Original article

Scand J Work Environ Health 2024;50(3):178-186    pdf

https://doi.org/10.5271/sjweh.4140 | Published online: 24 Jan 2024, Issue date: 01 Apr 2024

Respirable crystalline silica and lung cancer in community-based studies: impact of job-exposure matrix specifications on exposure–response relationships

by Ohlander J, Kromhout H, Vermeulen R, Portengen L, Kendzia B, Savary B, Cavallo D, Cattaneo A, Migliori E, Richiardi L, Plato N, Wichmann H-E, Karrasch S, Consonni D, Landi MT, Caporaso NE, Siemiatycki J, Gustavsson P, Jöckel K-H, Ahrens W, Pohlabeln H, Fernández-Tardón G, Zaridze D, Lissowska, Swiatkowska, Field, McLaughlin JR, Demers PA, Pandics T, Forastiere F, Fabianova E, Schejbalova M, ForetovaL, Janout V, Mates D, Barul C, Brüning T, Behrens T, Straif K, Schüz J, Olsson A, Peters S

Objectives The quantitative job-exposure matrix SYN-JEM consists of various dimensions: job-specific estimates, region-specific estimates, and prior expert ratings of jobs by the semi-quantitative DOM-JEM. We analyzed the effect of different JEM dimensions on the exposure–response relationships between occupational silica exposure and lung cancer risk to investigate how these variations influence estimates of exposure by a quantitative JEM and associated health endpoints.

Methods Using SYN-JEM, and alternative SYN-JEM specifications with varying dimensions included, cumulative silica exposure estimates were assigned to 16 901 lung cancer cases and 20 965 controls pooled from 14 international community-based case-control studies. Exposure–response relationships based on SYN-JEM and alternative SYN-JEM specifications were analyzed using regression analyses (by quartiles and log-transformed continuous silica exposure) and generalized additive models (GAM), adjusted for age, sex, study, cigarette pack-years, time since quitting smoking, and ever employment in occupations with established lung cancer risk.

Results SYN-JEM and alternative specifications generated overall elevated and similar lung cancer odds ratios ranging from 1.13 (1st quartile) to 1.50 (4th quartile). In the categorical and log-linear analyses SYN-JEM with all dimensions included yielded the best model fit, and exclusion of job-specific estimates from SYN-JEM yielded the poorest model fit. Additionally, GAM showed the poorest model fit when excluding job-specific estimates.

Conclusion The established exposure–response relationship between occupational silica exposure and lung cancer was marginally influenced by varying the dimensions of SYN-JEM. Optimized modelling of exposure–response relationships will be obtained when incorporating all relevant dimensions, namely prior rating, job, time, and region. Quantitative job-specific estimates appeared to be the most prominent dimension for this general population JEM.

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