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Associations between occupational exposure to benzene, toluene and xylene and risk of lung cancer in Montréal
  1. Hunter Warden1,
  2. Harriet Richardson1,
  3. Lesley Richardson2,
  4. Jack Siemiatycki2,3,
  5. Vikki Ho2,3
  1. 1Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
  2. 2University of Montréal Hospital Research Centre (CRCHUM), Health Innovation and Evaluation Hub, Montréal, Québec, Canada
  3. 3Department of Social and Preventive Medicine, University of Montréal, Montréal, Québec, Canada
  1. Correspondence to Dr Vikki Ho; vikki.ho{at}


Background Benzene, toluene and xylene (BTX) are aromatic hydrocarbons with inconclusive evidence of lung carcinogenicity. The aim of this research was to assess the associations between occupational exposures to BTX agents and lung cancer.

Methods In a population-based case-control study of lung cancer, occupational histories were obtained and exposures were assessed by experts. Unconditional multivariate logistic regression was used to estimate ORs and 95% CIs, among men, between various metrics of occupational exposure to BTX and lung cancer, while adjusting for established and possible risk factors.

Results Considerable overlap was found between occupational exposure to BTX, where the majority of exposed participants were exposed to all three chemicals. Lung cancer was associated with exposure to benzene (OR=1.35; 95% CI 0.99 to 1.84), toluene (OR=1.31; 95% CI 0.99 to 1.74) and xylene (OR=1.44; 95% CI 1.03 to 2.01). While these results were adjusted for smoking and other recognised and possible lung cancer risk factors, they were not mutually adjusted among the three BTX agents.

Conclusions Our study provides suggestive evidence that occupational exposure to one or more of the BTX agents may be associated with lung cancer.

  • lung cancer
  • occupational exposure
  • benzene
  • toluene
  • xylene

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  • Contributors Each author has directly participated in the planning, execution or analysis of the study. JS and LR designed the study. HW, HR, LR and VH designed the study’s analytic strategy and interpreted the results. JS provided expert advices in study design and data analysis and in the interpretation of study results. HW, HR and VH drafted the manuscript. All authors critically revised and commented on the manuscript.

  • Funding Funding for the study was provided by the National Cancer Institute of Canada, the Fonds de recherche en santé du Québec and the Canadian Institutes for Health Research. JS’s research team was supported in part by the Canada Research Chairs programme and the Guzzo-SRC Chair in Environment and Cancer. LR is supported in part by a salary award (NIH-R01) from the National Institutes of Health. VH is currently supported by the Cancer Research Society, Fonds de recherche du Québec—Santé (FRQS) and Ministère de l'Économie, de la Science et de l’Innovation du Québec (MESI).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Approval was obtained from the Institutional Review Boards of the Institut Armand-Frappier, McGill University, the Université de Montréal and all participating hospitals.

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