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. 2010 Apr 15;126(8):1928-1935.
doi: 10.1002/ijc.24924.

Occupational exposures contribute to educational inequalities in lung cancer incidence among men: Evidence from the EPIC prospective cohort study

Gwenn Menvielle  1   2   3 , Hendriek Boshuizen  1 , Anton E Kunst  2 , Paolo Vineis  4   5 , Susanne O Dalton  6 , Manuela M Bergmann  7 , Silke Hermann  8 , Fabrizio Veglia  9 , Pietro Ferrari  10 , Kim Overvad  11 , Ole Raaschou-Nielsen  6 , Anne Tjønneland  6 , Rudolf Kaaks  8 , Jakob Linseisen  8   12 , Domenico Palli  13 , Vittorio Krogh  14 , Rosario Tumino  15 , Laudina Rodriguez  16 , Antonio Agudo  17 , Maria-José Sánchez  18   19 , Jone Miren Altzibar Arozena  19   20 , Lluis Cirera  19   21 , Eva Ardanaz  19   22 , Sheila Bingham  23 , Kay-Tee Khaw  23 , Paolo Boffetta  10 , Eric Duell  10 , Nadia Slimani  10 , Valentina Gallo  5 , Elio Riboli  5 , H Bas Bueno-de-Mesquita  1
Affiliations

Occupational exposures contribute to educational inequalities in lung cancer incidence among men: Evidence from the EPIC prospective cohort study

Gwenn Menvielle et al. Int J Cancer. .

Abstract

The aim of this study is to investigate to what extent occupational exposures may explain socioeconomic inequalities in lung cancer incidence after adjusting for smoking and dietary factors. Analyses were based on a subsample of the European Prospective Investigation into Cancer and Nutrition (EPIC study), a prospective cohort. The analyses included 703 incident lung cancer cases among men in Denmark, the United Kingdom, Germany, Italy, Spain and Greece. The socioeconomic position was measured using the highest level of education. The estimates of relative indices of inequality (RII) were computed with Cox regression models. We first adjusted for smoking (with detailed information on duration and quantity) and dietary factors (fruits and vegetables consumption) and then for occupational exposures. The exposure to three carcinogens [asbestos, heavy metals and polycyclic aromatic hydrocarbons (PAH)] was analyzed. The occupational exposures explained 14% of the socioeconomic inequalities remaining after adjustment for smoking and fruits and vegetables consumption. The inequalities remained nevertheless statistically significant. The RII decreased from 1.87 (95% CI: 1.36-2.56) to 1.75 (1.27-2.41). The decrease was more pronounced when adjusting for asbestos than for heavy metals or PAH. Analyses by birth cohort suggested an effect of occupational exposures among older men, while due to small number of endpoints, no conclusion could be drawn about the role of occupational exposures in educational inequalities among younger men. Our study revealed that the impact of occupational exposures on socioeconomic inequalities in cancer incidence, rarely studied until now, exists while of modest magnitude.

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