Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
Occup Environ Med. 2011 Aug;68(8):599-604. doi: 10.1136/oem.2010.060004. Epub 2010 Nov 11.
OBJECTIVES: Despite the compelling association between wood dust and sinonasal cancer, there has been little systematic and rigorous study of the relationship between wood dust and lung cancer. We investigated whether a history of wood dust exposure through occupational and hobby-related activities was associated with increased lung cancer risk. METHODS: We conducted a population-based case-control study, with 440 cases and 845 age-matched controls. Using detailed work and personal histories, quantitative estimates of cumulative exposure to wood dust (thought to be primarily from softwood) were calculated for each participant. Using unconditional logistic regression adjusted for age and smoking status, risk of lung cancer was examined in relation to employment in wood-related occupations, working with wood as a hobby, as well as cumulative wood dust exposure that took into account both occupational and hobby-related sources. RESULTS: While we observed an increased risk of lung cancer associated with working in a sawmill (OR=1.5; 95% CI: 1.1, 2.1), we found no evidence of increased risks with other occupations, working with wood as a hobby or with estimated cumulative exposure to wood dust. Contrary to our hypothesis, we observed modest decreased risks with exposure to wood dust, although no dose-response relationship was apparent. CONCLUSIONS: This study provided somewhat reassuring evidence that softwood dust does not increase the risk of lung cancer, but future studies should evaluate exposure to hardwood dusts. Suggestive evidence for an inverse association may be attributable to the presence of endotoxin in the wood dust, but the lack of a dose-response relationship suggests a non-causal relationship.
目的:尽管木尘与鼻咽喉癌之间存在强烈关联,但针对木尘与肺癌之间的关系,鲜有系统性和严格的研究。我们调查了职业和业余活动中接触木尘的历史是否与肺癌风险增加有关。
方法:我们开展了一项基于人群的病例对照研究,纳入了 440 例病例和 845 名年龄匹配的对照。通过详细的职业和个人史,为每位参与者计算了累积接触木尘(据信主要来自软木)的定量估计值。使用调整了年龄和吸烟状况的非条件逻辑回归,我们检验了与从事木材相关职业、业余与木材打交道以及同时考虑职业和业余来源的累积木尘暴露相关的肺癌风险。
结果:虽然我们观察到与在锯木厂工作相关的肺癌风险增加(OR=1.5;95%CI:1.1,2.1),但我们没有发现与其他职业、业余与木材打交道或估计的累积木尘暴露相关的风险增加的证据。与我们的假设相反,我们观察到接触木尘的风险适度降低,尽管没有明显的剂量反应关系。
结论:这项研究提供了一些令人安心的证据,表明软木尘不会增加肺癌的风险,但未来的研究应评估对硬木尘的暴露。与木尘接触呈负相关的提示性证据可能归因于木尘中的内毒素,但缺乏剂量反应关系表明存在非因果关系。
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