Carcinogenic industrial air pollution and lung cancer risk in a large prospective U.S. cohort

Authors

• JM Madrigal
• JA Fisher
• CN Pruitt
• LM Liao
• BI Graubard
• MH ward
• DT Silverman
• RR Jones

Abstract

Rationale: Industrial facilities emit established lung carcinogens into air, but the association of these chemicals with lung cancer risk at environmental levels is unknown. Our aim was to investigate the association of industrial chemical emissions and lung cancer risk overall and by histologic subtype.

Methods: We used the U.S. Environmental Protection Agency’s Toxics Release Inventory to estimate exposure to historical airborne emissions (1987-1995) to known and probable human carcinogens for 442,986 participants in the NIH-AARP Diet and Health Study. We constructed inverse distance- and wind-weighted average exposure metrics from industrial emissions reported within 1, 2, 5, and 10km of the enrollment residence. Using Cox proportional hazards models adjusted for smoking and other confounders, we estimated associations for categories (tertiles, medians) of each chemical in association with lung cancer overall and by major histologic subtype (adenocarcinoma, squamous cell carcinoma, small cell carcinoma).

Results: Among the a priori lung carcinogens we evaluated, associations with cobalt were most apparent for squamous cell carcinoma (5km HRT3=1.36, 95%CI: 1.15-1.61; p-trend=0.0002; 10km HRT3=1.24, 95%CI: 1.10-1.39 p-trend=0.0003). For a posteriori chemicals, styrene emissions were associated with lung cancer risk at all distances, with the strongest association at 1km (HRT3=1.22, 95%CI: 1.00-1.48; p-trend=0.03). We also observed associations with a priori chemicals beryllium, benzene, hydrazine, and nickel and with diethyl sulfate, an a posteriori chemical.

Conclusions: Relatively high levels of industrial chemical emissions, including metals, styrene, and diethyl sulfate were associated with risk of lung cancer, with stronger associations observed for most chemicals and squamous cell carcinoma.

Scientific Focus Area: Epidemiology

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