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Original research
Sex-specific risks and trends in lung cancer mortality across occupations and economic activities in Switzerland (1990–2014)
  1. Nicolas Bovio1,
  2. David B. Richardson2,
  3. Irina Guseva Canu1
  1. 1Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), University of Lausanne, Lausanne, Switzerland
  2. 2Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to Nicolas Bovio, Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), University of Lausanne, Lausanne, Switzerland; nicolas.bovio{at}


Objectives To assess lung cancer mortality across occupations and economic activities/industries in Switzerland using three statistical estimates.

Methods All Swiss residents aged 18–65 during the 1990 or 2000 censuses were followed through 2014 to ascertain information on date and cause of death. For every occupation and economic activity/industry, causal mortality ratios (CMR) and standardised mortality ratios (SMR) were computed using national cause-specific mortality rates. We also calculated relative SMR (rSMR) and conducted analyses stratified by socioeconomic variables, job skill level and calendar periods.

Results The study sample comprised 5 834 618 participants (111 162 348 person-years). SMR and CMR led to similar results, while rSMR were generally higher. We found 18 occupations in men, 10 occupations in women and 3 industries in each sex with an excess of lung cancer mortality. Among men, rubber and plastic products machine operators, and workers in mining and quarrying, and construction industries were at high risk. Among women, motor vehicle drivers and workers in trade, repair of motor vehicles and of domestic articles and manufacture of goods industries showed the highest risks. In both sexes, hotel and restaurant workers presented an excess of lung cancer mortality.

Conclusion Most of the activities and occupations in which we observed excess lung cancer mortality have previously been observed to involve occupational exposure to lung carcinogens. These findings suggest that the number of occupational lung cancer is likely underestimated by the official Swiss statistics. Further research should address this question and the exposure–effect relationships in the most at-risk occupational groups.

  • epidemiology
  • cancer

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  • Contributors The Swiss National Cohort (SNC)

  • Funding This work was supported by the Swiss National Science Foundation (grant no 210.0-03-2018).

  • Competing interests This work was conducted in frame of the SNC nested study contract no 180036.

  • Patient consent for publication Not required.

  • Ethics approval The SNC and the present study were approved by the Cantonal Ethics Committees of Bern and Zurich, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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

  • Data availability statement No data are available. We do not own the data. To have acess to data, people should directly contact the person in charge of the Swiss National Cohort.