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Meta-Analysis
. 2007 Mar;97(3):545-51.
doi: 10.2105/AJPH.2004.061275. Epub 2007 Jan 31.

Lung cancer risk and workplace exposure to environmental tobacco smoke

Leslie Stayner  1 , James Bena, Annie J Sasco, Randall Smith, Kyle Steenland, Michaela Kreuzer, Kurt Straif
Affiliations
Meta-Analysis

Lung cancer risk and workplace exposure to environmental tobacco smoke

Leslie Stayner et al. Am J Public Health. 2007 Mar.

Abstract

Objectives: We sought to quantitatively evaluate the association between work-place environmental tobacco smoke exposure and lung cancer.

Methods: We performed a meta-analysis in 2003 of data from 22 studies from multiple locations worldwide of workplace environmental tobacco smoke exposure and lung cancer risk. Estimates of relative risk from these studies were analyzed by fitting the data to fixed and mixed effects models. Analyses of highly exposed workers and of the relationship between duration of exposure and lung cancer were also performed.

Results: The meta-analysis indicated a 24% increase in lung cancer risk (relative risk [RR]=1.24; 95% confidence interval [CI]=1.18, 1.29) among workers exposed to environmental tobacco smoke. A 2-fold increased risk (RR=2.01; 95% CI=1.33, 2.60) was observed for workers classified as being highly exposed to environmental tobacco smoke. A strong relationship was observed between lung cancer and duration of exposure to environmental tobacco smoke.

Conclusions: The findings from this investigation provide the strongest evidence to date that exposure to environmental tobacco smoke in the workplace is associated with an increased risk of lung cancer.

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Figures

FIGURE 1—
FIGURE 1—
Relative risks (with 95% confidence intervals) for a meta-analysis of individual studies from multiple locations worldwide: 2003. Note. The horizontal scale is displayed on a common logarithmic scale.
FIGURE 2—
FIGURE 2—
Relative risks plotted against duration of exposure: 2003 meta-analysis. Note. The diagonal line is the fitted fixed model effect of duration.
FIGURE 3—
FIGURE 3—
Funnel plot of relative risks (on a log scale) versus the inverse of the variance of the log relative risks for studies included in the 2003 meta-analysis. Note. The horizontal line is the meta-analysis relative risk estimate, which was 1.24.
See this image and copyright information in PMC

References

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    1. Current Intelligence Bulletin 54. Environmental Tobacco Smoke in the Workplace: Lung Cancer and Other Health Effects. Cincinnati, Ohio: National Institute for Occupational Safety and Health; 1991. DHHS (NIOSH) publication 91–108.
    1. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, DC: US Environmental Protection Agency; 1992. EPA publication 600/6-90/006F.
    1. Health Effects of Exposure to Environmental Tobacco Smoke. Office of Environmental Health Assessment. Sacramento, Calif: California Environmental Protection Agency; September 1997.
    1. The Health Effects of Passive Smoking. A Scientific Information Paper. Canberra, Australia: The National Health and Medical Research Council; 1997.

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