Akciğer Kanseri Tanılı Hastalarda Çevresel ve Mesleki Risk Faktörlerinin Değerlendirilmesi: Bir Olgu Kontrol Çalışması

Giriş: Akciğer kanseri, dünyada en sık görülen kanser türüdür. Sigara gibi temel etmenin dışında birçok etkenin patofizyolojide yer almaktadır. Bu çalışma ile akciğer kanseri için mesleki ve çevresel maruz kalım özelliklerin değerlendirilmesi amaçlanmıştır. Yöntemler: Çalışmamız kesitsel olgu/kontrol çalışmasıdır. Ocak 2009 ve Mart 2014 tarihleri arasında primer akciğer kanseri almış 57 kadın, 572 erkek toplam 629 olgu ve 219 gönüllü olgu seçimi yapılmadan dahil edilmiştir. Olguların sosyodemografik bulguları, çevresel ve mesleksel maruziyet oluşturacak etkenleri, spesifik maruz kalımları (asbest, silika, kimyasal ve organik madde), tütün kullanım öyküleri değerlendirilmiştir. Çoklu Değişkenli Lojistik Regresyon analizi kullanılarak grupları birbirinden ayırt etmede en fazla belirleyiciliği olan risk faktörleri tespit edildi. Bulgular: Olgular ile kontrol grubu arasında yaş, cinsiyet, eğitim durumu, gelir açısından fark yoktu. Sigara içme durumu ve paket yıl kontrol grubuna göre yüksek izlendi (p<0.001). Mesleki ve çevresel asbest maruz kalımı, iç ortam hava kirliliği (biomass ve radon), egzoz gazı, organik toz, silika, tarım ilacı ve metal dumanı gibi mesleksel risk faktörlerine olan maruziyet anlamlı düzeyde daha yüksekti (p<0,001). Lojistik regresyon analizinde meyve tüketmeme (p<0,001, OR:21,998, %95 CI=8,408-57,552), tarım ve hayvancılıkla uğraşmak (p=0,007, OR:5,158, %95 CI=1,571-16,934), işçi olmak (p=0,013, OR:6,751, %95 CI=1,494-30,504), tütün kullanımı (p=0,033, OR:1,782, %95 CI=1,09-3,029) ve tütün kullanım miktarı (p<0,001, OR:1,053, %95 CI=1,038-1,069) bağımsız risk faktörleri olarak saptandı. Sonuç: Akciğer kanseri etiyolojisinde tütün kullanımı, artmış tütün kullanım miktarı, meyve tüketmeme, işçi olmak ve tarım hayvancılıkla uğraşmak bağımsız birer risk faktörü olarak bulunmuştur. Akciğer kanserinin etiyolojisinde yeri olabilecek çeşitli risk faktörlerinin saptanması önleyici hekimlik alanında ve taramada kullanım yeri bulması açısından önemlidir.

Anahtar Kelimeler:

: Akciğer kanseri, mesleki maruziyet, risk faktörleri

Environmental and occupational risk factors of lung cancer: a case-control study

Aim: Lung cancer has been demonstrated to be caused by several occupational and environmental exposures. We conducted a large case–control study to evaluate exposure to known and suspected carcinogens and by performing an exploratory analysis.Material and Method: This study is a Case / Control study. Between January 2009 and March 2014, 57 (9.1%) women, 572 (90.9%) men, a total of 629 cases who had primary lung cancer and 219 volunteers were included without selection. Data of sociodemographic features, environmental and occupational history and specific exposures (asbestos, silica, chemical and organic substances), physical activity properties and dietary factors were evaluated.Results: There was no difference between the subjects and the control group in terms of age, gender, education level, and income. Smoking and pack / year were higher than the control group (p <0.001). Occupational and environmental exposure to asbestos and indoor air pollution (biomass and radon), exposure to occupational risk factors such as exhaust gas, organic dust, silica, pesticides and metal fumes was significantly higher than control group (p<0.001). In logistic regression analysis, low fruit and vegetable consumption (p<0.001, OR:21.998, 95%CI=8.408-57.552), working in agriculture and animal husbandry (p=0.007, OR:5.158, 95%CI=1.571-16.934), being a worker in industrial sector (p=0.013, OR:6.751, 95%CI=1.494-30.504), cigarette smoking, (p=0.033, OR: 1.782, 95%CI=1.09-3.029) and tobacco use (packyears) (p<0.001, OR:1.053, 95% CI=1.038-1.069) were determined as independent risk factors.Conclusion: Determining various risk factors that may have a place in the etiology of lung cancer is important in terms of finding a place of use in preventive medicine and screening.Keywords: Lung cancer, occupational exposure, risk factors

Keywords:

Lung cancer, occupational exposure, risk factors,

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