Case-control study of radon and lung cancer in New Jersey.

Radon is known to cause lung cancer in humans; however, there remain uncertainties about the effects associated with residential exposures. This case-control study of residential radon and lung cancer was conducted in five counties in New Jersey and involved 561 cases and 740 controls. A year long alpha-track detector measurement of radon was completed for approximately 93% of all residences lived in at the time of interview (a total of 2,063). While the odds ratios (ORs) for whole data were suggestive of an increased risk for exposures >75 Bq m(-3), these associations were not statistically significant. The adjusted excess OR (EOR) per 100 Bq m(-3) was -0.13 (95% CI: -0.30 to 0.44) for males, 0.29 (95% CI: -0.12 to 1.70) for females and 0.05 (95% CI: -0.14 to 0.56) for all subjects combined. An analysis of radon effects by histological type of lung cancer showed that the OR was strongest for small/oat cell carcinomas in both males and females. There was no statistical heterogeneity of radon effects by demographic factors (age at disease occurrence, education level and type of respondent). Analysis by categories of smoking status, frequency or duration did not modify the risk estimates of radon on lung cancer. The findings of this study are consistent with an earlier population-based study of radon and lung cancer among New Jersey women, and with the North American pooling of case control radon seven studies, including the previous New Jersey study. Several uncertainties regarding radon measurements and assumptions of exposure history may have resulted in underestimation of a true exposure-response relationship.

Relationship among short- and long-term radon measurements within dwellings: influence of radon concentrations.

As part of a retrospective epidemiologic study of lung cancer in women, alpha-track and charcoal canister radon measurements were made in a sample of New Jersey residences. The alpha-track measurements were designed to yield estimates of annual average exposures of dwelling occupants, while charcoal canister measurements were designed to yield "worst case" concentrations for screening purposes. The year-long living area and basement screening measurements had geometric means of 19 Bq m-3 (0.52 pCi L-1) and 56 Bq m-3 (1.5 pCi L-1), respectively. Measurements of radon gas with different detectors and on different floors were compared to each other within residences. Ratios of screening to annual average results became more extreme as the measured concentrations increased; the mean ratio of basement canisters to year-long living area alpha-track detectors was 5.6 vs. 2.7 for houses that screened above and below 150 Bq m-3 (4 pCi L-1), respectively. Although the residence sample from which these data were drawn is not necessarily representative of either state or national housing stock, these observations, if verified, may have important implications for procedures and decision strategies designed to reduce individual and population exposures to radon.

Race and sex differences in associations of vegetables, fruits, and carotenoids with lung cancer risk in New Jersey (United States).

We used data from a case-control study conducted in New Jersey between 1980 and 1983 to evaluate race and sex differences in associations of vegetable, fruit, and carotenoid consumption with lung cancer. Cases included 736 White males, 860 White females, 269 Black males, and 86 Black females with incident, histologically confirmed, primary cancer of the trachea, bronchus, or lung. Controls were identified through drivers' license and Health Care Financing Administration files and included 548 White males, 473 White females, 170 Black males, and 47 Black females. Usual intakes of vegetables (predominantly yellow/green) and fruit (predominantly yellow/orange) as well as other food sources of carotenoids were ascertained by a food frequency questionnaire. White females showed significant inverse associations of lung cancer with vegetables, fruit, and carotenoids. White males showed nonsignificant inverse associations with vegetables and carotenoids, and Black females just with vegetables. No inverse associations were found for Black males. Vegetable consumption was associated with risk of all histologic types of lung cancer, but the pattern of increasing risk with decreasing intake was limited to smokers. We infer that consumption of yellow/green vegetables and carotenoids may confer protection from lung cancer to White male and White female smokers. Further studies are needed to clarify the effect in Blacks.

Oral and pharyngeal cancer and occupation: a case-control study.

We studied the relation between occupation and oral and pharyngeal cancer with a population-based case-control study conducted in four areas of the United States. The study group included 1,114 incident male and female cases and 1,268 frequency-matched controls. After adjustment for age, race, smoking, alcohol, and study location, an analysis of lifetime occupational histories revealed a small number of noteworthy associations. Risk was increased among male carpet installers (23 cases, 4 controls), with an adjusted odds ratio of 7.7 [95% confidence interval (CI) = 2.4-24.9], and tended to rise with longer duration of employment. A decreased risk was found among male and female textile mill workers (odds ratio 0.48, 95% CI = 0.27-0.88). Previously reported increases in oral cancer risks among printing workers, electrical and electronics workers, and workers other than carpet installers who were possibly exposed to formaldehyde were not found in this study. For several employment groups, including male machinists, primary metal industry workers, petroleum industry workers, painters, furniture and fixture industry workers, woodworking machine operators, and workers with inferred exposure to fossil fuel combustion, odds ratios were approximately 2.0 for cancers of pharyngeal sites.

Case-control study of residential radon and lung cancer among New Jersey women.

To evaluate the association of indoor radon exposure with lung cancer risk, yearlong alpha track detector measurements of radon were conducted in dwellings which had been occupied for at least 10 years by 433 New Jersey female lung cancer cases and 402 controls who were subjects in a larger population-based study. Adjusted odds ratios were 1.1 (90% confidence interval, 0.79-1.7), 1.3 (90% confidence interval, 0.62-2.9), and 4.2 (90% confidence interval, 0.99-17.5) for exposures of 1.0-1.9, 2.0-3.9, and 4.0-11.3 pCi/liter, respectively, relative to exposures of less than 1.0 pCi/liter, showing a significant trend (1-sided P = 0.04) with increasing radon concentration. The trend was strongest among light smokers (less than 15 cigarettes/day, 1-sided P = 0.01). The trend for lung cancer risk with estimated cumulative radon exposure was slightly weaker (1-sided P = 0.09). The increase in relative risk for each unit of cumulative exposure, 3.4% (90% confidence interval 0.0-8.0%) per working level month, was consistent with the range of 0.5-4.0% per working level month generally reported for underground miner studies, supporting the extrapolation of the occupational data to the residential setting. However, the possibility of selection biases, the small number of high exposures, and other uncertainties necessitate caution in interpretation of these data.

Variation in smoking-related lung cancer risk among New Jersey women.

A population-based incident lung cancer case-control study was conducted among New Jersey women in 1982-1983. Interviews were completed for 994 cases and 995 controls. The association of lung cancer with cigarette smoking had an overall age-, race-, and respondent type-adjusted odds ratio of 8.5, with risks of 11.1, 62.6, and 3.9 for squamous cell, small cell, and adenocarcinoma, respectively. Analyses for squamous cell carcinoma showed significantly higher odds ratios for self-respondents than for subjects with next of kin respondents; this heterogeneity may be partially explained by misclassification in next of kin reports. Analyses for adenocarcinoma showed a significantly lower smoking-related risk among older women, which may be related to the later age at which these women began smoking. Analyses by histologic subtype showed lower risks for poorly differentiated squamous cell carcinoma and higher risks for poorly differentiated adenocarcinoma. This could be due to misclassification of histologic type and suggests that the actual smoking-related risk for squamous cell carcinoma might be higher than observed, and that for adenocarcinoma might be lower. Comparison of the results in this study with those from a similar study of lung cancer among men showed little difference between men and women in the magnitude of the association with smoking, or in the patterns of risk with intensity and duration.

Smoking and lung cancer: risk as a function of cigarette tar content.

The hypothesis of reduction in lung cancer risk associated with the adoption of low-tar cigarettes was examined in a subset of subjects from a population-based, case-control study of incident primary lung cancer among New Jersey white men. Risk was related to time-weighted average tar levels of cigarettes smoked in 1973-1980. Unadjusted estimates of risk were significantly low for the lowest tar (less than 14 mg/cig) smokers [odds ratio = 0.53 (0.29,0.97)] compared with the highest (21.1-28 mg/cig). However, adjustment by age and total pack-years rendered the risk reduction insignificant. Of note was the finding that cases who smoked low-tar cigarettes compensated for reducing tar by increasing the number of cigarettes they smoked by almost half a pack per day from the years 1963-1972 to 1973-1980, while in the same period controls and high-tar cigarette smoking cases did not increase the numbers smoked.

Seasonal variation in intake of carotenoids and vegetables and fruits among white men in New Jersey.

In a population-based case-control study of lung cancer among New Jersey men, usual adult consumption of many vegetables and fruits was included in the interview to assess the protective potential of carotenoids. With data from 900 controls the percentage of New Jersey white men who eat specific vegetables and fruits primarily in certain seasons, the relative importance of in-season and out-of-season consumption, and the median length of season were determined. Although first asking whether a food item was consumed all-year-round or primarily in certain seasons and then asking for the appropriate frequency of consumption facilitated the interview, obtaining out-of-season frequency of consumption and length of season was not necessary. Substituting 0 for reported out-of-season frequencies and 3 mo for reported season lengths reduced slightly the observed associations between diet and lung cancer risk but did not modify the overall pattern noted. Carotenoid intake in winter-fall was estimated to be about two-thirds that in summer-spring.