Occupations and lung cancer: a population-based case-control study in British Columbia

Occupational exposure to endotoxins and small cell lung cancer: a systematic review with meta-analysis

The relationship of occupational exposure to endotoxins with different histologic subtypes of lung cancer has not been established. Our objective was to conduct a systematic review with meta-analysis to assess the effect of exposure to endotoxins on the development of small cell lung cancer (SCLC). A bibliographic search was conducted using MEDLINE, Embase, CENTRAL, and Web of Science databases until December 2022, including all cohort and/or case-control studies that examined occupational exposure to endotoxins and SCLC. Risk of bias was assessed using the U.S. Office of Health Assessment and Translation tool. A random effects model was applied, publication bias were assessed, and a sensitivity analysis was conducted. Four papers were selected for meta-analysis purposes. A total of 144 incident cases of SCLC and 897 population or hospital controls were included. Occupational exposure to endotoxins was considered for textile/leather industry and agricultural sector workers exposed to endotoxins originating from wool, cotton, or leather dust. Except for one study, all investigations were classified as having a low probability of risk of biases. The results of the meta-analysis were not statistically significant (pooled OR: 0.86; 95% CI:0.69-1.08). In addition, neither between-study heterogeneity (I2=0%;p=0.92) nor publication bias was observed (p=0.49). The results of the sensitivity analysis, after including five studies that assessed the risk of SCLC among textile industry and crop/livestock farm workers (not specifically exposed to endotoxins), showed a negative statistically non-significant association and low between-study heterogeneity (pooled OR: 0.90; 95% CI:0.79-1.02; I2=22%;p=0.23). Subjects exposed to occupational exposure to endotoxins seem to exhibit a negative association with the development of SCLC, although the results are not conclusive.

Wood dust exposure and small cell lung cancer: a systematic review and meta-analysis

INTRODUCTION

Occupational exposure role on small cell lung cancer (SCLC) onset has been little studied. Wood dust has been recognized as a human carcinogen, and many occupations have high wood-dust exposure. The aim of this study was therefore to perform a systematic review and meta-analysis of the scientific literature to summarize and analyse the risks of wood dust-related occupations on development of SCLC, taking tobacco use into account.

METHODS

We conducted a literature search of PubMed, EMBASE, Web of Science and Cochrane using a predefined strategy and including case-control and cohort studies assessing occupational exposure to wood dust or wood dust-related occupations. To perform the meta-analysis, the odds ratio (OR) and 95% confidence interval (CI) of each of the studies were extracted. A random-effects model was fitted using the DerSimonian Laird method. Sensitivity and subgroup analyses were performed. Quality was assessed using the Office and Health Assessment and Translation (OHAT) for human and animal studies instrument.

RESULTS

Eleven studies with a total of 2,368 SCLC cases and 357,179 controls were included. Overall, exposure to wood dust significantly increases risk of SCLC (RR = 1.41, 95% CI 1.11-1.80), with low heterogeneity between studies (I2 = 40%). The association was maintained in studies conducted on males (RR = 1.41, 95% CI 1.12-1.78) but not in those conducted on females/both sexes (RR = 1.37, 95% CI 0.35-3.44). Sensitivity analysis showed that none of the studies significantly modified the results.

CONCLUSIONS

Our results support that exposure to wood-dust can increase the risk of SCLC. Although the level of evidence is low, there are strong arguments to recommend the implementation of effective control measures to reduce exposure in occupational settings, as a means of preventing SCLC.

IMPACT STATEMENT

The results of this study support that exposure to wood-dust can increase the risk of developing small cell lung cancer. Determining the impact of occupational exposure on workers is essential to improve their individual protection and prevention. There is a strong case for recommending the implementation of control measures to reduce occupational exposure to wood dust, specifically for highly exposed occupations such as carpenters and sawmills, in order to prevent small cell lung cancer.

Occupation as a risk factor of small cell lung cancer

Small cell lung cancer (SCLC) comprises approximately 10% of all lung cancer cases. Tobacco is its main risk factor; however, occupation might play a role in this specific lung cancer subtype. The effect of occupation on SCLC risk has been hardly studied and therefore we aim to assess the role of occupation on the risk of SCLC. To do this, we designed a multicentric, hospital-based, case-control study. Cases consisted exclusively in SCLC patients and controls were recruited from patients having minor surgery at the participating hospitals. Face to face interviews emphasizing occupation and tobacco consumption were held and residential radon was also measured. Logistic regression models were adjusted with odds ratios with 95%CI as estimations of the effect. 423 cases and 905 controls were included. Smoking prevalence was higher in cases compared to controls. Those who worked in known-risk occupations for lung cancer showed an OR of 2.17 (95%CI 1.33; 3.52), with a similar risk when men were analysed separately. The results were adjusted by age, sex, smoking and indoor radon exposure. Those who worked in known-risk occupations and were moderate or heavy smokers had a SCLC risk of 12.19 (95%CI 5.68-26.38) compared with never or moderate smokers who had not worked in such occupations. Occupation is a relevant risk factor of SCLC, and it seems that its effect is boosted when tobacco smoking is present.

Environmental implications of the quality of charcoal briquettes and lump charcoal used for grilling

Numerous studies have been conducted to assess air pollution and human health risks arising from exposure to outdoor cooking, but limited standards have been implemented around the world to assure fuel quality. While charcoal briquettes and lumps are a popular fuel choice for grilling, almost no data specifying their properties are available to consumers. Because the properties of fuels affect the flue gases, it is critical to understand how the quality of grilling briquettes and lumps translates not only into the quality of the grilled food, but, even more importantly, how their emissions impact human safety and the environment. The main purpose of this study is to investigate the impacts of the quality of charcoal briquettes and lumps on potentially harmful emissions during grilling. To analyze their quality, we used reflected light microscopy to identify a range of contaminants, including biomass, mineral matter, coal, coke, metal, rust, plastics, glues, and synthetic resins, in 74 commercially available products made in Poland, the United States of America, Ukraine, Germany, Belarus, the Czech Republic, and the Republic of South Africa. Our data show that majority of the products analyzed do not meet the existing quality standard EN 1860-2:2005 (E) of less than 1% contaminants, some of these products contain up to 26.6% of impurities. The amount of contaminants correlates with particulate matter, as well as CO and CO₂. The contribution of biomass is especially significant because it can be used to predict harmful particulate matter emissions during grilling. The relationship between the composition of charcoal briquettes and lump charcoal and their emissions is particularly strong during the first 15 to 20 min after ignition (when emissions are the highest), therefore, this initial stage is especially unsafe to consumers, and staying away from the grill during this time is recommended.

Histologic Distribution of Pulmonary Tumors in Lebanon: A 5-Year Single Institution Experience

BACKGROUND

To compare the current histologic distribution of lung cancer in Lebanon to the worldwide trends, according to the 2004 WHO Classification.

MATERIALS AND METHODS

1,760 patients with a pulmonary pathology examination at Hotel-Dieu de France University Hospital between July 2009 and July 2014 were included.

RESULTS

Some 676 out of the total investigated patients (38.4%) had a lung tumor. In 665 (98.4%) the tumors were malignant, with a mean age at diagnosis of 63.8 years and a male/female (M/F) sex ratio of 1.7:1. Among the malignant tumors, 86.2% were epithelial tumors with a mean age at diagnosis of 64.8 years and an M/F sex ratio of 1.9. Other malignant tumors consisted of metastatic tumors (10.2%), lymphoproliferative tumors (2.1%) and mesenchymal tumors (1.5%). Most common carcinoma subtypes were adenocarcinoma (48.0%), squamous cell carcinoma (23.0%) and small cell carcinoma (13.3%). Carcinoid tumors were the only carcinoma subtype with an M/F sex ratio below 1 (0.7). Salivary gland tumors were the carcinoma with lowest mean age at diagnosis (45.5 years).

CONCLUSIONS

The histologic distribution of lung tumors in Lebanon is similar to that in developed countries. We believe this resemblance is due to common smoking habits, known to be responsible for the increase of lung adenocarcinoma at the expense of other subtypes.

Ultrafine particles from electric appliances and cooking pans: experiments suggesting desorption/nucleation of sorbed organics as the primary source

Ultrafine particles are observed when metal surfaces, such as heating elements in electric appliances, or even empty cooking pans, are heated. The source of the particles has not been identified. We present evidence that particles >10 nm are not emitted directly from the heating elements or the metal surfaces. Using repeated heating of an electric burner, several types of cooking pans, and a steam iron, the increase in the number of particles (>10 nm) can be reduced to 0. After the devices are exposed to indoor air for several hours or days, subsequent heating results in renewed particle production, suggesting that organic matter has sorbed on their surfaces. Also, after a pan has been heated to the point that no increase in particles is observed, washing with detergent results in copious production of particles the next time the pan is heated. These observations suggest that detergent residue and organics sorbed from indoor air are the sources of the particles. We hypothesize that organic compounds are thermally desorbed from the hot surface as gaseous molecules; as they diffuse from the hot air near the pan into cooler air, selected compounds exceed their saturation concentration and nucleation occurs.

Barbecue Fumes: An Overlooked Source of Health Hazards in Outdoor Settings?

Barbecuing or charcoal-grilling has become part of popular outdoor recreational activities nowadays; however, potential human health hazards through outdoor exposure to barbecue fumes have yet to be adequately quantified. To fill this knowledge gap, atmospheric size-fractioned particle and gaseous samples were collected near an outdoor barbecuing vendor stall (along with charcoal-grilled food items) in Xinjiang of Northwest China with a 10-stage micro-orifice uniform deposit impactor and a polyurethane foam (PUF) sampler and were analyzed for particulate matter and polycyclic aromatic hydrocarbons (PAHs). Exposure to PAHs through inhalation and dermal contact by adult consumers who spent 1 h per day near a charcoal-grilling vendor for a normal meal (lunch or dinner) amounted to a BaP equivalent (BaPeq) dosage of 3.0-77 ng day(-1) (inhalation: 2.8-27 ng day(-1) of BaPeq; dermal contact: 0.2-50 ng day(-1) of BaPeq), comparable to those (22-220 ng day(-1) of BaPeq) from consumer exposure through the consumption of charcoal-grilled meat, assumed to be at the upper limit of 50-150 g. In addition, the potential health risk was in the range of 3.1 × 10(-10) to 1.4 × 10(-4) for people of different age groups with inhalation and dermal contact exposure to PAHs once a day, with a 95% confidence interval (7.2 × 10(-9) to 1.2 × 10(-5)) comparable to the lower limit of the potential cancer risk range (1 × 10(-6) to 1 × 10(-4)). Sensitivity analyses indicated that the area of dermal contact with gaseous contaminants is a critical parameter for risk assessment. These results indicated that outdoor exposure to barbecue fumes (particularly dermal contact) may have become a significant but largely neglected source of health hazards to the general population and should be well-recognized.

Lung cancer risk among cooks when accounting for tobacco smoking: a pooled analysis of case-control studies from Europe, Canada, New Zealand, and China

OBJECTIVES

To investigate the risk of lung cancer among cooks, while controlling for smoking habits.

METHODS

We used data from the SYNERGY project including pooled information on lifetime work histories and smoking habits from 16 case-control studies conducted in Europe, Canada, New Zealand, and China.

RESULTS

Before adjustment for smoking, we observed an increased risk of lung cancer in male cooks, but not in female cooks. After adjusting, there was no increased risk and no significant exposure-response relationship. Nevertheless, subgroup analyses highlighted some possible excess risks of squamous cell carcinoma and small cell carcinoma in female cooks.

CONCLUSIONS

There is evidence that lung cancer risks among cooks may be confounded by smoking. After adjustment, cooks did not experience an increased risk of lung cancer overall. The subgroup analyses showing some excess risks among female cooks require cautious interpretation.

Comparative assessment of selected metals in the scalp hair and nails of lung cancer patients and controls

Lung cancer is seriously threatening human health and exposure to trace metals is the most important aetiology for lung cancer. Selected essential/toxic metals (Ca, Mg, Na, K, Fe, Zn, Cu, Sr, Li, Co, Mn, Ni, Cr, Cd and Pb) are measured in the scalp hair and nails of lung cancer patients and controls by atomic absorption spectrophotometric method employing nitric acid-perchloric acid-based wet digestion. Average concentrations of Pb, Cd, Mn, Co and Cu are found to be significantly higher (p < 0.05) in the scalp hair and nails of lung cancer patients compared with the controls, however, appreciably higher concentrations of Zn, Ca, Na, Mg and Cr are noted in the scalp hair of the controls. Most of the metal levels reveal higher dispersion and asymmetry in the scalp hair/nails of the patients compared with the controls. Average metal levels are also compared to investigate probable differences based on sex, abode, food and smoking habits. The correlation study shows significantly diverse mutual variations of the metals in the scalp hair and nails of the patients and controls. Considerable variations in the metal levels are also noted for various stages and types of lung cancer (adenocarcinoma, squamous cell carcinoma, large cell carcinoma and small cell lung cancer). Multivariate apportionment of the metals in the scalp hair and nails of the patients and controls are also significantly diverse. The study reveals considerably divergent variations in the metal levels in lung cancer patients in comparison with healthy subjects.

Cooking oil fumes and lung cancer: a review of the literature in the context of the U.S. population

There is growing evidence that exposure to cooking oil fumes (COF) is linked to lung cancer. Existing literature on this risk was reviewed, specifically as it may relate to potentially at-risk populations such as Chinese immigrants and restaurant workers in the United States. Studies were identified by searching the NCBI database with key terms. All studies that examined the significance, prevalence, and/or mechanism(s) of the association between COF exposure and cancer (all types) were included. A majority of epidemiologic studies found associations between lung cancer and COF exposure. All studies that examined the mechanisms underlying the risk found evidence for mutagenic and/or carcinogenic compounds in COF extract and/or molecular mechanisms for COF-induced DNA damage or carcinogenesis. The evidence reviewed underscores the need to thoroughly investigate the association among at-risk groups in the United States, as well as to develop and assess concrete interventions to reduce these risks.

Lung cancer risk among bakers, pastry cooks and confectionary makers: the SYNERGY study

INTRODUCTION

Some studies have suggested increased lung cancer risks among bakers, however the results overall were inconsistent. The authors studied lung cancer risks among bakers and baking-related occupations in the SYNERGY pooled case-control database from 16 countries.

METHODS

Occupation in a baking-related job was identified from the subjects' job histories. ORs adjusted for log(age), study centre, smoking behaviour and ever employment in a job with known exposure to occupational lung carcinogens were calculated by unconditional logistic regression. Findings were stratified by sex, histological subtype of lung cancer and smoking status.

RESULTS

19 366 cases (15 606 men) and 23 670 control subjects (18 528 men) were included. 473 cases (415 men, 58 women) and 501 controls (437 men, 64 women) had ever worked in baking or a related job. We did not observe an increased risk for men in baking (OR 1.01; 95% CI 0.86 to 1.18). No linear trends were observed for duration of employment. Some results suggested increased lung cancer risks for women, for example, for working as a baker for >30 years and in never-smokers, but after exclusion of one study these increased risks disappeared.

DISCUSSION

The findings from this study do not suggest increased lung cancer risks in baking-related professions.

Occupational exposure and thoracic malignancies, is there a relationship?

OBJECTIVES

The aim of this study was to evaluate the effect of occupational exposure in the occurrence of lung cancer.

METHOD

Three-hundred lung cancer cases diagnosed between September 1, 1999, and September 31, 2007, and 300 healthy controls were enrolled in this case-control study. Life-long occupational history, gender, age, exposure to asbestos, comorbidities, and smoking status were collected.

RESULTS

The mean age of the 300 lung cancer cases was 60.3 ± 9.9 year (91.7% male and 8.3% female), and the mean age of healthy control group was 60.4 ± 10.5 year (95.0% male and 5.0% female). The most frequent histological types were squamous (172, 57.3%), adeno (69, 23.1%), and small cell (37, 12.3%). There was an increased risk of lung cancer occurrence among agriculture workers (OR=1.89, 95% Cl=1.17-2.98) (p=0.009). Inorganic dust exposure (OR=1.81, 95% Cl=1.0-3.25) (p=0.049) and organic dust exposure (OR=1.89, 95% Cl=1.0-3.59) (p=0.05) were found to be related with high frequency of having lung cancer.

CONCLUSION

Workers who had occupational exposure to organic and inorganic dust, especially in the agricultural field, had higher risk of lung cancer occurrence when compared with office workers.

Occupational cooking and risk of uveal melanoma: a meta-analysis

BACKGROUND

Many observational studies have assessed the possible association between occupational cooking and uveal melanoma risk, but reported results are controversial. Our goal was to evaluate the association between occupational cooking and uveal melanoma risk by conducting a meta-analysis of observational studies.

METHODS

PubMed, EMBASE, and Web of Science were searched through June 2012 to identify all eligible studies. The pooled odds ratio (OR) with its 95% confidence interval (95%CI) was used to evaluate this association. Either a fixed- or a random-effects model were used to calculate pooled ORs.

RESULTS

Five case-control studies involving a total of 1,199 cases and 6,927 controls were included in the meta-analysis. Overall, occupational cooking was associated with an increased risk of uveal melanoma (OR: 1.81, 95%CI 1.33-2.46, P < 0.001). Subgroup analysis by gender suggested occupational cooking was associated with increased risk of uveal melanoma in both men (OR: 2.16, 95%CI 1.06-4.40, P = 0.034) and women (OR: 1.92, 95%CI 1.19-3.10, P = 0.008).

CONCLUSION

This meta-analysis suggests that occupational cooking is associated with an increased risk of uveal melanoma in both men and women.

Overview of lung cancer surgery in Ontario

BACKGROUND

Surgery is the primary curative treatment for lung cancer and thus appropriate surgical resource allocation is critical. This study describes the distribution of lung cancer incidence and surgical care in Ontario, a Canadian province with universal health care, for the fiscal year of 2004.

METHODS

All new lung cancer cases in Ontario between April 1, 2003 and March 31, 2004 were identified in the Ontario Cancer Registry. Incidence rates and surgical procedures were compared by age, health region, neighborhood income, and community size.

RESULTS

Lung cancer incidence was highest in lower income neighborhoods (90.2 cases of 100,000 vs 55.6 in the highest quintile, p < 0.001) and smaller communities (87.1 of 100,000 in communities less than 100,000 vs 56.3 of 100,000 in cities greater than 1.25 million, p < 0.001). Surgical interventions were most common in younger patients (47.4% aged 20 to 54 years versus 30.5% greater than 75 years, p < 0.001), and those in wealthier neighborhoods (43.4% in highest quintile versus 35.8% in the lowest, p < 0.001). Surgical procedures overall and specifically formal resections (20% in cities >1.25 million versus 18% in communities <100,000, p < 0.03) were more common in larger communities (43.4% versus 37.7%, p < 0.001). Pneumonectomy was more common in smaller communities (14.5% vs 9.9%, p = 0.048, whereas more lobar (53.8 vs 45.2%, p = 0.01) and sublobar resections (44.9% vs 31.7%, p < 0.0001) were more common in larger communities. Thoracic surgeons provided the majority of formal resections (51% to 57%) compared with general surgeons (17% to 21%).

CONCLUSIONS

Lung cancer incidence and surgical care vary significantly by health region, income level, and community size. These disparities require further evaluation to meet the needs of patients with lung cancer.

Lung cancer and occupation: A New Zealand cancer registry-based case-control study

BACKGROUND

There are many proven and suspected occupational causes of lung cancer, which will become relatively more important over time, as smoking prevalence decreases.

METHODS

We interviewed 457 cases aged 20-75 years notified to the New Zealand Cancer Registry during 2007-2008, and 792 population controls. We collected information on demographic details, potential confounders, and employment history. Associations were estimated using logistic regression adjusted for gender, age, ethnicity, smoking, and socio-economic status.

RESULTS

Among occupations of a priori interest, elevated odds ratios (ORs) were observed for sawmill, wood panel and related wood-processing plant operators (OR 4.63; 95% CI 1.05-20.29), butchers (OR 8.77, 95% CI 1.06-72.55), rubber and plastics products machine operators (4.27; 1.16-15.66), heavy truck drivers (2.24; 1.19-4.21) and workers in petroleum, coal, chemical and associated product manufacturing (1.80; 1.11-2.90); non-significantly elevated risks were also observed for loggers (4.67; 0.81-27.03), welders and flame-cutters (2.50; 0.86-7.25), pressers (5.74; 0.96-34.42), and electric and electronic equipment assemblers (3.61; 0.96-13.57). Several occupations and industries not of a priori interest also showed increased risks, including nursing associate professionals (5.45; 2.29-12.99), enrolled nurses (7.95; 3.10-20.42), care givers (3.47; 1.40-8.59), plant and machine operators and assemblers (1.61; 1.20-2.16), stationary machine operators and assemblers (1.67; 1.22-2.28), food and related products processing machine operators (1.98; 1.23-3.19), laborers and related elementary service workers (1.45; 1.05-2.00), manufacturing (1.34; 1.02-1.77), car retailing (3.08; 1.36-6.94), and road freight transport (3.02; 1.45-6.27).

CONCLUSIONS

Certain occupations and industries have increased lung cancer risks in New Zealand, including wood workers, metal workers, meat workers, textile workers and drivers. Am. J. Ind. Med. 54:89-101, 2011. © 2010 Wiley-Liss, Inc.