ArticleEnvironmental health perspectives2024
Lung Cancer Risks Associated with Occupational Exposure to Pairs of Five Lung Carcinogens: Results from a Pooled Analysis of Case-Control Studies (SYNERGY).
Article in Environmental health perspectives, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Mapping three decades of air pollution-lung cancer research: trends, hotspots, and networks (1990-2025).Frontiers in oncology · 2025Pooled it
- Occupational disease risks in natural resource-based industries among a large cohort of workers in Ontario, Canada.Work (Reading, Mass.) · 2026Article
- 1-Hydroxypyrene Promotes Bladder Cancer Progression and Tumor-Associated Immunosuppression via MIF.International journal of molecular sciences · 2026Article
- Combined Occupational Exposure to Lead and Other Metals and Risk of Lung Cancer.La Medicina del lavoro · 2026Article
- Thirty-year changes and future tendencies in Asian burden of tracheal, bronchus, and lung cancer: insights from the Global Burden of Disease Study.Journal of thoracic disease · 2026Article
- Toward multi-domain lung cancer research databases: opportunities and challenges from MCC-MELD.Journal of thoracic disease · 2026Article
- Non-Small-Cell Lung Cancer: From Histopathological Classification to Precision Oncology-A Narrative Review.Journal of clinical medicine · 2026Review
- Article
- Lung Cancer Risk Factors Beyond Smoking in Ethiopia: A Multicenter Matched Case-Control Study.Cancers · 2026Article
- Challenges and pitfalls in analyzing, reporting, and interpreting health effects related to occupational and environmental exposures.Frontiers in epidemiology · 2026Article
- Combined occupational exposure to carcinogenic metals/metalloids and risk of lung cancer.Frontiers in oncology · 2026Article
- Neglected Occupational Risk Factors-A Contributor to Diagnostic Delays in Lung Cancer.Healthcare (Basel, Switzerland) · 2026Article
- Polymorphisms in DNA repair related genes as risk factors for lung cancer in Cuban population: a case control study.BMC cancer · 2025Article
- Global burden of lung cancer attributable to occupational asbestos exposure: 1990 to 2021.Environmental health : a global access science source · 2025Article
- Article
- The Relationship between Occupation and Lung Cancer Incidence in the Women's Health Initiative Observational Study.Work and health · 2025Article
- Precision Medicine in Lung Cancer Screening: A Paradigm Shift in Early Detection-Precision Screening for Lung Cancer.Diagnostics (Basel, Switzerland) · 2025Review
- Estimating additive interaction in 2-stage individual participant data meta-analysis.American journal of epidemiology · 2025Article
- Oral Microbiota Dysbiosis in Firefighters and the Potential Contributing Environmental and Lifestyle Factors Based on a Case-Control Study.Microorganisms · 2025Article
- A 7-Year Active Surveillance Experience for Occupational Lung Cancer in Bologna, Italy (2017-2023).La Medicina del lavoro · 2025Article
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Authors and funding
42 authors at 20 institutions in 14 countries.
Funding
Abstract
backgroundWhile much research has been done to identify individual workplace lung carcinogens, little is known about joint effects on risk when workers are exposed to multiple agents.
objectivesWe investigated the pairwise joint effects of occupational exposures to asbestos, respirable crystalline silica, metals (i.e., nickel, chromium-VI), and polycyclic aromatic hydrocarbons (PAH) on lung cancer risk, overall and by major histologic subtype, while accounting for cigarette smoking.
methodsIn the international 14-center SYNERGY project, occupational exposures were assigned to 16,901 lung cancer cases and 20,965 control subjects using a quantitative job-exposure matrix (SYN-JEM). Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for ever vs. never exposure using logistic regression models stratified by sex and adjusted for study center, age, and smoking habits. Joint effects among pairs of agents were assessed on multiplicative and additive scales, the latter by calculating the relative excess risk due to interaction (RERI).
resultsAll pairwise joint effects of lung carcinogens in men were associated with an increased risk of lung cancer. However, asbestos/metals and metals/PAH resulted in less than additive effects; while the chromium-VI/silica pair showed marginally synergistic effect in relation to adenocarcinoma (RERI: 0.24; CI: 0.02, 0.46; DISCUSSION: Small or no deviation from additive or multiplicative effects was observed, but co-exposure to the selected lung carcinogens resulted generally in higher risk than exposure to individual agents, highlighting the importance to reduce and control exposure to carcinogens in workplaces and the general environment. https://doi.org/10.1289/EHP13380.
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