Jang Jungwon, Kim Eun Mi, Kim Jaiyong, Min Jeehee, Kim Inah
Department of Occupational and Environmental Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Department of Big Data Management, National Health Insurance Service, Wonju, Republic of Korea.
Saf Health Work. 2025 Mar;16(1):105-112. doi: 10.1016/j.shaw.2025.01.002. Epub 2025 Jan 9.
Exposure to cooking fumes exposure likely increases the lung cancer risk in school cooks, but research on the incidence of lung cancer in school cooks is lacking. Therefore, this study aimed to examine a nationwide cohort of school cooks for lung cancer by linking three Korean social insurance databases to determine whether working as a school cook increases lung cancer risk.
A nationwide retrospective cohort of school cooks and clerks with lung cancer was established by linking Employment Insurance, Industrial Accident Compensation Insurance, and National Health Insurance Service databases. Covariates were matched using 1:1 propensity score matching (PSM) for school cooks and clerks. Age-standardized incidence and hazard ratios (HRs) for lung cancer were calculated using the Cox proportional hazards model. Fine-Gray subdistribution HRs were used for sensitivity analysis. After further categorization into never- and ever-smoked subcohorts, the same analyses were performed.
Post PSM, we identified 76 cases of lung cancer in school cooks during 259,819 person-years of follow-up. The age-standardized incidence was 199.8 (95% confidence interval [CI]: 120.7-278.9) and 166.8 (95% CI: 95.8-237.7) for school cooks and clerks, respectively. The subdistribution HR for school cooks post PSM was 1.72 (95% CI: 1.14-2.60). In the never-smoked subcohort, the subdistribution HR for school cooks post PSM was 4.23 (95% CI: 2.36-7.58).
School cooks were at an elevated risk of developing lung cancer, likely due to exposure to cooking fumes, highlighting the need for improved ventilation and preventive measures in school kitchens to reduce lung cancer risk.
接触烹饪油烟可能会增加学校厨师患肺癌的风险，但目前缺乏关于学校厨师肺癌发病率的研究。因此，本研究旨在通过链接三个韩国社会保险数据库，对全国范围内的学校厨师队列进行肺癌检查，以确定从事学校厨师工作是否会增加患肺癌的风险。
通过链接就业保险、工业事故赔偿保险和国民健康保险服务数据库，建立了一个全国范围内的学校厨师和患肺癌职员的回顾性队列。使用1:1倾向得分匹配（PSM）对学校厨师和职员的协变量进行匹配。使用Cox比例风险模型计算肺癌的年龄标准化发病率和风险比（HRs）。采用Fine-Gray子分布HRs进行敏感性分析。在进一步分为从不吸烟和曾经吸烟的亚队列后，进行相同的分析。
PSM后，在259,819人年的随访期间，我们在学校厨师中确定了76例肺癌病例。学校厨师和职员的年龄标准化发病率分别为199.8（95%置信区间[CI]：120.7 - 278.9）和166.8（95%CI：95.8 - 237.7）。PSM后学校厨师的子分布HR为1.72（95%CI：1.14 - 2.60）。在从不吸烟的亚队列中，PSM后学校厨师的子分布HR为4.23（95%CI：2.36 - 7.58）。
学校厨师患肺癌的风险较高，可能是由于接触烹饪油烟所致，这突出了改善学校厨房通风和预防措施以降低肺癌风险的必要性。
