Publications : 2016

Panko JM, Benson SM, Kreider ML. Meta-analysis of lung cancer risk related to diesel exposure by occupation and evaluation of exposure response. Abstract #2976. Poster at Society of Toxicology 55th Annual Meeting, New Orleans, LA, March 2016.

Abstract

In 2012, the International Agency for Research on Cancer (IARC) changed the designation of diesel exhaust from a probable to causal lung carcinogen. Their decision was based on a qualitative assessment of many cohorts that had diesel exposure but also could have had ex-posure to other lung carcinogens. They did not attempt to account for any potential co-exposures nor did they evaluate whether there was a dose response relationship for diesel exposure and cancer risk. Our objective was to conduct meta-analyses for three occupational cohorts that are often overlooked in the evaluation of diesel exhaust exposure and the risk of lung cancer: dock workers, heavy equipment operators, and diesel engine mechanics. In all, 17 peer-reviewed manuscripts (n = 7 for dockworkers, n = 8 for heavy equipment operators, and n = 9 for mechanics) met our inclusion criteria and specifically identified diesel exhaust as the exposure of interest. Pooled effect estimates (meta-RR) and their corresponding 95% confidence intervals (CI) were calculated for each occupational group using the DerSimonian and Laird random effects model. Heavy equipment operators (meta-RR = 1.38; 95% CI: 1.00, 1.89) and dock workers (meta-RR = 1.34; 1.07, 1.68) had compa-rable risks of lung cancer, but mechanics were not at an increased risk (meta-RR = 1.15; 95% CI: 0.93, 1.44). Using exposure estimates reported in the IARC monograph we calculated the median elemental carbon exposures from diesel emissions for dock workers (7 μg/m^3), diesel en-gine mechanics (20 μg/m^3), and heavy equipment operators (47.5 μg/m^3). In short, the diesel exposure estimates do not correspond to the risk estimates, which suggests the lack of a dose-response relationship. The increased risks observed could be related to exposures to other car-cinogens or other confounding factors. Hence, a finding of “risk” for any given diesel cohort may not necessarily mean the risk was related to diesel exhaust.