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. 2015 Apr;35(4):676-700.
doi: 10.1111/risa.12371. Epub 2015 Apr 10.

Reanalysis of the DEMS nested case-control study of lung cancer and diesel exhaust: suitability for quantitative risk assessment

Kenny S Crump  1 , Cynthia Van Landingham  2 , Suresh H Moolgavkar  3 , Roger McClellan  4
Affiliations

Reanalysis of the DEMS nested case-control study of lung cancer and diesel exhaust: suitability for quantitative risk assessment

Kenny S Crump et al. Risk Anal. 2015 Apr.

Abstract

The International Agency for Research on Cancer (IARC) in 2012 upgraded its hazard characterization of diesel engine exhaust (DEE) to "carcinogenic to humans." The Diesel Exhaust in Miners Study (DEMS) cohort and nested case-control studies of lung cancer mortality in eight U.S. nonmetal mines were influential in IARC's determination. We conducted a reanalysis of the DEMS case-control data to evaluate its suitability for quantitative risk assessment (QRA). Our reanalysis used conditional logistic regression and adjusted for cigarette smoking in a manner similar to the original DEMS analysis. However, we included additional estimates of DEE exposure and adjustment for radon exposure. In addition to applying three DEE exposure estimates developed by DEMS, we applied six alternative estimates. Without adjusting for radon, our results were similar to those in the original DEMS analysis: all but one of the nine DEE exposure estimates showed evidence of an association between DEE exposure and lung cancer mortality, with trend slopes differing only by about a factor of two. When exposure to radon was adjusted, the evidence for a DEE effect was greatly diminished, but was still present in some analyses that utilized the three original DEMS DEE exposure estimates. A DEE effect was not observed when the six alternative DEE exposure estimates were utilized and radon was adjusted. No consistent evidence of a DEE effect was found among miners who worked only underground. This article highlights some issues that should be addressed in any use of the DEMS data in developing a QRA for DEE.

Keywords: Diesel engine exhaust; lung cancer; nonmetal mines; risk assessment.

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Figures

Figure 1
Figure 1
Mine-specific REC historical predictions for the underground job, mine operator. Mine A had no mine operator job, and REC estimates for the underground job, loader operator, are shown.
Figure 2
Figure 2
Paired CO–REC samples from the DEMS 1998–2001 survey.
Figure 3
Figure 3
Fig. 2-20 from USEPA (2002) showing the decrease in diesel engine PM emissions per brake HP overtime.
See this image and copyright information in PMC

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