Annals of Oncology Advance Access first published online on January 10, 2006
This version published online on May 5, 2006
Annals of Oncology, doi:10.1093/annonc/mdj125
1 Istituto di Ricerche Farmacologiche ‘Mario Negri’, via Eritrea 62, 20157 Milano, Italy
* To whom correspondence should be addressed. Background: In 1997, a Monograph from the International Agency for Research on Cancer (IARC) classified occupational exposure to crystalline silica as carcinogenic to humans. Large amounts of epidemiological data have been published subsequently. Methods: We conducted a systematic review of epidemiological investigations on silica exposure and lung cancer risk published after the IARC Monograph, including 28 cohort, 15 case-control and two proportionate mortality ratio (PMR) studies. These were identified in the available literature. Results: The pooled RR of lung cancer, calculated using random effects models, from all cohort studies considering occupational exposure to silica was 1.34. The RRs were 1.69 in cohort studies of silicotics only, 1.25 in studies where silicosis status was undefined and 1.19 among non silicotic subjects. The pooled RR was 1.41 for all case-control studies. The RRs were 3.27 in case-control studies of silicotics only, 1.41 in studies where silicosis status was undefined and 0.97 among non silicotic subjects. The RR was 1.24 for PMR studies. Conclusions. In this re-analysis, the association with lung cancer was consistent for silicotics, but the data were limited for non silicotic subjects and not easily explained for undefined silicosis status workers. This leaves open the issue of dose-risk relation and pathogenic mechanisms and supports the conclusion that the carcinogenic role of silica per se in absence of silicosis is still unclear. This version contains a sixth author The original version was mistakenly published as an original article.
Received November 9, 2005
Accepted December 1, 2005
review
Occupational silica exposure and lung cancer risk: a review of epidemiological studies 1996-2005
C. Pelucchi 1 *,
E. Pira 2,
G. Piolatto 2,
M. Coggiola 3,
P. Carta 4,
and
C. La Vecchia 5
2 Dipartimento di Traumatologia, Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, via Zuretti 29, 10126 Torino, Italy
3 Dipartimento di Traumatologia, Ortopedia e Medicina del Lavoro, Università degli Studi di Torino, via Zuretti 29, 10126 Torino
4 Department of Public Health, Section of Occupational Medicine, University of Cagliari, via S. Giorgio 12, 09124 Cagliari, Italy
5 Istituto di Ricerche Farmacologiche ‘Mario Negri’, via Eritrea 62, 20157 Milano, Italy; Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, via Venezian 1, 20133 Milano, Italy
C. Pelucchi, E-mail: pelucchi{at}marionegri.it
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