| Lung Cancer and Vehicle Exhaust in Trucking Industry Workers Eric Garshick,1,2 Francine Laden,2,3,4 Jaime E. Hart,2,3 Bernard Rosner,2 Mary E. Davis,3,5 Ellen A. Eisen,6,7 and Thomas J. Smith3 1Pulmonary and Critical Care Medicine Section, Medical Service, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA; 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; 3Exposure, Epidemiology, and Risk Program, Department of Environmental Health, and 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA; 5School of Economics, University of Maine, Orono, Maine, USA; 6Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA; 7Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, California, USA Abstract
Background: An elevated risk of lung cancer in truck drivers has been attributed to diesel exhaust exposure. Interpretation of these studies specifically implicating diesel exhaust as a carcinogen has been limited because of limited exposure measurements and lack of work records relating job title to exposure-related job duties. Objectives: We established a large retrospective cohort of trucking company workers to assess the association of lung cancer mortality and measures of vehicle exhaust exposure. Methods: Work records were obtained for 31,135 male workers employed in the unionized U.S. trucking industry in 1985. We assessed lung cancer mortality through 2000 using the National Death Index, and we used an industrial hygiene review and current exposure measurements to identify jobs associated with current and historical use of diesel-, gas-, and propane-powered vehicles. We indirectly adjusted for cigarette smoking based on an industry survey. Results: Adjusting for age and a healthy-worker survivor effect, lung cancer hazard ratios were elevated in workers with jobs associated with regular exposure to vehicle exhaust. Mortality risk increased linearly with years of employment and was similar across job categories despite different current and historical patterns of exhaust-related particulate matter from diesel trucks, city and highway traffic, and loading dock operations. Smoking behavior did not explain variations in lung cancer risk. Conclusions: Trucking industry workers who have had regular exposure to vehicle exhaust from diesel and other types of vehicles on highways, city streets, and loading docks have an elevated risk of lung cancer with increasing years of work. Key words: diesel exhaust, lung cancer, occupational exposure, particulate matter, traffic. Environ Health Perspect 116:1327–1332 (2008) . doi:10.1289/ehp.11293 available via http://dx.doi.org/ [Online 30 May 2008]
Address correspondence to E. Garshick, Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Pkwy., West Roxbury, MA 02132 USA. Telephone: (617) 323-7700, Ext. 5536. Fax: (857) 203-5670. E-mail: eric.garshick@va.gov Supplemental Material is available online at http://www.ehponline.org/members/2008/11293/suppl.pdf We thank M.J. Canner for programming assistance, F. Speizer for his suggestions, the Teamster Safety and Health Department (L. Byrd) , Central States Pension Fund (B. Schaefer) , the participating companies, and the workers who participated in the study. This work was supported by grant R01 CA90792 from the National Institutes of Health/National Cancer Institute and grant ES00002 from the National Institute of Environmental Health Sciences. The authors declare they have no competing financial interests. Received 25 January 2008 ; accepted 30 May 2008.
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