Lung cancer risk in painters: results from the SYNERGY pooled analysis

Abstract

The International Agency for Research on Cancer classified “occupational exposure as a painter” as carcinogenic to humans based on increased risks of cancers of the lung, bladder, and mesothelioma. Identifying the specific agent(s) contributing to the elevated risk of lung cancer has been difficult since painters are exposed to a mixture of known and suspected carcinogens, though these agents may be inferred through analyses by painter type. Data from the SYNERGY study, a pooled effort of 11 case-control studies in European countries and Canada, were used to evaluate the risk of lung cancer associated with ever working as a painter, duration of employment, and type of painter (classified according to ISCO and ISIC codes). Detailed individual data on smoking for 13389 lung cancer cases (462 painters) and 16384 age- and sex-matched controls (383 painters) were available. Multivariable logistic regression models were adjusted for age, gender, centre, tobacco pack-years, time since smoking cessation and lifetime occupational exposures to asbestos, crystalline silica, polycyclic aromatic hydrocarbons, chromium and nickel as assessed by a job-exposure matrix. An odds ratio of 1.18 (95% CI, 1.00-1.39) was associated with ever working as painter and the risk of lung cancer increased with increasing years of employment (pvalue for trend = 0.02). Ever spray and repair painters experienced the highest lung cancer risk among all painters. Exposure-response trends were present for construction and repair painters. Results were similar by histological type and when restricted to never smokers. These results corroborate the evidence of an increased risk of lung cancer among painters and results by type of painter may help in identifying causative agents.