Lung cancer case - Control study of beryllium workers

Background: Cohort mortality studies have found elevated lung cancer mortality among beryllium-exposed workers, but none evaluated the association between beryllium exposure level and lung cancer risk. A nested case-control study of lung cancer within a beryllium processing plant was conducted to investigate the relationship between level of beryllium exposure and lung cancer. Methods: Lung cancer cases were identified by mortality follow-up through 1992 of a cohort of male workers at a beryllium alloy production plant. Each of 142 lung cancer cases was age-race-matched to five controls. Calendar-time-specific beryllium exposure estimates were made for every job in the plant and were used to estimate workers' cumulative, average, and maximum exposures. The potential confounding effects of smoking were also evaluated. Results: Lung cancer cases had shorter tenures and lower lifetime cumulative beryllium exposures than controls, but higher average and maximum exposures. However, after applying a 10- and 20-year lag, exposure metrics were higher for cases. Odds ratios in analyses lagged 20 years were significantly elevated for those with higher exposure compared to the lowest exposure category. Significant positive trends were seen with the log of the exposure metrics. Smoking did not appear to confound exposure-response analyses. Conclusion: Increased lung cancer among workers with higher lagged beryllium exposures and lack of evidence for confounding by cigarette smoking, provide further evidence that beryllium is a human lung carcinogen.