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Lung cancer mortality among construction workers: implications for early detection

Journal Article · · Occupational and Environmental Medicine
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Objectives

This study examined predictors of lung cancer mortality, beyond age and smoking, among construction workers employed at US Department of Energy (DOE) sites to better define eligibility for low-dose CT (LDCT) lung cancer screening.

Methods

Predictive models were based on 17 069 workers and 352 lung cancer deaths. Risk factors included age, gender, race/ethnicity, cigarette smoking, years of trade or DOE work, body mass index (BMI), chest X-ray results, spirometry results, respiratory symptoms, beryllium sensitisation and personal history of cancer. Competing risk Cox models were used to obtain HRs and to predict 5-year risks.

Results

Factors beyond age and smoking included in the final predictive model were chest X-ray changes, abnormal lung function, chronic obstructive pulmonary disease (COPD), respiratory symptoms, BMI, personal history of cancer and having worked 5 or more years at a DOE site or in construction. Risk-based LDCT eligibility demonstrated improved sensitivity, specificity and positive predictive value compared with current US Preventive Services Task Force guidelines. The risk of lung cancer death from 5 years of work in the construction industry or at a DOE site was comparable with the risk from a personal cancer history, a family history of cancer or a diagnosis of COPD. LDCT eligibility criteria used for DOE construction workers, which includes factors beyond age and smoking, identified 86% of participants who eventually would die from lung cancer compared with 51% based on age and smoking alone.

Conclusions

Results support inclusion of risk from occupational exposures and non-malignant respiratory clinical findings in LDCT clinical guidelines.

Research Organization:
Center to Protect Workers Rights, Silver Spring, MD (United States)
Sponsoring Organization:
USDOE
DOE Contract Number:
FC01-06EH06004
OSTI ID:
1799595
Journal Information:
Occupational and Environmental Medicine, Journal Name: Occupational and Environmental Medicine Journal Issue: 4 Vol. 77; ISSN 1351-0711
Publisher:
BMJ Publishing Group
Country of Publication:
United States
Language:
English

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