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Occupation and the risk of lung cancer by histologic types and morphologic distribution: a case control study in
O C Elci1, M Akpinar-Elci, M Alavanja
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA. OElci@cdc.gov
Background:
The lung cancer incidence rate in Turkey has been increasing since the early 1980's. Etiology of lung cancer could be affected by differences in lifestyle, working conditions, and occupational exposures.
Objectives:
A hospital based case-control study was conducted in Turkey to provide information on the role that occupation plays in lung cancer etiology and the relationship between occupations and histologic types and the morphologic distribution of lung cancer.
Methods:
A total of 1,354 male cases and 1,519 controls were analysed. Basic information was obtained from patients from a standardised questionnaire. Occupational titles of the subjects were classified by standard occupational and industrial codes. Age- and smoking-adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated.
Results:
Excess lung cancer occurred among fire-fighters (OR: 6.8, CI: 1.3-37.4), drivers (OR: 1.4, CI: 1.1-2.0), textile workers (OR: 1.7, CI: 1.1-2.7), water treatment plant workers (OR: 2.2, CI: 1.1-4.3) and highway construction workers (OR: 1.5, CI: 1.0-2.5). Workers in the textile and grain milling industries were shown to have a significant excess risk of squamous cell carcinoma. Textile workers, and those working at water treatment plants had excess risk of small cell carcinoma. Construction workers had excess risk of adenocarcinoma. Fire-fighters and workers at textile plants, grain mills, water treatment plants, and in steel production were exposed to a high risk of peripheral tumors while the risk of central tumors was excessive among drivers and highway construction workers.
Conclusions:
The risk of lung cancer was associated with several occupations and peripheral located tumors and squamous lung cancer was the most common type.
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