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Occup Environ Med. 2018 Sep;75(9):617-622. doi: 10.1136/oemed-2017-104950. Epub 2018 Apr 28.

Burden of lung cancer attributable to occupational diesel engine exhaust exposure in Canada.

Author information

1
Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.
2
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
3
CAREX Canada, Simon Fraser University, Burnaby, British Columbia, Canada.
4
Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada.
5
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
6
Chemical and Biological Hazards Prevention, Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec (IRSST), Montreal, Quebec, Canada.
7
Département de santé environnementale et santé au travail, Université de Montréal, Montreal, Quebec, Canada.
8
Institute for Risk Assessment Sciences, Universiteit Utrecht, Utrecht, The Netherlands.
9
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
10
Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.

Abstract

OBJECTIVE:

To estimate the population attributable fraction (PAF) and number of incident and fatal lung cancers in Canada from occupational exposure to diesel engine exhaust (DEE).

METHODS:

DEE exposure prevalence and level estimates were used with Canadian Census and Labour Force Survey data to model the exposed population across the risk exposure period (REP, 1961-2001). Relative risks of lung cancer were calculated based on a meta-regression selected from the literature. PAFs were calculated using Levin's equation and applied to the 2011 lung cancer statistics obtained from the Canadian Cancer Registry.

RESULTS:

We estimated that 2.4% (95% CI 1.6% to 6.6%) of lung cancers in Canada are attributable to occupational DEE exposure, corresponding to approximately 560 (95% CI 380 to 1570) incident and 460 (95% CI 310 to 1270) fatal lung cancers in 2011. Overall, 1.6 million individuals alive in 2011 were occupationally exposed to DEE during the REP, 97% of whom were male. Occupations with the highest burden were underground miners, truck drivers and mechanics. Half of the attributable lung cancers occurred among workers with low exposure.

CONCLUSIONS:

This is the first study to quantify the burden of lung cancer attributable to occupational DEE exposure in Canada. Our results underscore a large potential for prevention, and a large public health impact from occupational exposure to low levels of DEE.

KEYWORDS:

burden of disease; diesel engine exhaust; lung cancer; occupational cancer

PMID:
29705772
DOI:
10.1136/oemed-2017-104950

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