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I I I I I I I I I I I I I I I I ENVIRONMENTAL RISK FACTORS FOR LUNG CANCER AMONG SWEDISH MEN Cecilia Mddieh, Gosta Axelsson and Ragnar Rylander Department of Environmental Medicine, University of Gothenburg, Gothenburg, Sweden A prospective case-control study in Sweden investigates the relationship between lung cancer and environmental exposures. Cases are recruited from suspect lung cancer cases at two hospitals in West Sweden and corresponding controls are drawn from population registers. This report comprises 304 cases and 508 controls, collected between 1989 and 1992. Participation rate for cases was 90% and 789'o for controls. A previous analysis showed that smoking and milk consumption were risk factors and vegetables protective factors. Thus these factors were corrected for in the analysis. The data reported here relate to occupation, living in built-up areas and keeping birds at home. Regarding occupational exposure, 50 persons (10%) among the controls and 45 (14.6%) of the cases reported a history of shipyard work - the most common asbestos related workplace in Gothenburg. When the asbestos exposure was expressed as lifetime day exposures, 42 persons (8.390) of the controls and 37 (12%) of the cases reported exposure in excess of 2000 days. Only a few cases and controls were related to other occupations related to lung cancer risks. When persons who had lived in city environments more than 20 years were compared to those living in suburban and country type areas, the unadjusted odds ratio was 1.59 (95% CI 0.96-2.64). Adjusting for age, marital status, socioeconomic job classification, vegetable consumption and milk drinking only altered the odds ratio marginally. Adjusting for smoking decreased the ratio to 0.87 (CI 0.43-1.75). Regarding pet birds, the material was small but a tendency to increased risk was found (OR = 1.28, CI 0.62-2.63). In conclusion, the data demonstrate that in this material, based on the general population, occupational exposure was not a major risk factor for lung cancer. No effects of air pollution in terms of living in a city were found which is in accordance with the relatively low levels of air pollution in Sweden. The slight increase related to bird keeping is in agreement with previous reports and merits further investigation, particularly as this exposure - if real - could lead to new hypotheses concerning causative agents. O ~ V O 46 W ~ w tV I