Lung Cancer in Radon-Exposed Miners and Estimation of Risk From Indoor Exposure

Lubin, Jay H.; Boice, John D.; Edling, Christer; Hornung, Richard; Howe, Geoffrey R.; Kunz, E; Kusiak, Robert A.; Morrison, Howard; Radford, Edward P.; Samet, Jonathan M.; Tirmarche, M.; Woodward, Alistair; Yao, Shu Xiang; Pierce, Donald A.

doi:10.1093/jnci/87.11.817

Cited by 347 publications

(200 citation statements)

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“…The risk increased with estimated cumulative exposure and decreased with attained age, time since exposure, and time since cessation of exposure (National Research Council, 1999). The excess RR estimated from occupational cohorts, which included over 2500 cases of lung cancer occurring among over 60 000 miners, has been estimated in the order of 0.0049 per working level month of exposure (Lubin et al, 1995). Further refinements of this estimates took into account age at exposure and time since first exposure (National Research Council, 1999), as well as smoking status, with a stronger effect being shown among never-smokers than among smokers.…”

Section: Ionizing Radiationmentioning

confidence: 99%

Epidemiology of environmental and occupational cancer

Boffetta

2004

Oncogene

122

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Environmental carcinogens, in a strict sense, include outdoor and indoor air pollutants, as well as soil and drinking water contaminants. An increased risk of mesothelioma has consistently been detected among individuals experiencing residential exposure to asbestos, while results for lung cancer are less consistent. Several good-quality studies have investigated lung cancer risk from outdoor air pollution based on measurement of specific agents. Their results tend to show an increased risk in the categories at highest exposure, with relative risks in the range 1.5. A causal association has been established between exposure to environmental tobacco smoke and lung cancer, with a relative risk in the order of 1.2. Radon is another carcinogen present in indoor air, with a relative risk in the order of 1.06 for exposure at 100 Bq/m 3 . In several Asian populations, an increased risk of lung cancer results among women from indoor pollution from cooking and heating. There is strong evidence of an increased risk of bladder, skin and lung cancers following consumption of water with high arsenic contamination; results for other drinking water contaminants, including chlorination by-products, are inconclusive. A total of 29 occupational agents are established human carcinogens, and another 30 agents are suspected carcinogens. In addition, at least 12 exposure circumstances entail exposure to carcinogens. Exposure is still widespread for many important occupational carcinogens, such as asbestos, coal tar, arsenic and silica, in particular in developing countries. Although estimates of the global burden of occupational and environmental cancer result in figures in the order of 2% and less than 1%, respectively, these cancers concentrate in subgroups of the population; furthermore, exposure is involuntary and can, to a large extent, be avoided.

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Section: Ionizing Radiationmentioning

confidence: 99%

Epidemiology of environmental and occupational cancer

Boffetta

2004

Oncogene

122

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“…The decay products of radon emit alpha particles of high energy and mass that may damage nuclear DNA of cells in the lungs and airways. In fact, a very high risk of LC (40%) was observed in underground miners of uranium who had been exposed to radon chronically (70). In the study, the rates of deaths from LC were 70% and 39% for never-smokers and current smokers, respectively (70).…”

Section: Radiationmentioning

confidence: 69%

Relationships between chronic obstructive pulmonary disease and lung cancer: biological insights

Barreiro¹,

Bustamante

Curull³

et al. 2016

J. Thorac. Dis.

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Lung cancer (LC) has become one of the leading causes of preventable death in the last few decades. Cigarette smoking (CS) stays as the main etiologic factor of LC despite that many other causes such as occupational exposures, air pollution, asbestos, or radiation have also been implicated. Patients with chronic obstructive pulmonary disease (COPD), which also represents a major cause of morbidity and mortality in developed countries, exhibit a significantly greater risk of LC. The study of the underlying biological mechanisms that may predispose patients with chronic respiratory diseases to a higher incidence of LC has also gained much attention in the last few years. The present review has been divided into three major sections in which different aspects have been addressed: (I) relevant etiologic agents of LC; (II) studies confirming the hypothesis that COPD patients are exposed to a greater risk of developing LC; and (III) evidence on the most relevant underlying biological mechanisms that support the links between COPD and LC. Several carcinogenic agents have been described in the last decades but CS remains to be the leading etiologic agent in most geographical regions in which the incidence of LC is very high. Growing evidence has put the line forward the implications of COPD and especially of emphysema in LC development. Hence, COPD represents a major risk factor of LC in patients. Different avenues of research have demonstrated the presence of relevant biological mechanisms that may predispose COPD patients to develop LC. Importantly, the so far identified biological mechanisms offer targets for the design of specific therapeutic strategies that will further the current treatment options for patients with LC. Prospective screening studies, in which patients with COPD should be followed up for several years will help identify biomarkers that may predict the risk of LC among these patients.

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“…Another explanation might be found in the interaction between radon exposure and smoking, a habit much more prevalent among males than among females in Japan. In fact, animal experiments reveal a multiplicative synergistic relationship 11) and studies with miners suggest a superadditive relationship 1) between smoking and radon exposure. Unfortunately, no smoking data for individual study subjects were available for this study.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a pooled analysis on data from 11 studies of radon-exposed miners showed that over the full range of radon exposure, to as low as 50-100 WLM, the relative risk relationship remains linear. 1) Hei et al reported that many cells may survive traversal by one to four particles to express a dose-dependent increase in the frequency of mutations, 17) which may provide a biological basis for the validity of utilizing data from miners, although mutation may not be directly related to the carcinogenic process. However, the fact that air in underground mines may contain other lung carcinogens or irritants, and the differences in mode of exposure acquisition contribute uncertainties to the linear extrapolation.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiological studies of underground miners and some experimental studies with laboratory animals have shown that exposure to high-level radon and its decay products may increase the risk of lung cancer. [1][2][3] Based on the linear no-threshold model, the Environmental Protection Agency (EPA) of the United States recommended that indoor radon levels be kept below 4 pCi/m 3 (148 Bq/m 3 ). 4) However, the fact that air in underground mines may contain other lung carcinogens or irritants, and the differences in mode of exposure acquisition make the validity of such an extrapolation uncertain.…”

mentioning

confidence: 99%

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