92

ABSTRACTS

Prevention

Lung Cancer, 5 (1989) 92-116

Long cancer risks of underground miners: Cohort and case-control studies. Archer VE. Rocky Mountain Center for Occupational and Environ- mentalHealth,DepartmentofFamiiyandPreventiveMedicine, Univer- sity of Utah, School ofMedicine, Salt Lake City, LT. Yale J Biol Med 1988;61:183-93.

All underground mines have higher radon levels than are found in surface air. Ventilation is the primary method of controlling radon levels. Fourteen cohort and seven case-control studies done on under- ground miners are reviewed; they include many types of ore. Only five of the studies deal with more than 100 lung cancer deaths. Variations in the attributable risk are given. Some generalizations can be drawn from thesestudies: thelongerthefollow-up, thegreateris theattributablerisk, even though the relative risk is reasonably constant. The induction- latent period is quite variable but is shortened by high exposure rates, by cigarette smoking, and by increasing age at stan of mining. The predominant histological type of lung cancer among miners changed from small-cell undifferentiated for short follow-up time to epidermoid after long follow-up times. With a short follow-up time, a multiplicative interactionbetween smokingandradiation was indicated but, with long follow-up time, the two factors appear to be simply additive. This difference is probably dueto theshortenedlatentperiodamong cigarette smokers, not to synergism.

Indoor radon exposure and active and passive smoking in relation to the occurrence of lung cancer. Axelson 0, Andersson K, Desai G, Fagerltmd I, Jansson B, Karlsson C, Wingren G. Department of Occupofional Medicine, University Hospi- tal, 58185,Linkoping. Stand J Work Environ Health 1988;14:286-92.

Exposure to indoor radon and radon daughters is currently attracting great interest as a possible cause of lung cancer. This concern is supported by several studies, most of them relatively small in numbers or weak m the assessment of exposure. This study encompasses 177 persons with lung cancer and 677 noncancer referents, all deceased and with 30 years or more of residency in the same house in an area with radon-leaking alum shale deposits in the central part of southern Sweden. Exposure categories based on building material, type of house, and ground conditions were created, but measurements of the indoor radon daughter concentration were also made for 142 cases and 264 referents. Active and passive smoking was ascertained through ques- tionnaires sent to the next-of-kin. Overall, the lung cancer risk was approximately twofold with regard to the categories of assumed radon daughter exposure for the rural sector of the population but not for the same categories of the urban sector, possibly because of less precise exposure assessment and influence from other factors. Occasional and passive smokers, as well as passive smokers alone, had a particularly mcreased risk of lung cancer in association with the increased exposure categories.

Reduction in risk of long cancer among ex-smokers with particular reference to histologic type. Higgins IT, Wynder EL. American Health Foundation, New York, NY 10017. Cancer 1988;62:2397-401.

Reduction of the risk of lung cancer as a result of giving up smoking isexaminedaccordingtotbenumberofyearsofcessationfmmsmoking and the number of cigarettes that were smoked per day before quitting smoking. Patients with histologically diagnosed lung cancer fmm 26 hospitals in six cities in the US were compared with controls matched for age, sex, race, time of diagnosis, and hospital. Smoking habits were recorded by trained interviewers using a questionnaire. In men, a fairly

consistent reduction m risk with years of cessation for each category of cigarettes per day before giving up smoking was found. In women, however, a much less consistent pattern was observed. Analysis of the data by histologic type of lung cancer showed that among women, as among men, risk was well and declined more consistently in those with Kreyberg I cancers that in those with Kreyberg II tumors. The inconsis- tency was seen mainly in patients wnb Kreyberg II cancers, which were m*re common among women.

On air pollution, environmental tobacco smoke, radon, and lung cancer. Crawford WA. Occupational and Environmental Health Consultancy, Seaforth. NSW2092. J Air Pollut Conaol Assoc 1988;38:1386-91.

The health of populations in industrial&d socieues has been affected for many years by ambient air pollutants presenting a threat of chronic bronchitisandhmgcancer. Inthe 1980sindoorpollutantsreceivedmuch needed investigation to assess their hazards to health. Exposure to environmental tobacco smoke and radon is now the subject of much research and concern. This review attempts to put some perspective on lung cancer that is attributable to lifetime exposure to airborne pollut- ants. The view is expressed that air pollution control authorities have played and are playing a major role in health improvement,

The effect of dietary cholesterol and fat on the risk of lung cancer in Hawaii. Goodman MT, Kolonel LN, Yoshizawa CN, Hankin JH. Epidemiotogj Program. Cancer Research Center. Universtty of Hawaii, Honolulu. HI 96813. Am J Epldemiol 1988;128:1241-55.

A population-based case-conuol study of the associauon between dietary lipids and lung cancer was carried out in Hawaii between March 1983 and October 1985. The sample included 226 men and 100 women with lung cancer and 597 male and 268 female controls, frequency- matchedtothecasesonsexandfive-yearagegroup.Personalinterviews were conducted in the home by trained interviewers using a quantitative diet history method. The items in the questionnaire were chosen to provide an estimate of 85% or more of the intakes of dietary cholesterol and fat for individuals in each of the five ethnic groups included in the study. The results showed a significant positive association of dietary cholesterol and the risk of lung cancer in men, but not in women. The oddsratiofortheriskoflungcanceramongmenin thehighestcompared with the lowest quartile of cholesterol intake was 2.2 (95% conftdence interval 1.3-3.8). Although there was a significant trend (p < 0.05). the effect of cholesterol suggested a threshold rather than continuous gradient. The association of cholesterol and lung cancer was consistent for three of four ethnic groups analyzed separately. These results confirmed earlier findings by these investigators. The effect of choles- terol on the development of lung cancer was resuicted to current cigarette smokers who smoked tobacco heavily and to squamous and small cell histologic types of lung cancer. Similar results were found for total, saturated,and, to someextent, unsaturateddietary fat, but because of the high correlation between fat and cholesterol (r = 0.76 for total fat and cholesterol), it was not possible to separate the effects of these nutrients.

Lung cancer and passive smoking: Predicted effects from a mathe- matical model for cigarette smoking and lung cancer. Darby SC, Pike MC. Clinical Trials Unit, University of Oxford, Gibson Laboratories. Radcliffe Infirmary, Oxford OX2 6HE. Br J Cancer 1988;58:825-31.

Epidemiological studies of active smokers have shown that the

0169-5002/89/$ 03.50 0 1989 Elsevier Science Publishers B.V. (Biomedical Division)