Occupational Benzene Exposure and Lung Cancer Risk: A Pooled Analysis of 14 Case-Control Studies.

Publisher: American Thoracic Society Country of Publication: United States NLM ID: 9421642 Publication Model: Print Cited Medium: Internet ISSN: 1535-4970 (Electronic) Linking ISSN: 1073449X NLM ISO Abbreviation: Am J Respir Crit Care Med Subsets: MEDLINE

Publication: 2000- : New York, NY : American Thoracic Society
Original Publication: New York, NY : American Lung Association, c1994-

Lung Neoplasms*/chemically induced ; Lung Neoplasms*/epidemiology ; Occupational Exposure*/adverse effects ; Occupational Diseases*/chemically induced ; Occupational Diseases*/epidemiology; Humans ; Benzene/toxicity ; Carcinogens ; Lung ; Case-Control Studies

Rationale: Benzene has been classified as carcinogenic to humans, but there is limited evidence linking benzene exposure to lung cancer. Objectives: We aimed to examine the relationship between occupational benzene exposure and lung cancer. Methods: Subjects from 14 case-control studies across Europe and Canada were pooled. We used a quantitative job-exposure matrix to estimate benzene exposure. Logistic regression models assessed lung cancer risk across different exposure indices. We adjusted for smoking and five main occupational lung carcinogens and stratified analyses by smoking status and lung cancer subtypes. Measurements and Main Results: Analyses included 28,048 subjects (12,329 cases, 15,719 control subjects). Lung cancer odds ratios ranged from 1.12 (95% confidence interval, 1.03-1.22) to 1.32 (95% confidence interval, 1.18-1.48) ( P trend  = 0.002) for groups with the lowest and highest cumulative occupational exposures, respectively, compared with unexposed subjects. We observed an increasing trend of lung cancer with longer duration of exposure ( P trend  < 0.001) and a decreasing trend with longer time since last exposure ( P trend  = 0.02). These effects were seen for all lung cancer subtypes, regardless of smoking status, and were not influenced by specific occupational groups, exposures, or studies. Conclusions: We found consistent and robust associations between different dimensions of occupational benzene exposure and lung cancer after adjusting for smoking and main occupational lung carcinogens. These associations were observed across different subgroups, including nonsmokers. Our findings support the hypothesis that occupational benzene exposure increases the risk of developing lung cancer. Consequently, there is a need to revisit published epidemiological and molecular data on the pulmonary carcinogenicity of benzene.

Comment in: Am J Respir Crit Care Med. 2024 Jan 15;209(2):128-130. doi: 10.1164/rccm.202311-2023ED. (PMID: 38029296)

J Biochem Mol Toxicol. 2000;14(6):303-9. (PMID: 11083083)
Int J Cancer. 2023 Feb 15;152(4):645-660. (PMID: 36054442)
Environ Health. 2014 Feb 19;13(1):10. (PMID: 24552493)
Scand J Work Environ Health. 1996 Apr;22(2):94-101. (PMID: 8738886)
Am J Respir Crit Care Med. 1998 Feb;157(2):512-7. (PMID: 9476866)
J Occup Environ Med. 2015 Feb;57(2):159-63. (PMID: 25654516)
Scand J Work Environ Health. 2020 May 1;46(3):231-234. (PMID: 32356897)
Epidemiol Prev. 2001 Jul-Oct;25(4-5):215-21. (PMID: 11789462)
Int J Cancer. 2015 Nov 1;137(9):2184-97. (PMID: 25944549)
Saf Health Work. 2011 Mar;2(1):26-33. (PMID: 22953184)
Am J Respir Crit Care Med. 2022 Oct 15;206(8):1008-1018. (PMID: 35649154)
Carcinogenesis. 2014 Feb;35(2):339-45. (PMID: 24148823)
Am J Epidemiol. 2014 Feb 15;179(4):443-51. (PMID: 24287467)
Am J Respir Crit Care Med. 2011 Apr 1;183(7):941-8. (PMID: 21037020)
Chem Biol Interact. 2005 May 30;153-154:43-53. (PMID: 15935799)
Environ Health Perspect. 1989 Jul;82:299-307. (PMID: 2792048)
Chem Biol Interact. 2010 Mar 19;184(1-2):58-66. (PMID: 20056112)
Environ Health Perspect. 1993 Dec;101 Suppl 6:63-76. (PMID: 8020450)
Br J Ind Med. 1987 Jun;44(6):382-95. (PMID: 3606967)
Int J Occup Environ Health. 1998 Oct-Dec;4(4):236-40. (PMID: 9876632)
Occup Environ Med. 2013 Feb;70(2):81-5. (PMID: 23104733)
Epidemiology. 1996 May;7(3):286-90. (PMID: 8728443)
Environ Health Perspect. 2011 Feb;119(2):159-67. (PMID: 20880796)
Evid Based Ment Health. 2019 Nov;22(4):153-160. (PMID: 31563865)
Thorax. 2005 Aug;60(8):645-51. (PMID: 16061705)
Regul Toxicol Pharmacol. 2006 Nov;46(2):149-56. (PMID: 16989927)
Epidemiology. 2017 Mar;28(2):288-299. (PMID: 28141674)
Int J Cancer. 2012 Sep 1;131(5):1210-9. (PMID: 22052329)
Occup Environ Med. 2018 Oct;75(10):696-702. (PMID: 29764994)
J Natl Cancer Inst. 2020 Jan 1;112(1):30-37. (PMID: 31498409)
Cancer Epidemiol Biomarkers Prev. 2022 Jul 1;31(7):1433-1441. (PMID: 35437574)
Am J Respir Crit Care Med. 2020 Aug 1;202(3):412-421. (PMID: 32330394)
Environ Int. 2017 Nov;108:84-91. (PMID: 28802171)
Int J Occup Environ Health. 2014 Apr-Jun;20(2):141-5. (PMID: 24999849)
Am J Ind Med. 1998 Aug;34(2):144-56. (PMID: 9651624)
Regul Toxicol Pharmacol. 2003 Oct;38(2):109-11. (PMID: 14550753)
Environ Health Perspect. 2017 Jun 23;125(6):067013. (PMID: 28665274)
Occup Environ Med. 2003 Sep;60(9):676-9. (PMID: 12937190)
Lancet Planet Health. 2021 Sep;5(9):e633-e643. (PMID: 34450064)
Am J Respir Crit Care Med. 2020 Aug 1;202(3):402-411. (PMID: 32330395)
Ann Occup Hyg. 2016 Aug;60(7):795-811. (PMID: 27286764)
J Thorac Oncol. 2015 Sep;10(9):1243-1260. (PMID: 26291008)
Occup Environ Med. 2005 Apr;62(4):231-6. (PMID: 15778255)

001 International WHO_ World Health Organization; United States NH NIH HHS; Canada CIHR

Keywords: benzene; lung cancer; occupational exposure

J64922108F (Benzene)
0 (Carcinogens)

Date Created: 20231009 Date Completed: 20240115 Latest Revision: 20241023

20241023

PMC10806413

10.1164/rccm.202306-0942OC

37812782