Diesel exhaust exposure and lung cancer: adjustment for the effect of smoking in a retrospective cohort study.
Larkin EK; Smith TJ; Stayner LT; Rosner B; Speizer FE; Garshick E
Am J Ind Med 2000 Oct; 38(4):399-409
The extent that cigarette smoking may confound the relationship between diesel exhaust exposure and lung cancer was assessed in a retrospective cohort study of 55,395 U.S. railroad workers followed from 1959 to 1976. The relative risk (RR) of lung cancer due to diesel exhaust was indirectly adjusted using job-specific smoking data from a case-control study of railroad workers who died between 1981-1982 and from a survey of 514 living workers from an active railroad in 1982. Adjustment factors were developed based on the distribution of job-specific smoking rates. The unadjusted RR for lung cancer was 1.58 (95% CI = 1.14-2.20) for workers aged 40-44 in 1959, who experienced the longest possible duration of exposure, and the smoking adjusted RR was 1.44 (1.01-2.05). After considering differences in smoking rates between workers exposed and unexposed to diesel exhaust in a relatively large blue-collar cohort, there were still elevated risks of lung cancer in workers in jobs with diesel exhaust exposure.
Diesel exhausts; Diesel emissions; Lung cancer; Lung disorders; Lung function; Cigarette smoking; Railroad industry; Railroads; Pulmonary system disorders; Respiratory system disorders; Statistical analysis; Demographic characteristics;
Author Keywords: confounding; diesel exhaust; lung cancer; railroad workers; smoking
Eric Garshick, MOH Medical and Research Service, VA Boston Health Care Systems, 1400 UFW Parkway, Boston, MA 02132
Work Environment and Workforce: Mixed Exposures
American Journal of Industrial Medicine
Harvard Medical School, Boston, Massachusetts