Occupational exposure to silica and lung cancer: pooled analysis of two case-control studies in Montreal, Canada.

Abstract : BACKGROUND: Respirable crystalline silica is a highly prevalent occupational exposure and a recognized lung carcinogen. Most previous studies have focused on selected high-exposure occupational groups. This study examines the relationship between occupational exposure to silica and lung cancer in an occupationally diverse male population. METHODS: Two large population-based case-control studies of lung cancer were conducted in Montreal, one in 1979-1986 (857 cases, 533 population controls, 1,349 cancer controls) and the second in 1996-2001 (738 cases and 899 controls). Interviews provided descriptive lifetime job histories, smoking histories, and other information. Industrial hygienists translated job histories into histories of exposure to a host of occupational substances, including silica. Relative risk was estimated, adjusting for several potential confounders, including smoking. RESULTS: The odds ratio for substantial exposure to silica was 1.67 (95% confidence interval, 1.21-2.31) and for any exposure was 1.31 (95% confidence interval, 1.08-1.59). Joint effects between silica and smoking were between additive and multiplicative, perhaps closer to the latter. In this population, it is estimated that approximately 3% of lung cancers were attributable to substantial silica exposure. CONCLUSIONS: The carcinogenicity of inhaled crystalline silica was observed in a population with a wide variety of exposure circumstances. IMPACT: The finding of carcinogenicity across a wide range of occupations complements prior studies of specific high-exposure occupations. This suggests that the burden of cancer induced by silica may be much greater than previously thought.
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Stephen Vida, Javier Pintos, Marie-Elise Parent, Jerome Lavoué, Jack Siemiatycki. Occupational exposure to silica and lung cancer: pooled analysis of two case-control studies in Montreal, Canada.. Cancer Epidemiology, Biomarkers and Prevention, American Association for Cancer Research, 2010, 19 (6), pp.1602-11. ⟨10.1158/1055-9965.EPI-10-0015⟩. ⟨pasteur-00819525⟩

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