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APHA Scientific Session and Event Listing

Jung Yee Kim, MPH, Preventive Medicine & Community Health, UMDNJ-New Jersey Medical School, 30 Bergen Street, ADMC 16, Suite 1614, Newark, NJ 07107-3000, 973-972-4623, kimjy@umdnj.edu and Stanley Weiss, MD, Department of Preventive Medicine & Community Health / Epidemiology, UMDNJ - New Jersey Medical School & New Jersey School of Public Health, 30 Bergen St, Bldg 16, Suite ADMC 1614, Newark, NJ 07107-3000.

We conducted an exploratory analysis of the possible association between LCI and DE, posited as a causative factor in lung cancer. Data from the EPA's 1996 National-Scale Air Toxics Assessment for modeled concentrations of estimated statewide median annual diesel PM_2.5 exposure (range: 0.09959-2.731 micrograms/m³) were used. Because a lag from exposure to cancer detection is expected, the 1998-2002 average annual age-adjusted LCI rates for males (42.3-138.2/100,000) and females (21.5-72.3/100,000) were used for 44 states plus DC. The 1996 BRFSS estimates of current smokers were used.

Among men, current smoking (p<10^-4) and proportion African-American (p=0.006), but not DE, were associated with LCI.

Among women, we found that LCI was associated with DE (p=0.012) and current smoking (p<10^-4). The R-square using smoking alone is 0.38, increasing to 0.47 when DE is added to the model. Thus, ~9% of variance in female LCI may be attributable to DE. The large range in female LCI rates suggests a considerable number of cases may be associated with DE. Analyses with age and race stratification are underway to examine consistency.

Smoking is a widely accepted risk factor for lung cancer; however, this association is weaker for lung adenocarcinoma, a subtype more common in women. Thus the proportion of known risk for lung cancer is lower among women. Our results suggest DE may explain some undetermined risk among women. In states such as NJ, with elevated LCI but smoking resembling national averages, high DE may play a part. Possible cancer risk posed by DE deserves further investigation.

Learning Objectives:

• Describe the major strengths and limitations of using an ecologic analysis
• Describe some sentinel differences in lung cancer epidemiology between men and women
• Understand why diesel exposure may play a larger role in lung cancer incidence among women

Presenting author's disclosure statement:

Any relevant financial relationships? No