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Diesel exhaust exposure and lung cancer: Adjustment for the effect of smoking in a retrospective cohort study
Author(s) -
Larkin Emma K.,
Smith Thomas J.,
Stayner Leslie,
Rosner Bernard,
Speizer Frank E.,
Garshick Eric
Publication year - 2000
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/1097-0274(200010)38:4<399::aid-ajim5>3.0.co;2-d
Subject(s) - medicine , lung cancer , cohort , retrospective cohort study , diesel exhaust , cohort study , cancer , relative risk , environmental health , diesel fuel , surgery , waste management , confidence interval , engineering
Background 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. Methods 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. Results 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). Conclusions 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. Am. J. Ind. Med. 38:399–409, 2000. Published 2000 Wiley‐Liss, Inc.