Lung cancer risk among bricklayers in a pooled analysis of case-control studies.

Dario Consonni; Sara De Matteis; Angela C Pesatori; Pier Alberto Bertazzi; Ann C Olsson; Hans Kromhout; Susan Peters; Roel CH Vermeulen; Beate Pesch; Thomas Brüning; +41 more... Benjamin Kendzia; Thomas Behrens; Isabelle Stücker; Florence Guida; Heinz-Erich Wichmann; Irene Brüske; Maria Teresa Landi; Neil E Caporaso; Per Gustavsson; Nils Plato; Lap Ah Tse; Ignatius Tak-Sun Yu; Karl-Heinz Jöckel; Wolfgang Ahrens; Hermann Pohlabeln; Franco Merletti; Lorenzo Richiardi; Lorenzo Simonato; Francesco Forastiere; Jack Siemiatycki; Marie-Élise Parent; Adonina Tardón; Paolo Boffetta; David Zaridze; Ying Chen; John K Field; Andrea 't Mannetje; Neil Pearce ORCID logo; John McLaughlin; Paul Demers; Jolanta Lissowska; Neonila Szeszenia-Dabrowska; Vladimir Bencko; Lenka Foretova; Vladimir Janout; Peter Rudnai; Eleonóra Fabiánová; Rodica Stanescu Dumitru; H Bas Bueno-de-Mesquita; Joachim Schüz; Kurt Straif; (2014) Lung cancer risk among bricklayers in a pooled analysis of case-control studies. International journal of cancer Journal international du cancer, 136 (2). pp. 360-371. ISSN 0020-7136 DOI: 10.1002/ijc.28986
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Bricklayers may be exposed to several lung carcinogens, including crystalline silica and asbestos. Previous studies that analyzed lung cancer risk among these workers had several study design limitations. We examined lung cancer risk among bricklayers within SYNERGY, a large international pooled analysis of case-control studies on lung cancer and the joint effects of occupational carcinogens. For men ever employed as bricklayers we estimated odds ratios (OR) and 95% confidence intervals (CI) adjusted for study center, age, lifetime smoking history and employment in occupations with exposures to known or suspected lung carcinogens. Among 15,608 cases and 18,531 controls, there were 695 cases and 469 controls who had ever worked as bricklayers (OR: 1.47; 95% CI: 1.28-1.68). In studies using population controls the OR was 1.55 (95% CI: 1.32-1.81, 540/349 cases/controls), while it was 1.24 (95% CI: 0.93-1.64, 155/120 cases/controls) in hospital-based studies. There was a clear positive trend with length of employment (p < 0.001). The relative risk was higher for squamous (OR: 1.68, 95% CI: 1.42-1.98, 309 cases) and small cell carcinomas (OR: 1.78, 95% CI: 1.44-2.20, 140 cases), than for adenocarcinoma (OR: 1.17, 95% CI: 0.95-1.43, 150 cases) (p-homogeneity: 0.0007). ORs were still elevated after additional adjustment for education and in analyses using blue collar workers as referents. This study provided robust evidence of increased lung cancer risk in bricklayers. Although non-causal explanations cannot be completely ruled out, the association is plausible in view of the potential for exposure to several carcinogens, notably crystalline silica and to a lesser extent asbestos.


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