Socioeconomic status and lung cancer incidence in men in The Netherlands: Is there a role for occupational exposure?

Socioeconomic status and lung cancer incidence in men in The Netherlands: Is there a role for occupational exposure?

van Loon, A.J.M.
Goldbohm, R.A.
Kant, I.
Swaen, G.M.H.
Kremer, A.M.
van den Brandt, P.A.
Centraal Instituut voor Voedingsonderzoek TNO TNO Preventie en Gezondheid

1997

Study objective - To evaluate the influence of occupational exposure to carcinogens in explaining the association between socioeconomic status and lung cancer. Design - A prospective cohort study. Data on diet, other lifestyle factors, sociodemographic characteristics and job history were collected by means of a self administered questionnaire. Follow up for incident cancer was established by record linkage with a national pathology register and with regional cancer registries. Setting - Population originating from 204 municipalities in The Netherlands. Participants - These comprised 58,279 men aged 55-69 years in September 1986. After 4.3 years of follow up there were 470 microscopically confirmed incident lung cancer cases with complete data on dietary habits and job history. Measurements and main results - Estimation of occupational exposure to asbestos, paint dust, polycyclic aromatic hydrocarbons, and welding fumes was carried out by two experts, using information on job history from the baseline questionnaire. Socioeconomic status was measured by means of highest attained level of education and two indicators based on occupation. In the initial multivariate analyses of socioeconomic status and lung cancer, adjustment was made for age, smoking habits, intake of vitamin C, betacarotene and retinol, and history of chronic obstructive pulmonary disease or asthma. Additional adjustment for occupational exposure to the four carcinogens mentioned above did not change the inverse association between the level of education and lung cancer risk (initial model: RR highest/lowest level of education = 0.53; 95% CI 0.34,0.82; additional model: RR highest/lowest level of education = 0.53; 95% CI 0.34,0.84). Nor was the association between the two occupation based indicators of socioeconomic status and lung cancer risk influenced by occupational exposure to carcinogens. The effect of occupational exposure on the association between the level of education and lung cancer risk did not differ between ex-smokers and current smokers. Conclusions - Occupational exposure to asbestos, paint dust, polycyclic aromatic hydrocarbons, and welding fumes could not explain the inverse association between socioeconomic status and lung cancer risk. More research which explicitly addresses possible explanations for the association between socioeconomic status and lung cancer risk is needed.

Aged
Asbestos
Asthma
Carcinogens
Cohort Studies
Dust
Humans
Lung Diseases, Obstructive
Lung Neoplasms
Male
Middle Aged
Multivariate Analysis
Netherlands
Occupational Exposure
Paint
Polycyclic Hydrocarbons, Aromatic
Prospective Studies
Risk Assessment
Smoking
Socioeconomic Factors
Welding

http://resolver.tudelft.nl/uuid:ad10249d-7d56-4375-a303-ae6d7611d189

https://doi.org/10.1136/jech.51.1.24

233791

0143-005X

Journal of Epidemiology and Community Health, 51 (1), 24-29

article