Lung cancer mortality in the European cohort of titanium dioxide workers: a reanalysis of the exposure-response relationship
| Autor: | Irina Guseva Canu, Alan Gaillen-Guedy, Ahti Antilla, Sandrine Charles, Sandrine Fraize-Frontier, Danièle Luce, Damien Martin McElvenny, Franco Merletti, Cecile Michel, Eero Pukkala, Mary K Schubauer-Berigan, Kurt Straif, Pascal Wild, David B Richardson |
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| Přispěvatelé: | Université de Lausanne = University of Lausanne (UNIL), Mass Screening Registry, Finnish Cancer Registry, Direction de l'Evaluation des Risques (DER), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), University of Manchester [Manchester], Università degli studi di Torino = University of Turin (UNITO), Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), University of California (UC), ANSES (2017-CRD-18) |
| Rok vydání: | 2021 |
| Předmět: |
Lung Diseases
Longitudinal studies [SDV]Life Sciences [q-bio] Statistics as Topic MESH: Occupational Health Public Health Environmental and Occupational Health technology industry and agriculture Dust MESH: titanium dioxide [Supplementary Concept] MESH: Lung Neoplasms [SDV.TOX]Life Sciences [q-bio]/Toxicology [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Interstitial MESH: Longitudinal Studies Occupational Health |
| Zdroj: | Occupational and Environmental Medicine Occupational and Environmental Medicine, 2022, 79 (9), pp.637-640. ⟨10.1136/oemed-2021-108030⟩ |
| ISSN: | 1470-7926 1351-0711 |
| DOI: | 10.1136/oemed-2021-108030⟩ |
| Popis: | ObjectivesAnimal bioassays have demonstrated convincing evidence of the potential carcinogenicity to humans of titanium dioxide (TiO2), but limitations in cohort studies have been identified, among which is the healthy worker survivor effect (HWSE). We aimed to address this bias in a pooled study of four cohorts of TiO2 workers.MethodsWe reanalysed data on respirable TiO2 dust exposure and lung cancer mortality among 7341 male workers employed in TiO2 production in Finland, France, UK and Italy using the parametric g-formula, considering three hypothetical interventions: setting annual exposures at 2.4 (U.S. occupational exposure limit), 0.3 (German limit) and 0 mg/m3 for 25 and 35 years.ResultsThe HWSE was evidenced. Taking this into account, we observed a positive association between lagged cumulative exposure to TiO2 and lung cancer mortality. The estimated number of lung cancer deaths at each age group decreased across increasingly stringent intervention levels. At age 70 years, the estimated number of lung cancer deaths expected in the cohort after 35-year exposure was 293 for exposure set at 2.4 mg/m3, 235 for exposure set at 0.3 mg/m3, and 211 for exposure set at 0 mg/m3.ConclusionThis analysis shows that HWSE can hide an exposure–response relationship. It also shows that TiO2 epidemiological data could demonstrate an exposure–effects relationship if analysed appropriately. More epidemiological studies and similar reanalyses of existing cohort studies are warranted to corroborate the human carcinogenicity of TiO2. This human evidence, when combined with the animal evidence, strengthens the overall evidence of carcinogenicity of TiO2. |
| Databáze: | OpenAIRE |
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