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

Objectives

The International Agency for Research on Cancer identified “occupational exposure as a painter” as a cause of lung cancer. Identifying the specific causative agent(s) has been difficult since painters are exposed to mixtures of known and suspected carcinogens that change over time. Using a large pooled dataset, we evaluated the risk of lung cancer among painters by duration of employment and painting activity.

Methods

Detailed individual data on smoking were available for 16258 lung cancer cases (605 painters, 3.7%) and 19922 age- and sex-matched controls (473 painters, 2.4%) from SYNERGY, a pooled effort of 12 case-control studies in Europe and Canada. Painting activity was classified from job titles using ISCO 1968 and ISIC Revision 2 codes. Multivariable logistic regression models were adjusted for age, gender, centre, smoking habits and previous employment in high-risk occupations.

Results

An OR of 1.38 (95% CI 1.20 to 1.59) was found for ever working as a painter; the excess risk of lung cancer increased with increasing years of employment (p-trend<0.0001). In never smokers, the OR was 1.75 (95% CI 1.01 to 3.02). The highest lung cancer risks with significant exposure-response trends were observed for construction (p-trend<0.0001), spray (p-trend=0.01) and repair painters (p-trend=0.03). Results were similar by histological type.

Conclusions

These findings support the evidence of an increased risk of lung cancer among painters. Analyses by painting activity may help to identify causative agents.