Occupation and Lung Cancer Mortality in a Nationally Representative US Cohort: The National Health Interview Survey (NHIS)

David J. Lee PhD^1.3 , Lora E. Fleming MD, PhD^1,2 , William G. LeBlanc PhD² , Kristopher L. Arheart, EdD² , Katherine Chung-Bridges MD MPH³ ,
Sharon L Christ MS⁴ , Alberto J. Caban MPH² , Terry Pitman BS²

University of Miami Miller School of Medicine
Sylvester Comprehensive Cancer Center¹
Department of Epidemiology & Public Health²
Department of Family Medicine³
Odum Institute for Research in Social Science⁴

Correspondence can be sent to:
David J. Lee, Ph.D.
Department of Epidemiology & Public Health
University of Miami Miller School of Medicine
P.O. Box 016069 (R-699)
Miami, FL 33101
Tel: 305-243-6980
Fax: 305-243-5544
E-Mail: dlee@med.miami.edu

Funding/Support: This work was supported by the National Institute of Occupational Safety and Health grant # R01 OH03915.

Objectives: To assess the risk of lung cancer mortality in a nationally representative sample of US workers by occupation.

Methods: National Death Index linkage identified 1,812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys.  

Results: Current and former smoking status was predictive of lung cancer mortality (Hazard Ratio [HR]=15.1;  HR=3.8), respectively.  Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included:  heating/air/refrigeration mechanics (HR=3.0); not specified mechanics and repairers (HR=2.8); financial records processing occupations (HR=1.8); freight, stock and materials handlers (HR=1.5); and precision production occupations (HR=1.4)

Conclusion: Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer. 

Medical Subject Headings: Occupational Health, Smoking, Lung Neoplasms