Lung cancer among construction workers in California, 1988-2007

Introduction
Although lung cancer risks can vary by race/ethnicity and by construction occupation, these risks have not been examined extensively.

Methods
This study analyzed 110,937 lung cancer cases identified from the California Cancer Registry between 1988 and 2007. Mean age at diagnosis, proportion diagnosed at an advanced stage, proportion with 3-year survival, and age-standardized incidence rates were calculated for lung cancer cases employed in the construction industry. Case-control methodology was also used to assess the risk of lung cancer. Morbidity odds ratios (MORs) were estimated by conditional logistic regression.

Results
Compared to non-construction workers, construction workers were diagnosed at an earlier age, at a more advanced stage, and had significantly lower 3–year survival. Construction workers were found to have a significantly elevated risk for all lung cancer combined (MOR=1.57) and for each lung cancer histologic subtype examined. All construction occupations, except managers/engineers and supervisors, had a significantly elevated risk for all lung cancer combined. Roofers and welders had the highest risks for total lung cancer and each of the histologic subtypes. Construction workers in each of the four race/ethnicity groups also had significantly increased lung cancer risks.

Discussion
These findings justify additional reductions in carcinogenic exposures in construction, and increased support for smoking cessation programs at construction sites.