Lung cancer near an industrial site in Lithuania with major emissions of airway irritants

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Abstract
To assess the relation between air pollution with airway irritants, including sulfuric acid and lung cancer, a case‐control study was performed near an industry producing sulfuric acid and fertilizers in Kėdainiai county, central Lithuania. The county had the highest lung cancer rates of the country among men. Between 1967 and 1973, the levels of sulfuric acid exceeded 500 μg/m3 within 2 km of the industry and 100 μg/m3 more than 5 km away. A total of 277 men who were diagnosed as having lung cancer during 1981–1991 in Kėdainiai county were included as well as 1,108 population controls. Information on residential history since 1960, smoking habits, occupations and workplaces during lifetime was obtained from questionnaires mailed to next‐of‐kin. The relative risk of lung cancer associated with living within approximately 5 km from the plant was 1.02 (95% CI: 0.76–1.38) compared to those who had never lived in this area. No relation with distance or duration of residence was observed. Furthermore, workers at the plant did not have an increased lung cancer risk. The relative risk of lung cancer associated with smoking was 21.2 (95% CI: 7.51; 60.1) for current smokers and 14.0 (95% CI: 4.88; 40.3) for exsmokers. The duration of smoking, a low age at start and amount of cigarettes smoked daily were positively associated with lung cancer risk. Smoking levels appeared more pronounced among study controls than in the rest of the country. Our study could not confirm earlier evidence of an association between exposure to airway irritants, such as sulfuric acid and lung cancer. Smoking is the major determinant of the risk of lung cancer in men in Kėdainiai county. It is probable that higher smoking rates constitute the main reason for the increased lung cancer risk among men in this area.

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