Nested case-control study of lung cancer among chemical workers

A recent cohort mortality study of 19,608 male employees of a major Texas chemical production facility had suggested that they might be at higher risk of lung cancer compared with the male population of the United States or Texas but not with the male population of the five-county area in which they reside. An occupational exposure was a possible explanation for this pattern, and a nested case-control study was undertaken of the 308 lung cancer deaths observed between 1940 and 1981. Two control groups, one a decedent and the other a "living" series, were individually matched to cases one-for-one. Interviews were conducted with subjects or their next of kin to collect information on smoking and other potential confounders. These data were combined with employee work history records and industrial hygiene data to form the basis of the analyses. Traditional stratification methods and conditional logistic regression were employed to examine for effect modification and to control confounding. Statistically significant, positive and negative associations were found for assignment to several work areas within the facility. Suggestive associations were observed for exposure to sulfur dioxide and heat. These and additional associations are discussed relative to evidence from other studies.