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Trajectories of cigarette smoking and exposure to welding fumes and their impact on lung cancer risks: A latent class modelling approach.
BMJ Open 16:e099920 (2026)
OBJECTIVES: Traditional epidemiological approaches usually assume a constant relationship between cumulative exposure and disease, which implies that exposure duration and intensity contribute equally to the studied outcome. But individuals with the same cumulative exposure but different temporal exposure patterns may show different risks. Trajectory classification is a good way to assess exposure-risk associations and leads to a better understanding of lifetime variability in exposure levels. Therefore, this study aimed to estimate lung cancer risk according to the exposure trajectory classes on welding fumes and cigarette smoking. DESIGN: Two population-based German case-control studies. PARTICIPANTS: 3498 male lung cancer cases and 3539 male control subjects. METHODS: Separate latent class mixed models (LCMM) were determined to identify profiles of exposure trajectories of cigarette smoking and occupational exposure to welding fumes. To investigate the risk of lung cancer by class membership, ORs with 95% CI were estimated via multiple logistic regression analyses. RESULTS: LCMM each identified four latent classes of smoking and welding-fume exposure. Classes of smokers showed much higher risk of lung cancer compared with never smokers or subjects exposed to welding fumes. Smokers in one class characterised with the highest exposure over the past 10 years had the highest adjusted lung cancer risk (OR=39; 95% CI 29 to 53). For welding, the highest lung cancer risks were found for the class in which exposure to welding fumes in the past 10 years prior to the diagnosis of lung cancer was highest and the duration of welding was also quite high (OR=1.71; 95% CI 0.92 to 3.15). CONCLUSIONS: In summary, LCMM opens a new perspective on dose-effect relationships and could be employed to complement established epidemiological methods.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Epidemiology ; Lung Diseases ; Occupational & Industrial Medicine ; Statistics & Research Methods; Time
ISSN (print) / ISBN
2044-6055
e-ISSN
2044-6055
Journal
BMJ Open
Quellenangaben
Volume: 16,
Issue: 1,
Article Number: e099920
Publisher
BMJ Publishing Group
Publishing Place
British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)
Grants
German Federal Ministry of Education, Science, Research, and Technology and the Ministry of Labour and Social Affairs
Deutsche Gesetzliche Unfallversicherung
Ministry of Labour and Social Affairs
Bundesministerium fr Wissenschaft und Forschung
Deutsche Gesetzliche Unfallversicherung
Ministry of Labour and Social Affairs
Bundesministerium fr Wissenschaft und Forschung