Lung cancer risk among bricklayers in a pooled analysis of case-control studies.

Dario Consonni (1) , Sara de Matteis (2, 3) , Angela C Pesatori (1, 2) , Pier Alberto Bertazzi (1, 2) , Ann C Olsson (4, 5) , Hans Kromhout (6) , Susan Peters (7, 6) , Roel C H Vermeulen (6) , Beate Pesch (8) , Thomas Brüning (8) , Benjamin Kendzia (8) , Thomas Behrens (8) , Isabelle Stücker (9) , Florence Guida (9) , Heinz-Erich Wichmann (10) , Irene Brüske (10) , Maria Teresa Landi (11) , Neil E Caporaso (11) , Per Gustavsson (5) , Nils Plato (5) , Lap Ah Tse (12) , Ignatius Tak-Sun Yu (12) , Karl-Heinz Jöckel (13) , Wolfgang Ahrens (14, 15) , Hermann Pohlabeln (14) , Franco Merletti (16) , Lorenzo Richiardi (16) , Lorenzo Simonato (17) , Francesco Forastiere (18) , Jack Siemiatycki (19) , Marie-Élise Parent (20) , Adonina Tardón (21) , Paolo Boffetta (22, 23) , David Zaridze (24) , Ying Chen (25, 26) , John K Field (26) , Andrea 'T Mannetje , Neil Pearce (27) , John Mclaughlin (28) , Paul Demers (29) , Jolanta Lissowska (30) , Neonila Szeszenia-Dabrowska (31) , Vladimir Bencko (32) , Lenka Foretova (33) , Vladimir Janout (34) , Peter Rudnai (35) , Eleonóra Fabiánová (36) , Rodica Stanescu Dumitru (37) , H Bas Bueno-De-Mesquita (38, 3) , Joachim Schüz (4) , Kurt Straif (4)

1 Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
2 UNIMI - Università degli Studi di Milano = University of Milan
3 Imperial College London
4 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
5 IMM - The Institute of Environmental Medicine [Stockholm]
6 Institute for Risk Assessment Sciences
7 UWA - The University of Western Australia
8 IPA - Institute for Prevention and Occupational Medicine of the German Social Accident Insurance
9 CESP - Centre de recherche en épidémiologie et santé des populations
10 Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH)
11 NCI-NIH - National Cancer Institute [Bethesda]
12 The Chinese University of Hong Kong [Hong Kong]
13 University Hospital Essen
14 Leibniz Institute for Prevention Research and Epidemiology - BIPS
15 University of Bremen
16 Unit of Cancer Epidemiology
17 Unipd - Università degli Studi di Padova = University of Padua
18 ASL - Azienda Sanitaria Locale [ROMA]
19 CHUM - Centre Hospitalier de l'Université de Montréal
20 INRS-IAF - Institut Armand Frappier
21 CIBER de Epidemiología y Salud Pública (CIBERESP)
22 IPRI - International Prevention Research Institute
23 MSSM - Icahn School of Medicine at Mount Sinai [New York]
24 Institute of Carcinogenesis
25 Keele University [Keele]
26 University of Liverpool
27 LSHTM - London School of Hygiene and Tropical Medicine
28 Samuel Lunenfeld Research Institute
29 Cancer Care Ontario
30 The M Sklodowska-Curie Cancer Center and Institute of Oncology
31 The Nofer Institute of Occupational Medicine
32 Institute of Hygiene and Epidemiology
33 MUNI - Masaryk University [Brno]
34 Department of Optics [Univ Palacký]
35 National Institutes of Environmental Health Sciences
36 RAPH - Regional Authority of Public Health [Slovaquia]
37 Institute of Public Health
38 RIVM - National Institute for Public Health and the Environment [Bilthoven]

Bricklayers may be exposed to several lung carcinogens, including crystalline silica and asbestos. Previous studies that analyzed lung cancer risk among these workers had several study design limitations. We examined lung cancer risk among bricklayers within SYNERGY, a large international pooled analysis of case-control studies on lung cancer and the joint effects of occupational carcinogens. For men ever employed as bricklayers we estimated odds ratios (OR) and 95% confidence intervals (CI) adjusted for study center, age, lifetime smoking history and employment in occupations with exposures to known or suspected lung carcinogens. Among 15,608 cases and 18,531 controls, there were 695 cases and 469 controls who had ever worked as bricklayers (OR: 1.47; 95% CI: 1.28-1.68). In studies using population controls the OR was 1.55 (95% CI: 1.32-1.81, 540/349 cases/controls), while it was 1.24 (95% CI: 0.93-1.64, 155/120 cases/controls) in hospital-based studies. There was a clear positive trend with length of employment (p < 0.001). The relative risk was higher for squamous (OR: 1.68, 95% CI: 1.42-1.98, 309 cases) and small cell carcinomas (OR: 1.78, 95% CI: 1.44-2.20, 140 cases), than for adenocarcinoma (OR: 1.17, 95% CI: 0.95-1.43, 150 cases) (p-homogeneity: 0.0007). ORs were still elevated after additional adjustment for education and in analyses using blue collar workers as referents. This study provided robust evidence of increased lung cancer risk in bricklayers. Although non-causal explanations cannot be completely ruled out, the association is plausible in view of the potential for exposure to several carcinogens, notably crystalline silica and to a lesser extent asbestos.

Keywords: lung neoplasms; case-control studies; epidemiology; bricklayers; occupational health

Domains: Life Sciences [q-bio]; Cancer; Health

Dario Consonni, Sara de Matteis, Angela C Pesatori, Pier Alberto Bertazzi, Ann C Olsson, et al.. Lung cancer risk among bricklayers in a pooled analysis of case-control studies.. International Journal of Cancer, 2015, 136 (2), pp.360-71. ⟨10.1002/ijc.28986⟩. ⟨pasteur-01351908⟩