Mireille Matrat

Risk of lung cancer and occupational history: results of a French population-based case-control study, the ICARE study.

Objectives: To assess the risk of lung cancer associated with occupations and industries. Methods: A French population-based case-control study included 2923 cases and 3555 controls. Lifelong occupational history was collected. Two lists of occupations known (A) or suspected (B) to be associated with lung cancer were used. Occupations and industries not included in these lists were also explored. Results: Among men, the smoking-adjusted odds ratio was 1.97 for list A (attributable fraction: 12.3%), 1.4 for list B (due especially to carpenters/joiners and transport workers). Among unlisted occupations, excess risks were found for welders, plumbers, and several construction crafts. Odds ratios among women were elevated for list A, list B (due especially to launderers/dry cleaners), cleaners and hairdressers. Conclusions: These results confirm the role of known occupations and give insight into new occupational risk factors among men and women.

Risk of lung cancer associated with occupational exposure to mineral wools: updating knowledge from a french population-based case-control study, the ICARE study.

Objectives: To assess the risk of lung cancer associated with exposure to mineral wools (MWs), while taking into account smoking, asbestos, and crystalline silica exposures. Methods: The analyses were restricted to men (1350 cases and 1912 controls). Lifelong occupational history was collected. MWs and asbestos exposures were assessed, using task-exposure matrices and silica exposure, a job-exposure matrix. Results: We observed consistent not-significant increased risks of lung cancer of the same order of magnitude among workers exposed to high levels of MWs (odds ratio, 1.4; 95% confidence interval: 0.9 to 2.2; for highest quartile of the Cumulative Exposure Index). Conclusions: These results do not allow to draw firm conclusion about a carcinogenic effect of MWs on the lung, but they cannot exclude it. Given the high number of potentially exposed workers, it will be necessary to replicate them in a future further removed from the asbestos ban.

Multidimensional analysis of the effect of occupational exposure to organic solvents on lung cancer risk: the ICARE study

Background The association between lung cancer and occupational exposure to organic solvents is discussed. Since different solvents are often used simultaneously, it is difficult to assess the role of individual substances. Objectives The present study is focused on an in-depth investigation of the potential association between lung cancer risk and occupational exposure to a large group of organic solvents, taking into account the well-known risk factors for lung cancer, tobacco smoking and occupational exposure to asbestos. Methods We analysed data from the Investigation of occupational and environmental causes of respiratory cancers (ICARE) study, a large French population-based case–control study, set up between 2001 and 2007. A total of 2276 male cases and 2780 male controls were interviewed, and long-life occupational history was collected. In order to overcome the analytical difficulties created by multiple correlated exposures, we carried out a novel type of analysis based on Bayesian profile regression. Results After analysis with conventional logistic regression methods, none of the 11 solvents examined were associated with lung cancer risk. Through a profile regression approach, we did not observe any significant association between solvent exposure and lung cancer. However, we identified clusters at high risk that are related to occupations known to be at risk of developing lung cancer, such as painters. Conclusions Organic solvents do not appear to be substantial contributors to the occupational risk of lung cancer for the occupations known to be at risk.

Occupational exposure to textile dust and lung cancer risk: Results from the ICARE Study

BACKGROUND To investigate the association of lung cancer with occupational exposure to textile dust and specifically to cotton dust in the population-based case-control study ICARE. METHODS Lifelong occupational history of 2926 cases and 3555 controls was collected using standardized questionnaires, with specific questions for textile dust exposure. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using unconditional logistic regression models controlling for confounding factors including smoking and asbestos exposure. RESULTS An inverse association between textile dust exposure and lung cancer was found among workers exposed ≥5% of their work time (OR = 0.80, 95%CI = 0.58-1.09), more pronounced for distant exposures (40+ years; up to a 56% reduced risk, statistically significant). The OR of lung cancer was significantly decreased among workers exposed to cotton fibers (OR = 0.70, 95%CI = 0.48-0.97). CONCLUSIONS Our results provide some evidence of a decreased risk of lung cancer associated with exposure to textile dust, particularly cotton.

0156 Lung cancer among meat industry workers: results of the icare study

Purpose Lung cancer among butchers and others meat workers has been investigated in a French population based case-control study ICARE. Methods Detailed information was collected on occupational history and smoking habits from 2926 patients with histologically confirmed lung cancer and 3555 matched controls. Jobs were defined according to the international Standard Classification of Occupations (ISCO) codes and categorised according to the French Nomenclature of Activities (NAF). Smoking history was combined into a comprehensive smoking index (CSI) that included mean number of cigarettes/day, duration and time since cessation. Personal history of hand warts were used as a proxy for an eventual exposure to the HPV (2,7). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression models and controlled for well-established risk factors for lung cancer including smoking and occupational exposure to asbestos. Results We found an increased risk of lung cancer among meat workers (101 cases/85 controls; OR=1.46, 95% Cl=1.01–2.13), especially among those who started working before the age of 17 (OR=1.72, 95% Cl=1.08–2.74). The risk was concentrated in workers exposed to slaughtered meat including Slaughterers (ISCO code 77320) and Meat Cutters (ISCO code 77330). Associations were not affected by history of hand warts. However, pronounced inverse associations for lung cancer were shown with personal history of hand warts (OR=0.63, 95% CI=0.56–0.71). Conclusions Working in meat industry may increase risk of lung cancer suggesting the role of oncogenic viruses other than HPV. Associations with history of hand warts remain to be clarified by future studies.