Occupational exposure to endotoxins and lung cancer risk: results of the ICARE Study.
Occup Environ Med
; 74(9): 667-679, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28490662
ABSTRACT
OBJECTIVES:
To investigate the role of occupational exposure to endotoxins in lung cancer in a French population-based case-control study (ICARE (Investigation of occupational and environmental causes of respiratory cancers)).METHODS:
Detailed information was collected on the occupational history and smoking habits from 2926 patients with histologically confirmed lung cancer and 3555 matched controls. We evaluated each subject's endotoxin exposure after cross referencing International Standard Classification of Occupations (ISCO) codes (for job tasks) and Nomenclature d'Activités Françaises (NAF) codes (for activity sectors). Endotoxin exposure levels were attributed to each work environment based on literature reports. ORs and 95% CIs were estimated using unconditional logistic regression models and controlled for main confounding factors.RESULTS:
An inverse association between exposure to endotoxins and lung cancer was found (OR=0.80, 95% CI 0.66 to 0.95). Negative trends were shown with duration and cumulative exposure, and the risk was decreased decades after exposure cessation (all statistically significant). Lung cancer risk was particularly reduced among workers highly exposed (eg, in dairy, cattle, poultry, pig farms), but also in those weakly exposed (eg, in waste treatment). Statistically significant interactions were shown with smoking, and never/light smokers were more sensitive to an endotoxin effect than heavy smokers (eg, OR=0.14, 95% CI 0.06 to 0.32 and OR=0.80, 95% CI 0.45 to 1.40, respectively, for the quartiles with the highest cumulative exposure, compared with those never exposed). Pronounced inverse associations were shown with adenocarcinoma histological subtype (OR=0.37, 95% CI 0.25 to 0.55 in the highly exposed).CONCLUSIONS:
Our findings suggest that exposure to endotoxins, even at a low level, reduces the risk of lung cancer.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Prevencao_e_fatores_de_risco
/
Agentes_cancerigenos
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Tipos_de_cancer
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Pulmao
Base de dados:
MEDLINE
Assunto principal:
Trabalho
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Exposição Ocupacional
/
Endotoxinas
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Pulmão
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Neoplasias Pulmonares
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Ocupações
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Occup Environ Med
Assunto da revista:
MEDICINA OCUPACIONAL
/
SAUDE AMBIENTAL
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
França