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Estimating impacts of reducing acrylonitrile exposure on lung cancer mortality in an occupational cohort with the parametric g-formula.

التفاصيل البيبلوغرافية
العنوان: Estimating impacts of reducing acrylonitrile exposure on lung cancer mortality in an occupational cohort with the parametric g-formula.
المؤلفون: Keil A; Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA keilap@nih.gov., Haber G; Information Technology Laboratory, National Institute of Standards and Technology, Gaithersburg, Maryland, USA., Graubard B; Biostatistics Branch, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA., Stewart PA; Stewart Exposure Assessments, LLC, Arlington, Virginia, USA., Silverman D; Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA., Koutros S; Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
المصدر: Occupational and environmental medicine [Occup Environ Med] 2024 Jun 03; Vol. 81 (5), pp. 225-231. Date of Electronic Publication: 2024 Jun 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 9422759 Publication Model: Electronic Cited Medium: Internet ISSN: 1470-7926 (Electronic) Linking ISSN: 13510711 NLM ISO Abbreviation: Occup Environ Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Pub. Group, c1994-
مواضيع طبية MeSH: Lung Neoplasms*/mortality , Acrylonitrile* , Occupational Exposure*/adverse effects , Occupational Diseases*/mortality, Humans ; Male ; Female ; Middle Aged ; Adult ; United States/epidemiology ; Cohort Studies ; Aged ; Bias ; Healthy Worker Effect
مستخلص: Objectives: To inform the potential human carcinogenicity of acrylonitrile, we estimate associations between acrylonitrile exposures and lung cancer mortality in US workers with the objectives of (1) assessing potential for healthy worker survivor bias and (2) adjusting for this bias while assessing the expected lung cancer mortality under different hypothetical occupational exposure limits on acrylonitrile exposure using the parametric g-formula.
Methods: We used data from a cohort of 25 460 workers at facilities making or using acrylonitrile in the USA. We estimated HRs to quantify associations between employment and lung cancer mortality, and exposure and leaving employment. Using the parametric g-formula, we estimated cumulative lung cancer mortality at hypothetical limits on acrylonitrile exposure.
Results: Recent and current employment was associated with lung cancer, and exposure was associated with leaving employment, indicating potential for healthy worker survivor bias. Relative to no intervention, reducing the historical exposure under limits of 2.0, 1.0 and 0.45 parts per million would have been expected to reduce lung cancer mortality by age 90 by 4.46 (95% CI 0.78 to 8.15), 5.03 (95% CI 0.96 to 9.11) and 6.45 (95% CI 2.35 to 10.58) deaths per 1000 workers, respectively. A larger lung cancer mortality reduction would be expected under elimination of exposure: 7.21 (95% CI 2.72 to 11.70) deaths per 1000 workers.
Conclusions: Healthy worker survivor bias likely led to underestimation of excess risk. Our results corroborate previous study findings of an excess hazard of lung cancer among the highest exposed workers.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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معلومات مُعتمدة: Z99 CA999999 United States ImNIH Intramural NIH HHS; ZIA CP010120 United States ImNIH Intramural NIH HHS
فهرسة مساهمة: Keywords: Epidemiology; Longitudinal studies; Occupational Health; Statistics; Volatile Organic Compounds
المشرفين على المادة: MP1U0D42PE (Acrylonitrile)
تواريخ الأحداث: Date Created: 20240520 Date Completed: 20240604 Latest Revision: 20240608
رمز التحديث: 20240608
مُعرف محوري في PubMed: PMC11153044
DOI: 10.1136/oemed-2024-109532
PMID: 38769004
قاعدة البيانات: MEDLINE
الوصف
تدمد:1470-7926
DOI:10.1136/oemed-2024-109532