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Olsson, A.* ; Bouaoun, L.* ; Schüz, J.* ; Vermeulen, R.* ; Behrens, T.* ; Ge, C.* ; Kromhout, H.* ; Siemiatycki, J.* ; Gustavsson, P.* ; Boffetta, P.* ; Kendzia, B.* ; Radoi, L.* ; Barul, C.* ; Karrasch, S. ; Wichmann, H.-E. ; Consonni, D.* ; Landi, M.T.* ; Caporaso, N.E.* ; Merletti, F.* ; Migliore, E.* ; Richiardi, L.* ; Jöckel, K.H.* ; Ahrens, W.* ; Pohlabeln, H.* ; Fernández-Tardón, G.* ; Zaridze, D.* ; Field, J.K.* ; Lissowska, J.* ; Świątkowska, B.* ; McLaughlin, J.R.* ; Demers, P.A.* ; Schejbalova, M.* ; Foretova, L.* ; Janout, V.* ; Pándics, T.* ; Fabianova, E.* ; Mates, D.* ; Forastiere, F.* ; Straif, K.* ; Brüning, T.* ; Vlaanderen, J.* ; Peters, S.*

Lung cancer risks associated with occupational exposure to pairs of five lung carcinogens: Results from a pooled analysis of case-control studies (SYNERGY).

Environ. Health Perspect. 132:17005 (2024)

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BACKGROUND: While much research has been done to identify individual workplace lung carcinogens, little is known about joint effects on risk when workers are exposed to multiple agents. OBJECTIVES: We investigated the pairwise joint effects of occupational exposures to asbestos, respirable crystalline silica, metals (i.e., nickel, chromium-VI), and polycyclic aromatic hydrocarbons (PAH) on lung cancer risk, overall and by major histologic subtype, while accounting for cigarette smoking. METHODS: In the international 14-center SYNERGY project, occupational exposures were assigned to 16,901 lung cancer cases and 20,965 control subjects using a quantitative job-exposure matrix (SYN-JEM). Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for ever vs. never exposure using logistic regression models stratified by sex and adjusted for study center, age, and smoking habits. Joint effects among pairs of agents were assessed on multiplicative and additive scales, the latter by calculating the relative excess risk due to interaction (RERI). RESULTS: All pairwise joint effects of lung carcinogens in men were associated with an increased risk of lung cancer. However, asbestos/metals and metals/PAH resulted in less than additive effects; while the chromium-VI/silica pair showed marginally synergistic effect in relation to adenocarcinoma (RERI: 0.24; CI: 0.02, 0.46; p = 0.05). In women, several pairwise joint effects were observed for small cell lung cancer including exposure to PAH/silica (OR = 5.12; CI: 1.77, 8.48), and to asbestos/silica (OR = 4.32; CI: 1.35, 7.29), where exposure to PAH/silica resulted in a synergistic effect (RERI: 3.45; CI: 0.10, 6.8). DISCUSSION: Small or no deviation from additive or multiplicative effects was observed, but co-exposure to the selected lung carcinogens resulted generally in higher risk than exposure to individual agents, highlighting the importance to reduce and control exposure to carcinogens in workplaces and the general environment. https://doi.org/10.1289/EHP13380.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Asbestos; Smoking

ISSN (print) / ISBN 0091-6765

e-ISSN 1552-9924

Journal Environmental Health Perspectives

Quellenangaben Volume: 132, Issue: 1, Article Number: 17005

Publisher Research Triangle Park

Publishing Place NC [u.a.]

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Epidemiology (EPI)

Grants NIH/NCI/DCEG Intramural Research Program
Swedish Council for Work Life Research
Roy Castle Foundation
Polish State Committee for Science Research
EC 's INCO-COPERNICUS Program
Ministry of Labour and Social Affairs
German Federal Ministry of Education, Science, Research, and Technology
Fondation de France
Canadian Cancer Society
Guzzo-SRC Chair in Environment and Cancer
Canadian Institutes of Health Research
Swedish EPA
Lombardy Region

Europe Against Cancer Program
Compagnia di San Paolo
Region Piedmont
CIBERESP
Italian Association for Cancer Research
State Budget of the Czech Republic (RECAMO)
European Union Nuclear Fission Safety Program
European Regional Development Fund
INAIL
University of Oviedo
German Social Accident Insurance