Lifetime residential and workplace exposure to environmental tobacco smoke and lung cancer in never-smoking women, Canada 1994-97

Abstract

Although the risk of lung cancer among never-smokers living with a spouse who smokes has been extensively studied, the impact of lifetime residential and workplace environmental tobacco smoke has received less attention. As part of a large population-based case-control study of lung cancer, we collected lifetime residential and occupational passive smoking information from 71 women with lung cancer and 761 healthy control subjects, all of whom reported being lifetime nonsmokers. The adjusted odds ratio (OR) for lung cancer associated with residential passive exposure only was 1.21 (95% confidence interval [CI] 0.5-2.8). Although more years of and more intense residential passive smoke exposure tended to be associated with higher risk estimates, no clear dose-response relationship was evident. The OR for women with passive exposure as a child and as an adult was 1.63 (95% CI 0.8 -3.5) and for those only exposed as an adult Key words: lung neoplasms; environmental pollution; smoking; tobacco smoke pollutionSince the early 1980s, more than 3 dozen studies have examined passive smoking and lung cancer in nonsmokers, primarily in relation to residential exposure resulting from a spouse who smoked. 1 The United States Environmental Protection Agency has concluded that environmental tobacco smoke (ETS) is a group A (known human) carcinogen and that passive smoking is causally associated with lung cancer in adults. 2 Nevertheless, uncertainty remains concerning the dose-response relationship, the nature and timing of exposure critical to lung cancer development and the impact of workplace passive smoking exposure on lung cancer risk. 3 A limited number of studies have collected data on lifetime passive exposure, 4 -13 particularly workplace exposure. 14 As part of a large population-based case-control study of lung cancer, we were able to collect lifetime residential and occupational passive smoking information from 71 women who had developed lung cancer and 761 healthy control subjects, all of whom reported being lifetime nonsmokers. The purpose of our analysis was to examine the lung cancer risk among neversmoking women in relation to their lifetime residential and lifetime occupational passive smoking exposure history. MATERIAL AND METHODSFrom 1994 to 1997, we collected population-based case-control data through the National Enhanced Cancer Surveillance System from 8 of the 10 Canadian provinces through the provincial cancer registries. Cancer risk factor information was collected through a mailed questionnaire. Collection included data from 1,558 women with histologically confirmed primary lung cancer and 2,531 control women, all between 20 and 74 years of age. Controls were frequency-matched to the expected distribution of cancer cases by 5-year age group and province. In 5 provinces (where access was possible), controls were ascertained through the publicly-funded provincial health insurance plans (which cover in excess of 95% of the provincial populations); 1 province sampled the provincial property assessment ...

Environmental Tobacco Smoke and Bladder Cancer Risk in Never Smokers of Los Angeles County

“…These results are consistent with our findings in the present study. A stronger association for bladder cancer risk with occupational than domestic ETS exposure may be explained by the more intense and sustained ETS exposure under the former circumstance (32)(33)(34) and is consistent with previous results on ETS and lung cancer (35).…”

Risk factors for lung cancer among nonsmoking women

“…1 Tobacco smoke is one of the major causes, accounting for a range of 14% to 85% of the lung cancer deaths among women in the different European countries. 2 Other risk factors, including environmental tobacco smoke, 3,4 residential radon, 5,6 occupational hazards, 7 previous non-malignant lung diseases, 8,9 prior cancer, 10 family history of cancer, [11][12][13] diet 14,15 and hormonal factors, 16 have been suggested to contribute to lung cancer occurrence among women, although to a much lower extent than tobacco smoke. Most of these factors are not nearly as well quantified as cigarette smoking.…”

Second hand smoke, age of exposure and lung cancer risk

“…Growing evidence (19,22,29,30) suggests that exposure to SHS in childhood increases the risk of lung cancer in adulthood. With the decline of adult smoking in public and work places in the United States and Europe but still very prevalent in other regions around the world, SHS exposure and associated risks are still a major source of uncontrolled exposure in younger individuals, especially in children without the ability to negotiate a smoke free environment at home, work or leisure.…”

“…Most studies (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) have focused on paternal and maternal smoking during pregnancy and the effect on childhood illnesses and cancers in general or more recently the risk of lung cancer for non-smoking women exposed to tobacco smoke during childhood (19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Very few studies (19,22,29,30) have focused on the effect of the period of exposure relevant for lung cancer development while also assessing the significance of lifetime exposure by location.…”