Multifactorial Study of the Risk of Lung Cancer among French Uranium Miners: Radon, Smoking and Silicosis

Abstract

This case-control study nested in the French cohort of uranium miners provides an opportunity to take account of silicosis and smoking in the assessment of the relation between radon and lung cancer. The study includes 100 miners who died of lung cancer and 500 matched controls born within the same period of birth and of the same age at the time of death of the matching case. Data on radon exposure are obtained from individual monitoring of the miners, and data on smoking come from medical records and interviews. To identify cases of silicosis among the 600 miners surveyed, appraisals carried out as part of the compensation process for occupational diseases are used. Statistical analyses are based on a conditional logistic regression, and the linear model for excess relative risk was used to model the risk of death due to lung cancer according to cumulative radon exposure. The percentage of missing data on silicotic status is less than 20%. The study reveals a significant association between the relative risk of lung cancer and silicosis (ORsilicosis = 3.6; 95% CI: 1.4-8.9), and the relation between radon and lung cancer persists after adjusting for smoking and silicotic status (ERRradon per WLM = 1.0%; 95% CI: 0.1-3.5%). Radon, cigarette smoking and silicotic status appear to be three factors that each have a specific effect on the risk of lung cancer. This study reminds us of the complexity involved in assessing occupational risks in the case of multiple sources of exposure.

Evidence for a genetical contribution to non-smoking-related lung cancer

“…Recognised comorbid conditions such as COPD are independent risk factors regardless of smoking status 25. Additionally, unrecognised factors such as environmental tobacco smoke, radon, occupational exposures and diet may contribute to the development of lung cancer in smokers and non-smokers 5 17 26 27. This unique study of the familial clustering of lung cancer using a population-based resource linking genealogy, a tumour registry and DC data begins to clarify the role of genetics in non-smoking-related lung cancer.…”

“…While cigarette smoking is well established as the strongest risk factor for the development of lung cancer, environmental and genetical factors are suspected to play a role 4 5. Studies have shown familial clustering of lung cancer cases, supporting evidence for a genetical contribution to the development of lung cancer 6–12.…”

Ceramics manufacturing contributes to ambient silica air pollution and burden of lung disease

“…30-8.22) was also reported in the ceramics manufacturing (Scarselli et al 2011). Many studies have provided strong evidence for linking chronic inflammation resulting in fibrosis and lung damage to increased excess mortality from lung cancer risk in silicosis (Amabile et al 2009;Le Jeune et al 2007;Soutar et al 2000). Spigno et al (2007) reported that lung cancer risk was elevated among patients with silicosis, especially for those who smoke.…”

Posttranscriptional silencing of the lncRNA MALAT1 by miR-217 inhibits the epithelial–mesenchymal transition via enhancer of zeste homolog 2 in the malignant transformation of HBE cells induced by cigarette smoke extract

“…While cigarette smoking is well established as the strongest risk factor for the development of lung cancer, environmental and genetic factors are suspected to be involved (Sun et al, 2007;Amabile et al, 2009). Although cigarette smoke, which contains numerous chemicals, increases the risk of various lung diseases, including lung cancer and contributes to premature death (Nyunoya et al, 2014), the molecular mechanisms by which it causes cancer remain to be established.…”