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Diesel Engine Exhaust and Lung Cancer Mortality: Time‐Related Factors in Exposure and Risk
Author(s) -
Moolgavkar Suresh H.,
Chang Ellen T.,
Luebeck Georg,
Lau Edmund C.,
Watson Heather N.,
Crump Kenny S.,
Boffetta Paolo,
McClellan Roger
Publication year - 2015
Publication title -
risk analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 130
eISSN - 1539-6924
pISSN - 0272-4332
DOI - 10.1111/risa.12315
Subject(s) - lung cancer , environmental health , medicine , risk assessment , environmental science , cancer , cohort study , diesel exhaust , relative risk , proportional hazards model , cohort , risk analysis (engineering) , diesel fuel , oncology , surgery , engineering , waste management , computer science , confidence interval , computer security
To develop a quantitative exposure‐response relationship between concentrations and durations of inhaled diesel engine exhaust (DEE) and increases in lung cancer risks, we examined the role of temporal factors in modifying the estimated effects of exposure to DEE on lung cancer mortality and characterized risk by mine type in the Diesel Exhaust in Miners Study (DEMS) cohort, which followed 12,315 workers through December 1997. We analyzed the data using parametric functions based on concepts of multistage carcinogenesis to directly estimate the hazard functions associated with estimated exposure to a surrogate marker of DEE, respirable elemental carbon (REC). The REC‐associated risk of lung cancer mortality in DEMS is driven by increased risk in only one of four mine types (limestone), with statistically significant heterogeneity by mine type and no significant exposure‐response relationship after removal of the limestone mine workers. Temporal factors, such as duration of exposure, play an important role in determining the risk of lung cancer mortality following exposure to REC, and the relative risk declines after exposure to REC stops. There is evidence of effect modification of risk by attained age. The modifying impact of temporal factors and effect modification by age should be addressed in any quantitative risk assessment (QRA) of DEE. Until there is a better understanding of why the risk appears to be confined to a single mine type, data from DEMS cannot reliably be used for QRA.