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Epidemiology:
doi: 10.1097/EDE.0b013e3182458992
Letters

Leisure Time Activities and Lung Cancer

Prini-Guadalupe, Luciana; Pérez-Ríos, Mónica; Ruano-Ravina, Alberto; Abal Arca, José; Barros-Dios, Juan Miguel

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Department of Preventive Medicine and Public Health University of Santiago de Compostela Santiago de Compostela, Spain (Prini-Guadalupe, Pérez-Ríos)

Department of Preventive Medicine and Public Health University of Santiago de Compostela Santiago de Compostela, Spain alberto.ruano@usc.es CIBER de Epidemiología y Salud Pública. CIBERESP Spain (Ruano-Ravina)

Department of Pneumology Ourense Hospital Complex Ourense, Spain (Abal Arca)

Department of Preventive Medicine and Public Health University of Santiago de Compostela Santiago de Compostela, Spain CIBER de Epidemiología y Salud Pública. CIBERESP Spain (Barros-Dios)

Supported by a research grant from the Fondo de Investigaciones Sanitarias (FIS), Instituto de Salud Carlos III, Ministry of Science and Innovation, Spain. PI 031248/03. The authors reported no other financial interests related to this research.

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To the Editor:

Occupation is one of the most important nonsmoking-related risk factors for lung cancer.1 Some leisure-time activities or hobbies (eg, painting, wood-working, model-making, furniture-varnishing) involve the use of several agents that, in the occupational setting, are established carcinogens. Hobbyists sometimes spend considerable time in these leisure activities, often with little or no protection against these carcinogenic agents, leading to levels of exposure that can be as high as those in high-risk occupations.

A hospital-based case-control study of lung cancer was conducted in Galicia, North-west Spain between 2004 and 2007. The study included 442 cases with primary confirmed bronchopulmonary cancer and 548 controls (persons having trivial surgery unrelated to tobacco consumption).

We retrieved information about aspects of lifestyle, focusing on smoking, occupational history, lifetime participation in leisure activities that potentially involve exposure to carcinogens and use of certain types of substances. The activities considered were model-building, painting/artwork, furniture-refinishing, and wood-working or home carpentry. Subjects were classified as exposed if they had performed any of these hobbies and also reported exposure to wood dust, paints, lacquers, stains, organic solvents, or glues.

A multivariate logistic regression analysis was performed, in which the dependent variable was the case or control status and the independent variable was having performed any high-risk leisure-time activity. As adjustment variables, we considered sex, age (continuous), smoking (classified as never-smokers, former-smokers, and current smokers), and having worked in occupations carrying a risk of lung cancer.

Fifteen cases were exposed to high-risk leisure time activities, as were 9 controls. ORs for lung cancer according to self-reported exposures during leisure time are shown in the Table. The crude risk of lung cancer associated with high-risk hobbies was elevated, with an OR of 2.3 (95% confidence interval = 1.0–5.5) compared with those not engaged in those activities. When the results were adjusted for risky occupations and tobacco consumption, the OR was further elevated (2.82 [1.1–7.3]).

Table. Lung Cancer R...
Table. Lung Cancer R...
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There is scant information on this topic, with one publication that reported a risk of lung cancer more than 5-fold higher for those engaged in risky leisure activities.2 Other papers on the effect of these activities on other cancers provide conflicting results.3,4

The association between these leisure activities and lung cancer could be explained by the continued exposure to suspected or proven carcinogens such as wood dust, paints, lacquers, stains, organic solvents, and glues used in those hobbies.57 Although the leisure levels of exposure are usually minimal compared with occupational exposures, subjects exposed during leisure time are often unaware of (or not adequately informed about) the toxic nature of many products, and thus take fewer precautions. Hobbyists may work for many hours using materials in closed or poorly ventilated settings, and at a short distance from the source of exposure.

Our findings are consistent with occupational data suggesting elevated lung cancer risk for employment as a painter, carpenter, and employment in the wood or rubber industry—occupations that have profiles of exposure similar to the studied activities. Among the hobbyists we analyzed, the risk associated with leisure exposure seem to surpass that found for these occupations.7,8

These results suggest that some leisure-time activities or hobbies entailing exposure to carcinogenic agents are associated with a high risk of developing lung cancer. People engaged in these activities should be informed about the potential risk from materials they are exposed to, so that they can take protective measures or reduce their exposure.

Luciana Prini-Guadalupe

Mónica Pérez-Ríos

Department of Preventive Medicine and Public Health

University of Santiago de Compostela

Santiago de Compostela, Spain

Alberto Ruano-Ravina

Department of Preventive Medicine and Public Health

University of Santiago de Compostela

Santiago de Compostela, Spain

alberto.ruano@usc.es CIBER de Epidemiología y Salud Pública. CIBERESP

Spain

José Abal Arca

Department of Pneumology

Ourense Hospital Complex

Ourense, Spain

Juan Miguel Barros-Dios

Department of Preventive Medicine and Public Health

University of Santiago de Compostela

Santiago de Compostela, Spain

CIBER de Epidemiología y Salud Pública. CIBERESP

Spain

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REFERENCES

1. Alberg AJ, Ford JG, Samet JM. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:29S–55S.

2. Ruano-Ravina A, Figueiras A, Barros-Dios JM. Noxious exposures in leisure time and risk of lung cancer: a neglected exposure. Epidemiology. 2002;13:235–236.

3. Sharpe CR, Siemiatycki J, Parent ME. Activities and exposures during leisure and prostate cancer risk. Cancer Epidemiol Biomarkers Prev. 2001;10:855–860.

4. Colt JS, Hartge P, Davis S, Cerhan JR, Cozen W, Severson RK. Hobbies with solvent exposure and risk of non-Hodgkin lymphoma. Cancer Causes Control. 2007;18:385–390.

5. Barcenas CH, Delclos GL, El-Zein R, Tortolero-Luna G, Whitehead LW, Spitz MR. Wood dust exposure and the association with lung cancer risk. Am J Ind Med. 2005;47:349–357.

6. Lynge E, Anttila A, Hemminki K. Organic solvents and cancer. Cancer Causes Control. 1997;8:406–419.

7. Straif K, Benbrahim-Tallaa L, Baan R, et al.. WHO International Agency for Research on Cancer Monograph Working Group. A review of human carcinogens-part C: metals, arsenic, dusts, and fibres. Lancet Oncol. 2009;10:453–454.

8. Guha N, Merletti F, Steenland NK, Altieri A, Cogliano V, Straif K. Lung cancer risk in painters: a meta-analysis. Environ Health Perspect. 2010;118:303–312.

© 2012 Lippincott Williams & Wilkins, Inc.

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