British Journal of Cancer
Air Pollutatnt--toxicity; Lipopolysaccharides--toxicity; Lung Neoplasms--chemically induced; Occupational Diseases--chemically induced; Occupational Exposure
Endotoxin (lipopolysaccharide) is a widespread contaminant in many environmental settings. Since the 1970s, there has been generally consistent evidence indicating reduced risks for lung cancer associated with occupational endotoxin exposure.
We updated a case–cohort study nested within a cohort of 267 400 female textile workers in Shanghai, China. We compared exposure histories of 1456 incident lung cancers cases diagnosed during 1989–2006 with those of a reference subcohort of 3022 workers who were free of lung cancer at the end of follow-up. We applied Cox proportional hazards modelling to estimate exposure–response trends, adjusted for age and smoking, for cumulative exposures lagged by 0, 10, and 20 years, and separately for time windows of ⩽15 and >15 years since first exposure.
We observed no associations between cumulative exposure and lung cancer, irrespective of lag interval. In contrast, analyses by exposure time windows revealed modestly elevated, but not statistically significant relative risks (∼1.27) at the highest three exposure quintiles for exposures that occurred >15 years since first exposure.
The findings do not support a protective effect of endotoxin, but are suggestive of possible lung cancer promotion with increasing time since first exposure.
Checkoway, H., Lundin, J., Costello., Ray, R., Li, W. et al. (2014). Possible pro-carcinogenic effect of endotoxin on lung cancer in an extended follow-up of Shanghai women textile workers. Occupational and Environmental Medicine, 71(suppl.1), A42-A43.