Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114904

David James Lee, PhD¹, Lora E. Fleming, MD PhD, MPH, MSc¹, Orlando Gomez Marin, Phd², William LeBlanc, Phd¹, Alberto Juan Caban, BSc, MPH¹, and Terry Pitman¹. (1) Epidemiology & Public Health, University of Miami School of Medicine, PO Box 016069, Miami, FL 33101, 305-243-6980, dlee@med.miami.edu, (2) Epidemiology and Public Health, University of Miami School of Medicine, 1801 NW 9th Ave Suite 200, Miami, FL 33136

Objectives: To assess the risk of lung cancer mortality among US workers by occupation controlling for smoking, age and gender.

Methods: The NHIS is a multipurpose household survey of US civilian non-institutionalized population, conducted annually since 1957. Over 450,000 US workers, > 18 years, participated in the 1986-1994 NHIS surveys. Mortality information was collected via linkage with the National Death Index on deaths occurring through December 31, 2002 with 97% completeness. Current tobacco use data at the time of the survey were available on a random sample of 143,863 NHIS participants. Cox regression analyses were performed adjusting for smoking, gender and age. Before selecting final models, models with interactions (e.g. between smoking and occupation) were examined.

Results: There were 1812 lung cancer deaths, 791 (44%) among “current” smokers. Occupations with significantly higher risk for adjusted lung cancer mortality compared to all other workers included: “other protective service occupations” (Hazard Ratio=1.48; 95% confidence interval: 1.01-2.18); “freight, stock and material handlers” (1.35; 1.04-1.75); and “other sales workers” (1.32; 1.08-1.61). Occupations with significantly lower risk included: “engineers” (0.57; 0.36-0.89) and “teachers, librarians and counselors” (0.76; 0.59-0.99). Inclusion of current smoking in the model only slightly reduced the association between occupation and lung cancer mortality risk; and there were no significant interactions between current smoking and occupation.

Conclusion: The NHIS database offers an opportunity to investigate disease-specific mortality risk by occupation among US workers adjusting for confounding variables such as age, gender, and tobacco use.

Learning Objectives:

• 1.Describe the national health interview survey (NHIS)
• 2.Appreciate the potential of the NHIS to study the lung cancer mortality experience of the entire US workforce (taking into account smoking)
• 3.Describe the occupations at highest risk of lung cancer mortality.
• 4.Describe the occupations at lowest risk of lung cancer mortality.

Keywords: Occupational Disease, Cancer

Related Web page: www.rsmas.miami.edu/groups/niehs/niosh/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.