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A case–cohort study of lung cancer in poultry and control workers: occupational findings
  1. Martha Felini1,
  2. Nikiconia Preacely1,
  3. Nihita Shah1,
  4. Anita Christopher1,
  5. Vishnu Sarda2,
  6. Mohammed Elfaramawi1,
  7. Macodou Sall3,
  8. Saritha Bangara1,
  9. Subi Gandhi1,
  10. Eric S Johnson1
  1. 1Department of Epidemiology, UNT Health Sciences Center, Fort Worth, Texas, USA
  2. 2Department of Biostatistics, UNT Health Sciences Center, Fort Worth, Texas, USA
  3. 3Tulane University School of Public Health, New Orleans, Louisiana, USA
  1. Correspondence to Professor Eric S Johnson, Department of Epidemiology, School of Public Health, University of North Texas Health Sciences Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA; eric.johnson{at}


Objectives We conducted a mortality study of members of the United Food and Commercial Workers International Union who worked in poultry slaughtering/processing plants, and controls. Excess deaths from cancer at 11 different cancer sites including lung cancer were observed in the poultry workers. The study described here is a pilot case–cohort study of lung cancer nested within the cohort to examine if it is possible, in a larger study to be conducted later, to identify specific potentially carcinogenic occupational exposures in poultry workers.

Methods Subjects or the next of kin of deceased subjects were interviewed by phone. Logistic regression ORs and Cox proportional HRs were estimated.

Results Elevated risks for poultry exposure were recorded for subjects who (1) killed chickens at work (OR 4.2, 95% CI 1.2 to 14.7; HR 1.8, 95% CI 1.0 to 3.3) and (2) ever had direct contact with chicken blood at work (OR 1.9, 95% CI 1.0 to 3.8; HR 1.3, 95% CI 0.9 to 2.0). These activities are associated with high exposure to oncogenic viruses.

Conclusion These results may have important public health implications, since the general population is also exposed to these viruses. Elevated risks were observed for non-poultry-related occupational exposures such as working in a stockyard, working in a chemical plant, use of chemicals to kill moulds, and working in plants where plastic products were manufactured. These preliminary findings indicate that full scale epidemiological studies of adequate statistical power are needed to examine the role of occupational exposures in cancer occurrence in poultry workers.

  • Oncogenic viruses
  • chickens
  • meat
  • live animal
  • slaughter
  • cancer
  • public health
  • epidemiology
  • mortality studies
  • exposure monitoring
  • exposure assessment
  • cross sectional studies
  • environment
  • dioxins
  • developing countries
  • benzene
  • animal workers
  • zoonoses
  • leukaemia
  • communicable diseases

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  • Funding This study was funded by grant 1 RO1 OH008071 from the National Institute for Occupational Safety and Health.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Human Subjects Committee (Institutional Review Board) of the University of North Texas Health Science Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.