens11,
  21. Hermann Pohlabeln11,
  22. Karl-Heinz Jöckel12,
  23. David Zaridze13,
  24. Adrian Cassidy14,
  25. Jolanta Lissowska15,
  26. Neonila Szeszenia-Dabrowska16,
  27. Simone Benhamou17,
  28. Alena Slamova18,
  29. Lenka Foretova19,
  30. Vladimir Janout20,
  31. Peter Rudnai21,
  32. Eleonora Fabianova22,
  33. Rodica Stanescu Dumitru23,
  34. Francesco Forastiere24,
  35. Bas Bueno-de-Mesquita25,
  36. Susan Peters2,
  37. Paolo Boffetta26,
  38. Veronique Benhaim-Luzon1,
  39. Kurt Straif1
  1. 1IARC, Lyon, France
  2. 2Utrecht University, Utrecht, The Netherlands
  3. 3IPA, Bochum, Germany
  4. 4Institut für Epidemiologie, Neuherberg, Germany
  5. 5INSERM U 754 - IFR69, Villejuif, France
  6. 6Universita degli Studi di Milano, Milan, Italy
  7. 7NCI, Bethesda, USA
  8. 8University of Montreal Hospital, Montreal, Canada
  9. 9Karolinska Institute, Stockholm, Sweden
  10. 10University of Turin, Turin, Italy
  11. 11Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany
  12. 12University of Duisburg-Essen, Duisburg-Essen, Germany
  13. 13Russian Cancer Research Centre, Moscow, Russia
  14. 14University of Liverpool, Liverpool, UK
  15. 15Cancer Center and Institute of Oncology, Warsaw, Poland
  16. 16Nofer Institute, Lodz, Poland
  17. 17INSERM U 946, Paris, France
  18. 18Charles University, Prague, Czech Republic
  19. 19Masaryk Memorial Cancer Institute, Brno, Czech Republic
  20. 20Palacky University, Olomouc, Czech Republic
  21. 21National Institute of Environment Health, Budapest, Hungary
  22. 22Regional Authority of Public Health, Banska Bystrica, Slovakia
  23. 23Institute of Public Health, Bucharest, Romania
  24. 24Department of Epidemiology. ASL RomaE, Rome, Italy
  25. 25NIVM, Bilthoven, The Netherlands
  26. 26Tisch Cancer Insitute, New York, USA


Objectives The International Agency for Research on Cancer identified “occupational exposure as a painter” as a cause of lung cancer. Identifying the specific causative agent(s) has been difficult since painters are exposed to mixtures of known and suspected carcinogens that change over time. Using a large pooled dataset, we evaluated the risk of lung cancer among painters by duration of employment and painting activity.

Methods Detailed individual data on smoking were available for 16258 lung cancer cases (605 painters, 3.7%) and 19922 age- and sex-matched controls (473 painters, 2.4%) from SYNERGY, a pooled effort of 12 case-control studies in Europe and Canada. Painting activity was classified from job titles using ISCO 1968 and ISIC Revision 2 codes. Multivariable logistic regression models were adjusted for age, gender, centre, smoking habits and previous employment in high-risk occupations.

Results An OR of 1.38 (95% CI 1.20 to 1.59) was found for ever working as a painter; the excess risk of lung cancer increased with increasing years of employment (p-trend<0.0001). In never smokers, the OR was 1.75 (95% CI 1.01 to 3.02). The highest lung cancer risks with significant exposure-response trends were observed for construction (p-trend<0.0001), spray (p-trend=0.01) and repair painters (p-trend=0.03). Results were similar by histological type.

Conclusions These findings support the evidence of an increased risk of lung cancer among painters. Analyses by painting activity may help to identify causative agents.

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