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Wood dust exposure and small cell lung cancer: a systematic review and meta-analysis

Journal of Exposure Science & Environmental Epidemiology (2023)Cite this article

Abstract

Introduction

Occupational exposure role on small cell lung cancer (SCLC) onset has been little studied. Wood dust has been recognized as a human carcinogen, and many occupations have high wood-dust exposure. The aim of this study was therefore to perform a systematic review and meta-analysis of the scientific literature to summarize and analyse the risks of wood dust-related occupations on development of SCLC, taking tobacco use into account.

Methods

We conducted a literature search of PubMed, EMBASE, Web of Science and Cochrane using a predefined strategy and including case-control and cohort studies assessing occupational exposure to wood dust or wood dust-related occupations. To perform the meta-analysis, the odds ratio (OR) and 95% confidence interval (CI) of each of the studies were extracted. A random-effects model was fitted using the DerSimonian Laird method. Sensitivity and subgroup analyses were performed. Quality was assessed using the Office and Health Assessment and Translation (OHAT) for human and animal studies instrument.

Results

Eleven studies with a total of 2,368 SCLC cases and 357,179 controls were included. Overall, exposure to wood dust significantly increases risk of SCLC (RR = 1.41, 95% CI 1.11–1.80), with low heterogeneity between studies (I2 = 40%). The association was maintained in studies conducted on males (RR = 1.41, 95% CI 1.12–1.78) but not in those conducted on females/both sexes (RR = 1.37, 95% CI 0.35–3.44). Sensitivity analysis showed that none of the studies significantly modified the results.

Conclusions

Our results support that exposure to wood-dust can increase the risk of SCLC. Although the level of evidence is low, there are strong arguments to recommend the implementation of effective control measures to reduce exposure in occupational settings, as a means of preventing SCLC.

Impact statement

The results of this study support that exposure to wood-dust can increase the risk of developing small cell lung cancer. Determining the impact of occupational exposure on workers is essential to improve their individual protection and prevention. There is a strong case for recommending the implementation of control measures to reduce occupational exposure to wood dust, specifically for highly exposed occupations such as carpenters and sawmills, in order to prevent small cell lung cancer.

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Fig. 1: Flowchart of the included studies.
Fig. 2: Forest plot.
Fig. 3: Funnel plot of the included studies.

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Acknowledgements

Not applicable

Funding

This research has been funded by a research project (1215/2022) awarded by the Spanish Society of Respiratory Pathology (SEPAR), entitled “Occupation and lung cancer. A pooling study in Northwestern Spain”.

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Author notes

  1. These authors contributed equally: Teresa Curiel-García, Cristina Candal-Pedreira.

Authors and Affiliations

  1. Service of Medical Oncology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain

    Teresa Curiel-García

  2. Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain

    Teresa Curiel-García, Cristina Candal-Pedreira, Leonor Varela-Lema, Julia Rey-Brandariz, Lucía Moure-Rodríguez, Alberto Ruano-Ravina & Mónica Pérez-Ríos

  3. Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain

    Cristina Candal-Pedreira, Leonor Varela-Lema, Lucía Moure-Rodríguez, Adolfo Figueiras, Alberto Ruano-Ravina & Mónica Pérez-Ríos

  4. Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Madrid, Spain

    Leonor Varela-Lema, Adolfo Figueiras, Alberto Ruano-Ravina & Mónica Pérez-Ríos

  5. Scientific-Technical Advice Unit (avalia-t), Galician Agency for Health Knowledge Management, ACIS, Santiago de Compostela, Spain

    Beatriz Casal-Acción

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Contributions

LVL, MPR, and ARR designed the study and supervised the work. MPR, LVL, TGC, CCP, JRB, and BCA carried out the search strategy, selection, and extraction of data. MPR, LVL, and CCP analysed of results; TGC and CCP wrote the first version of the manuscript. All authors made a significant contribution to the work reported. All authors take public responsibility for the manuscript content and have approved the final version.

Corresponding author

Correspondence to Leonor Varela-Lema.

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Curiel-García, T., Candal-Pedreira, C., Varela-Lema, L. et al. Wood dust exposure and small cell lung cancer: a systematic review and meta-analysis. J Expo Sci Environ Epidemiol (2023). https://doi.org/10.1038/s41370-023-00538-w

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