Occupational exposure to polycyclic aromatic hydrocarbons and lung cancer risk: results from a pooled analysis of case-control studies (SYNERGY)

Ann Olsson, Neela Guha, Liacine Bouaoun, Hans Kromhout, Susan Peters, Jack Siemiatycki, Vikki Ho, Per Gustavsson, Paolo Boffetta, Roel Vermeulen, Thomas Behrens, Thomas Bruning, Benjamin Kendzia, Pascal Guénel, Danièle Luce, Stefan Karrasch, Heinz-Erich Wichmann, Dario Consonni, Maria Teresa Landi, Neil E CaporasoFranco Merletti, Dario Mirabelli, Lorenzo Richiardi, Karl-Heinz Jöckel, Wolfgang Ahrens, Hermann Pohlabeln, Adonina Tardon, David Zaridze, John K Field, Jolanta Lissowska, Beata Świątkowska, John R McLaughlin, Paul A Demers, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Tamas Pandics, Eleonora Fabianova, Dana Mates, Francesco Forastiere, Bas Bueno-de-Mesquita, Joachim Schüz, Kurt Straif

Research output: Contribution to journalArticleAcademicpeer-review


Background: Exposure to polycyclic aromatic hydrocarbons (PAH) occurs widely in occupational settings. We investigated the association between occupational exposure to PAH and lung cancer risk and joint effects with smoking within the SYNERGY project. Methods: We pooled 14 case–control studies with information on lifetime occupational and smoking histories conducted between 1985 and 2010 in Europe and Canada. Exposure to benzo[a]pyrene (BaP) was used as a proxy of PAH and estimated from a quantitative general population job-exposure matrix. Multivariable unconditional logistic regression models, adjusted for smoking and exposure to other occupational lung carcinogens, estimated ORs, and 95% confidence intervals (CI). Results: We included 16,901 lung cancer cases and 20,965 frequency-matched controls. Adjusted OR for PAH exposure (ever) was 1.08 (CI, 1.02–1.15) in men and 1.20 (CI, 1.04–1.38) in women. When stratified by smoking status and histologic subtype, the OR for cumulative exposure ≥0.24 BaP mg/m3-years in men was higher in never smokers overall [1.31 (CI, 0.98–1.75)], for small cell [2.53 (CI, 1.28–4.99)] and squamous cell cancers [1.33 (CI, 0.80–2.21)]. Joint effects between PAH and smoking were observed. Restricting analysis to the most recent studies showed no increased risk. Conclusions: Elevated lung cancer risk associated with PAH exposure was observed in both sexes, particularly for small cell and squamous cell cancers, after accounting for cigarette smoking and exposure to other occupational lung carcinogens. Impact: The lack of association between PAH and lung cancer in more recent studies merits further research under today’s exposure conditions and worker protection measures.

Original languageEnglish
Pages (from-to)1433-1441
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Issue number7
Early online date18 Apr 2022
Publication statusPublished - 1 Jul 2022


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