Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Thorax. 2012 Feb;67(2):111-6. doi: 10.1136/thoraxjnl-2011-200716. Epub 2011 Aug 19.
Organic dust is a complex mixture of particulate matter from microbial, plant or animal origin. Occupations with exposure to animal products have been associated with an increased lung cancer risk, while exposure to microbial components (eg, endotoxin) has been associated with a decreased risk. To date there has not been a comprehensive evaluation of the possible association between occupational organic dust exposure (and its specific constituents) and lung cancer risk in the general population.
The SYNERGY project has pooled information on lifetime working and smoking from 13 300 lung cancer cases and 16 273 controls from 11 case-control studies conducted in Europe and Canada. A newly developed general population job-exposure matrix (assigning no, low or high exposure to organic dust, endotoxin, and contact with animals or fresh animal products) was applied to determine level of exposure. ORs for lung cancer were estimated by logistic regression, adjusted for age, sex, study, cigarette pack-years, time since quitting smoking, and ever employment in occupations with established lung cancer risk.
Occupational organic dust exposure was associated with increased lung cancer risk. The second to the fourth quartile of cumulative exposure showed significant risk estimates ranging from 1.12 to 1.24 in a dose-dependent manner (p<0.001). This association remained in the highest quartile after restricting analyses to subjects without chronic obstructive pulmonary disease or asthma. No association was observed between lung cancer and exposure to endotoxin or contact with animals or animal products.
Occupational exposure to organic dust was associated with increased lung cancer risk in this large pooled case-control study.
有机粉尘是一种由微生物、植物或动物来源的颗粒物组成的复杂混合物。接触动物产品的职业与肺癌风险增加有关，而接触微生物成分（例如内毒素）与风险降低有关。迄今为止，尚未对职业性有机粉尘暴露（及其特定成分）与一般人群肺癌风险之间可能存在的关联进行全面评估。
SYNERGY 项目汇集了来自欧洲和加拿大的 11 项病例对照研究中 13300 例肺癌病例和 16273 例对照的终生工作和吸烟信息。应用新开发的一般人群职业暴露矩阵（将有机粉尘、内毒素、接触动物或新鲜动物产品的暴露水平分配为无、低或高）来确定暴露水平。使用逻辑回归估计肺癌的 OR，调整年龄、性别、研究、吸烟包年数、戒烟后时间和已知肺癌风险的职业就业情况。
职业性有机粉尘暴露与肺癌风险增加有关。累积暴露的第二至第四四分位数以剂量依赖性方式显示出 1.12 至 1.24 的显著风险估计值（p<0.001）。在将分析限制在没有慢性阻塞性肺疾病或哮喘的受试者后，这种关联仍然存在。未观察到肺癌与内毒素暴露或与动物或动物产品接触之间存在关联。
在这项大型病例对照研究中，职业性有机粉尘暴露与肺癌风险增加有关。
