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Abstract：
BACKGROUND: Lung cancer is the leading cause of cancer death in North America. Exposure to cotton dust has previously been reported to decrease the risk of lung cancer.
METHODS: We used data from two large case-control studies conducted in Montreal from 1979-1986 (Study 1) and 1996-2002 (Study 2) respectively, to examine the association between occupational exposure to cotton dust and risk of lung cancer. Cases were diagnosed with incident histologically-confirmed lung cancer (857 in Study 1, 1203 in Study 2). Population controls were randomly selected from electoral lists and frequency-matched to cases by age and sex (533 in Study 1, 1513 in Study 2). Interviews for the two studies used a virtually identical questionnaire to obtain lifetime occupational and smoking history, and several lifestyle covariates. Each participant\'s lifetime occupational history was reviewed by experts to assess exposure to a number of occupational agents, including cotton dust. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by unconditional logistic regression, adjusting for potential confounders.
RESULTS: The lifetime prevalence of exposure to cotton dust was approximately 10%-15% in both studies combined, with some variation by study and by sex. Overall there was no decreased risk of lung cancer among subjects exposed to cotton dust. Rather, among all subjects there was a suggestion of slightly increased risk associated with any lifetime exposure to cotton dust (OR = 1.2, 95% CI: 1.0-1.5). This risk appeared to be concentrated among cases of adenocarcinoma (OR = 1.6, 95% CI: 1.2-2.2), and among moderate and heavy smokers (OR = 1.3, 95% CI: 1.0-1.7). There was no association when restricting to cases of either squamous cell or small cell cancer, or among never smokers and light smokers. An analogous examination of subjects exposed to wool dust revealed neither increased nor decreased risks of lung cancer.
CONCLUSIONS: There was no evidence that cotton dust exposure decreased risks of lung cancer.
METHODS: We used data from two large case-control studies conducted in Montreal from 1979-1986 (Study 1) and 1996-2002 (Study 2) respectively, to examine the association between occupational exposure to cotton dust and risk of lung cancer. Cases were diagnosed with incident histologically-confirmed lung cancer (857 in Study 1, 1203 in Study 2). Population controls were randomly selected from electoral lists and frequency-matched to cases by age and sex (533 in Study 1, 1513 in Study 2). Interviews for the two studies used a virtually identical questionnaire to obtain lifetime occupational and smoking history, and several lifestyle covariates. Each participant\'s lifetime occupational history was reviewed by experts to assess exposure to a number of occupational agents, including cotton dust. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by unconditional logistic regression, adjusting for potential confounders.
RESULTS: The lifetime prevalence of exposure to cotton dust was approximately 10%-15% in both studies combined, with some variation by study and by sex. Overall there was no decreased risk of lung cancer among subjects exposed to cotton dust. Rather, among all subjects there was a suggestion of slightly increased risk associated with any lifetime exposure to cotton dust (OR = 1.2, 95% CI: 1.0-1.5). This risk appeared to be concentrated among cases of adenocarcinoma (OR = 1.6, 95% CI: 1.2-2.2), and among moderate and heavy smokers (OR = 1.3, 95% CI: 1.0-1.7). There was no association when restricting to cases of either squamous cell or small cell cancer, or among never smokers and light smokers. An analogous examination of subjects exposed to wool dust revealed neither increased nor decreased risks of lung cancer.
CONCLUSIONS: There was no evidence that cotton dust exposure decreased risks of lung cancer.
摘要：
背景：肺癌是北美癌症死亡的主要原因。以前有报道称，接触棉尘可以降低患肺癌的风险。
方法：我们分别使用了1979-1986年（研究1）和1996-2002年（研究2）在蒙特利尔进行的两项大型病例对照研究的数据，研究职业接触棉尘与肺癌风险之间的关系。病例被诊断为组织学证实的肺癌（研究1中的857，研究2中的1203）。从选举名单中随机选择人口对照，并按年龄和性别与病例进行频率匹配（研究1中为533，研究2中为1513）。两项研究的访谈使用了几乎相同的问卷来获得终身职业和吸烟史，和几个生活方式协变量。专家审查了每位参与者的终身职业史，以评估与许多职业代理的接触，包括棉尘。通过非条件逻辑回归估计赔率(ORs)和95%置信区间(CIs)，调整潜在的混杂因素。
结果：在两项研究中，暴露于棉尘的终生患病率约为10％-15％，因学习和性别而异。总体而言，暴露于棉尘的受试者患肺癌的风险没有降低。相反，在所有受试者中,有一项暗示与任何终身暴露于棉尘相关的风险略有增加(OR=1.2,95%CI:1.0~1.5).这种风险似乎集中在腺癌病例中（OR=1.6，95％CI：1.2-2.2），在中度和重度吸烟者中（OR=1.3，95%CI：1.0-1.7）。限制鳞状细胞癌或小细胞癌的病例时没有关联，或者从不吸烟者和轻度吸烟者。对暴露于羊毛粉尘的受试者进行的类似检查显示，患肺癌的风险既没有增加也没有减少。
结论：没有证据表明接触棉尘可以降低肺癌的风险。
方法：我们分别使用了1979-1986年（研究1）和1996-2002年（研究2）在蒙特利尔进行的两项大型病例对照研究的数据，研究职业接触棉尘与肺癌风险之间的关系。病例被诊断为组织学证实的肺癌（研究1中的857，研究2中的1203）。从选举名单中随机选择人口对照，并按年龄和性别与病例进行频率匹配（研究1中为533，研究2中为1513）。两项研究的访谈使用了几乎相同的问卷来获得终身职业和吸烟史，和几个生活方式协变量。专家审查了每位参与者的终身职业史，以评估与许多职业代理的接触，包括棉尘。通过非条件逻辑回归估计赔率(ORs)和95%置信区间(CIs)，调整潜在的混杂因素。
结果：在两项研究中，暴露于棉尘的终生患病率约为10％-15％，因学习和性别而异。总体而言，暴露于棉尘的受试者患肺癌的风险没有降低。相反，在所有受试者中,有一项暗示与任何终身暴露于棉尘相关的风险略有增加(OR=1.2,95%CI:1.0~1.5).这种风险似乎集中在腺癌病例中（OR=1.6，95％CI：1.2-2.2），在中度和重度吸烟者中（OR=1.3，95%CI：1.0-1.7）。限制鳞状细胞癌或小细胞癌的病例时没有关联，或者从不吸烟者和轻度吸烟者。对暴露于羊毛粉尘的受试者进行的类似检查显示，患肺癌的风险既没有增加也没有减少。
结论：没有证据表明接触棉尘可以降低肺癌的风险。
