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0373 Pooling case-control studies for enhanced evidence on occupational risk factors in lung cancer research – the SYNERGY project
  1. Ann Olsson1,2,
  2. Hans Kromhout3,
  3. Roel Vermeulen3,
  4. Susan Peters3,
  5. Beate Pesch4,
  6. Thomas Behrens4,
  7. Benjamin Kendzia4,
  8. Joachim Schüz1,
  9. Kurt Straif1
  1. 1International Agency for Research on Cancer, Lyon, France
  2. 2The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  3. 3Institute for Risk Assessment Sciences, Utrecht, The Netherlands
  4. 4Institute for Prevention and Occupational Medicine of the German Social Accident Insurance – Institute of the Ruhr-Universität Bochum, Bochum, Germany


Objectives Explore quantitative exposure-response association for exposure to asbestos, crystalline silica, nickel, chromium and polycyclic aromatic hydrocarbons in the general population; further study effects on specific cell types and potential interaction with smoking and co-occurring occupational exposures.

Method Fourteen studies from Europe and Canada were pooled including 17 700 lung cancer cases and 21 800 controls with detailed information on tobacco habits and lifetime occupations. A quantitative job-exposure-matrix (SYN-JEM) was developed based on more than 350.000 exposure measurements from the participating countries. Different model specifications were compared to predict historical job-, time-, and region-specific exposure levels. Individual exposure levels were calculated for each subject by linking the SYN-JEM with the individual occupational histories. Unconditional logistic regression models were fitted to estimate odds ratios, 95% confidence intervals, and trends.

Results We observed exposure-response relationships with increasing duration and cumulative exposure for all agents and generally saw a stronger effect for squamous- and small cell lung carcinomas than for adenocarcinomas. Smoking and simultaneous exposure to other occupational exposures exerted a minor confounding effect on the risk estimates. The effect modifications with smoking tended to be supra-additive.

Conclusions SYNERGY adds valuable knowledge to the field of occupational cancer epidemiology, and underlines the importance to collect data on histology, and lifelong information on occupational exposures and smoking.

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