home edit2 whole TSD November 2002 PDF format - OEHHA

Table 1 (continued):
Reference
Boffetta et
al. , 1990
USA
Damber and
Larsson,
1985
Sweden
Study Design,
Population, and
Exposures
Exposure by
occupation:
“Possible” exposure
“Probable” exposure
By duration:
“Probable” DE
1-15 years
16-30 years
31+ years
Truck driver*
1-15 years
16-30 years
30+ years
Self-reported
exposure:
By duration
1-15 years
16-30 years
31+ years
Case-control
By age of diagnosis:
Professional drivers
70 years
Truck drivers #
70 years
By age & smoking
status:
Drivers/
Nonsmokers**
70 years
Drivers/Smokers**
70 years
Epidemiological Studies of Exposure to Diesel Exhaust and Lung Cancer Studies
Among Truck Drivers
Cases
or
deaths
240
210
4
15
17
4
12
7
11
12
12
40
23
22
13
NG
NG
NG
NG
Effect
Measure
OR
0.92
0.95
0.52
0.70
1.49
1.83
0.94
1.17
1.21
0.90
1.04
2.39
OR
1.00*
3.15*
0.83*
5.70*
1.9
4.5
6.0
20.8
Confidence
Interval a or
P-Value
0.76-1.10
0.78-1.16
0.15-1.86
0.34-1.44
0.72-3.11
0.31-10.73
0.41-2.15
0.40-3.41
0.73-2.02
0.40-1.99
0.44-2.48
0.87-6.57
0.66-1.50
1.66-6.00
0.50-1.40
2.22-14.67
0.5-5.5
1.1-16.4
3.5-10.3
9.4-46.0
Comments
Study consisted of 2584 histologically confirmed lung cancer
cases and 5009 controls derived from 18 hospitals in six
cities. Controls were patients
with current non-tobacco-related diseases matched by age,
hospital and year of interview. Exposure was assessed by
occupational titles and self-reported
exposure to diesel exhaust. Results were adjusted for
smoking, education and asbestos exposure by logistic
regression. Occupations were classified as having probable,
possible or no diesel exhaust exposure. Exposure prevalence
was low. Only 15.6% of the controls were ever in an
exposed job and 6.4% were considered probably exposed.
Self-reported exposure to diesel exhaust had consistently
higher point estimates of risk than those based on
occupational classification, suggesting the
possibility of recall bias. See also Hall and Wynder, 1984.
*Duration of employment data only available for 23 cases
and 27 controls of all patients classified as truck drivers (114
cases and 176 controls).
Study included 604 male patients with lung cancer from the 3
most northern counties in Sweden (all new cases reported to
the Swedish Cancer Registry in 1972 to 77 who had died at
least one year before the start of the study in 1979).
Matched controls were drawn from the national registry for
causes of death. Living controls were also used. Data on
occupational and smoking habits were obtained by
questionnaire. Study focused on professional drivers, most of
whose vehicles had diesel engines. Investigators noted that
drivers had considerably higher average tobacco consumption
than nondrivers. Authors stated that the study suggests
a synergistic interaction between smoking and occupational
exposure. See also Damber and Larsson 1987. Risk estimates
presented for portion of cohort with date of birth after 1900.
# Subset of all drivers. * Compared to nondrivers.
** Compared to nondrivers/nonsmokers, where
“nonsmokers” included ex-smokers who had quit for at least
10 years.
a 95% Confidence intervals unless noted. N.S.= Not significant. No confidence intervals or p-values
reported in original study. DE = Diesel Exhaust. OR = Odds Ratio, RR = Relative Risk, SIR =
Standardized Incidence Ratio, SMR = Standardized Mortality Ratio
437