Abstract
Previous studies have suggested that in addition to respiratory system cancers, exposure to external airborne agents (EAAs) may also affect the risk of digestive tract cancer. However, previous epidemiological studies have been limited. To clarify this relationship, we conducted a Workers’ Korea National Health Insurance Service cohort study. The EAA exposure group comprised participants who had ever visited a hospital as an inpatient for ‘lung diseases due to external agents’. The reference population comprised men from the general working population. The EAA exposure group and reference group included a total of 98,666 and 79,959,286 person-years, respectively. Age-adjusted standardized incident rates (SIRs) with 95% confidence intervals (95%CI) were calculated for each 5-year age stratum. The SIR (95% CI) of EAA exposure was 1.30 (1.19–1.38) for all digestive tract cancers. The highest risk associated with EAA exposure was observed for oral cancer, followed by esophageal and stomach cancers [SIRs (95%CI): 3.96 (3.02–4.78), 3.47(2.60–4.25), and 1.34(1.17–1.47), respectively.] These statistically significant associations did not be attenuated in a subgroup analysis using logistic regression adjusted for age, smoking and alcohol consumption. Our findings suggest that EAA exposure should address risk reduction of both digestive tract and respiratory system cancers.
Highlights
Previous studies of the human health effects of external airborne agent (EAA) which were included aerosol, gas, vapor, mist, fume, dust, or smoke exposure have focused on the respiratory system[1,2,3], given the assumption that such exposure primarily causes respiratory system disease
A previous well-designed cohort study found that esophageal and stomach cancer were more closely correlated with EAA exposure when compared with lung cancer, the authors did not control for alcohol consumption[7]
We observed a statistically significantly increased risk of digestive cancer among the EAA exposure group, as shown in Table 2 and Fig. 1, with an age-standardized incidence ratio (SIR) (95% confidence interval (CI)) of 1.30 (1.19–1.38) for the risk of all digestive cancers
Summary
Previous studies of the human health effects of external airborne agent (EAA) which were included aerosol, gas, vapor, mist, fume, dust, or smoke exposure have focused on the respiratory system[1,2,3], given the assumption that such exposure primarily causes respiratory system disease. A previous well-designed cohort study found that esophageal and stomach cancer were more closely correlated with EAA exposure when compared with lung cancer, the authors did not control for alcohol consumption[7]. EAA exposure and the risk of digestive cancer[11], the authors found no significant effects after controlling for alcohol consumption and smoking habits; that study may have been limited by a relatively small sample size. Our subgroup analysis, which controlled for smoking and alcohol consumption, and the inclusion of a wash-out period in our study design have provided scientific evidence supporting a link between EAA and the risk of digestive tract cancer
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