A study of associations between cigarette smoking, nearby industry and high lung cancer mortality in North West Adelaide

Abstract

An industrial/residential region in North West (NW) Adelaide has lung cancer standardised mortality twice that expected. We conducted a case control study to evaluate potential risk factors, including residential exposures to industrial air pollution. The cases were from the Cancer Registry, and controls from the electoral roll. Lifetime exposure indices were calculated: cigarette smoking (pack-years), passive smoke duration, hobbies, occupation exposures by hygiene panel (weighted by intensity, duration), residential pollution exposure model (proximity to industry, duration, time down-wind) for six industries. The analysis was conditional logistic regression. One hundred and forty two (142) lung cancer cases, and 415 controls (response rates: 62%, 52%) were interviewed. Participating controls resided closer to industry than non-participants. Relationships with lung cancer (p<0.05) were for smoking pack-years (dose response relationship evident, OR up to 9.25, 95%CI: 4.62, 18.55 for 40 pack-years) and age left school <14 years (OR 2.52, 95%CI: 1.29, 4.95). No other risk factors were demonstrated, including cumulative residential exposure to the six industries. The conclusions were that cigarette smoking is the primary cause of elevated regional lung cancer mortality. While having more thorough exposure assessment than previous reports, our results might have been affected by limited participation. Future public health initiatives to curb lung cancer mortality in NW Adelaide should focus on smoking prevention and reduction strategies.