Laryngeal Cancer Risks in Workers Exposed to Lung Carcinogens: Exposure-Effect Analyses Using a Quantitative Job Exposure Matrix

Amy L Hall*, Hans Kromhout, Joachim Schüz, Susan Peters, Lützen Portengen, Roel Vermeulen, Antonio Agudo, Wolfgang Ahrens, Paolo Boffetta, Paul Brennan, Cristina Canova, David I Conway, Maria Paula Curado, Alexander W Daudt, Leticia Fernandez, Mia Hashibe, Claire M Healy, Ivana Holcatova, Kristina Kjaerheim, Rosalina KoifmanPagona Lagiou, Danièle Luce, Gary J Macfarlane, Ana Menezes, Gwenn Menvielle, Jerry Polesel, Heribert Ramroth, Lorenzo Richiardi, Isabelle Stücker, Peter Thomson, Marta Vilensky, Victor Wunsch-Filho, Amy Lee Yuan-Chin, Ariana Znaor, Kurt Straif, Ann Olsson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Introduction: Various established occupational lung carcinogens are also suspected risk factors for laryngeal cancer. However, individual studies are often inadequate in size to investigate this relatively rare outcome. Other limitations include imprecise exposure assessment and inadequate adjustment for confounders. Methods: This study applied a quantitative job exposure matrix (SYN-JEM) for four established occupational lung carcinogens to five case-control studies within the International Head and Neck Cancer Epidemiology Consortium. We used occupational histories for 2256 laryngeal cancer cases and 7857 controls recruited from 1989 to 2007. We assigned quantitative exposure levels for asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined (to address highly correlated exposures) via SYN-JEM. We assessed effects of occupational exposure on cancer risk for males (asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined) and females (asbestos and respirable crystalline silica), adjusting for age, study, tobacco smoking, alcohol consumption, and asbestos exposure where relevant. Results: Among females, odds ratios (ORs) were increased for ever versus never exposed. Among males, P values for linear trend were <0.05 for estimated cumulative exposure (all agents) and <0.05 for exposure duration (respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined); strongest associations were for asbestos at >90th percentile cumulative exposure (OR = 1.3, 95% confidence interval [CI] = 1.0, 1.6), respirable crystalline silica at 30+ years duration (OR = 1.4, 95% CI = 1.2, 1.7) and 75th-90th percentile cumulative exposure (OR = 1.4, 95% CI = 1.1, 1.8), chromium-VI at >75th percentile cumulative exposure (OR = 1.9, 95% CI = 1.2, 3.0), and chromium-VI and nickel combined at 20-29 years duration (OR = 1.5, 95% CI = 1.1, 2.2). Conclusions: These findings support hypotheses of causal links between four lung carcinogens (asbestos, respirable crystalline silica, chromium-VI, and nickel) and laryngeal cancer.

Original languageEnglish
Pages (from-to)145-154
Number of pages10
JournalEpidemiology
Volume31
Issue number1
Early online date1 Oct 2019
DOIs
Publication statusPublished - Jan 2020

Bibliographical note

Funding Information:
A.L.H. was supported by a postdoctoral fellowship at the International Agency for Research on Cancer. This work was also supported with the following funding: SYNERGY Project: German Social Accident Insurance (DGUV); INHANCE Pooled Data Project: National Cancer Institute (NCI) [R03CA113157]; National Institute of Dental and Craniofacial Research (NIDCR) [R03DE016611]; Western Europe (ARCAGE) study: European Community (5th Framework Programme) [QLK1-CT-2001-00182]; Germany-Heidelberg study: The German Ministry of Education and Research [01GB9702/3]; Latin America study: Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina, IMIM (Barcelona), São Paulo Research Foundation (FAPESP) [01/01768-2], and European Commission [IC18-CT97-0222]; ICARE study: French National Research Agency (ANR); French National Cancer Institute (INCA); French Agency for Food, Environmental and Occupational Health and Safety (ANSES); French Institute for Public Health Surveillance (InVS); Fondation pour la Recherche Médicale (FRM); Fondation de France; Fondation ARC pour la Recherche sur le Cancer; French Ministry of Labour (Direction Générale du Travail); French Ministry of Health (Direction Générale de la Santé).

Keywords

  • Occupational Exposure
  • Laryngeal Neoplasms
  • Case–control Studies
  • Asbestos
  • Respirable Crystalline Silica
  • Nickel, Chromium(VI)
  • Carcinogens
  • Cancer
  • chromium(VI)
  • OCCUPATIONAL EXPOSURES
  • DUST EXPOSURE
  • SYN-JEM
  • Occupational exposure
  • Respirable crystalline silica
  • NECK-CANCER
  • TOBACCO
  • CIGARETTE-SMOKING
  • Laryngeal neoplasms
  • Case-control studies
  • POOLED ANALYSIS
  • ASBESTOS EXPOSURE
  • Nickel
  • INTERNATIONAL HEAD

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