Leisure Time Activities and Lung Cancer

Abstract

To the Editor: Occupation is one of the most important nonsmoking-related risk factors for lung cancer.1 Some leisure-time activities or hobbies (eg, painting, wood-working, model-making, furniture-varnishing) involve the use of several agents that, in the occupational setting, are established carcinogens. Hobbyists sometimes spend considerable time in these leisure activities, often with little or no protection against these carcinogenic agents, leading to levels of exposure that can be as high as those in high-risk occupations. A hospital-based case-control study of lung cancer was conducted in Galicia, North-west Spain between 2004 and 2007. The study included 442 cases with primary confirmed bronchopulmonary cancer and 548 controls (persons having trivial surgery unrelated to tobacco consumption). We retrieved information about aspects of lifestyle, focusing on smoking, occupational history, lifetime participation in leisure activities that potentially involve exposure to carcinogens and use of certain types of substances. The activities considered were model-building, painting/artwork, furniture-refinishing, and wood-working or home carpentry. Subjects were classified as exposed if they had performed any of these hobbies and also reported exposure to wood dust, paints, lacquers, stains, organic solvents, or glues. A multivariate logistic regression analysis was performed, in which the dependent variable was the case or control status and the independent variable was having performed any high-risk leisure-time activity. As adjustment variables, we considered sex, age (continuous), smoking (classified as never-smokers, former-smokers, and current smokers), and having worked in occupations carrying a risk of lung cancer. Fifteen cases were exposed to high-risk leisure time activities, as were 9 controls. ORs for lung cancer according to self-reported exposures during leisure time are shown in the Table. The crude risk of lung cancer associated with high-risk hobbies was elevated, with an OR of 2.3 (95% confidence interval = 1.0–5.5) compared with those not engaged in those activities. When the results were adjusted for risky occupations and tobacco consumption, the OR was further elevated (2.82 [1.1–7.3]).Table: Lung Cancer Risk and Leisure Time ExposureThere is scant information on this topic, with one publication that reported a risk of lung cancer more than 5-fold higher for those engaged in risky leisure activities.2 Other papers on the effect of these activities on other cancers provide conflicting results.3,4 The association between these leisure activities and lung cancer could be explained by the continued exposure to suspected or proven carcinogens such as wood dust, paints, lacquers, stains, organic solvents, and glues used in those hobbies.5–7 Although the leisure levels of exposure are usually minimal compared with occupational exposures, subjects exposed during leisure time are often unaware of (or not adequately informed about) the toxic nature of many products, and thus take fewer precautions. Hobbyists may work for many hours using materials in closed or poorly ventilated settings, and at a short distance from the source of exposure. Our findings are consistent with occupational data suggesting elevated lung cancer risk for employment as a painter, carpenter, and employment in the wood or rubber industry—occupations that have profiles of exposure similar to the studied activities. Among the hobbyists we analyzed, the risk associated with leisure exposure seem to surpass that found for these occupations.7,8 These results suggest that some leisure-time activities or hobbies entailing exposure to carcinogenic agents are associated with a high risk of developing lung cancer. People engaged in these activities should be informed about the potential risk from materials they are exposed to, so that they can take protective measures or reduce their exposure. Luciana Prini-Guadalupe Mónica Pérez-Ríos Department of Preventive Medicine and Public Health University of Santiago de Compostela Santiago de Compostela, Spain Alberto Ruano-Ravina Department of Preventive Medicine and Public Health University of Santiago de Compostela Santiago de Compostela, Spain [email protected] CIBER de Epidemiología y Salud Pública. CIBERESP Spain José Abal Arca Department of Pneumology Ourense Hospital Complex Ourense, Spain Juan Miguel Barros-Dios Department of Preventive Medicine and Public Health University of Santiago de Compostela Santiago de Compostela, Spain CIBER de Epidemiología y Salud Pública. CIBERESP Spain