Occupational risk factors of lung cancer in Sao Paulo, Brazil

Objectives. This study estimated the risk of occupational exposure for lung cancer in the metropolitan region of Sao Paulo, the largest urbanized and industrialized area in Brazil. Methods. In this hospital-based case-referent study of 398 cases and 860 referents, the cases were matched to referents according to age, gender, and hospital and personally interviewed for information on lifetime job history, smoking habits, passive smoking exposure, cancer in relatives, socioeconomic status, and migratory history. The analysis concerned industrial titles and occupational categories. With the use of a job-exposure matrix, exposure to asbestos, polynuclear aromatic hydrocarbons, arsenic, dust, nickel and chromium was assessed. Results. For the men in the 56 industrial and 122 occupational categories examined, an excess risk of lung cancer was found in the machinery industry [odds ratio (OR) 1.62, 95% confidence interval (95% CI) 1.02-2.55). In pottery manufacturing the risk (OR 2.21, 95% CI 1.00-4.87) was increased for workers exposed ≤ 10 years (OR 6.43, 95% CI 1.12--37.01). Textile workers employed for ≤ 10 years with a latency of ≤ 40 years had an elevated risk (OR 21.93, 95% CI 1.96-245.0). In the analysis using the job-exposure matrix no risk was detected for the specific lung cancer carcinogens examined. For the women, no significantly elevated risk was observed. Conclusions. The results of this study revealed risks of lung cancer for men in the machinery industry and for pottery and textile workers with long-term exposure.