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ObjectivesWe evaluated the risk of lung cancer associated with ever working as a painter, duration of employment and type of painter by histological subtype as well as joint effects with smoking, within the SYNERGY project.MethodsData were pooled from 16 participating case–control studies conducted internationally. Detailed individual occupational and smoking histories were available for 19 369 lung cancer cases (684 ever employed as painters) and 23 674 age-matched and sex-matched controls (532 painters). Multivariable unconditional logistic regression models were adjusted for age, sex, centre, cigarette pack-years, time-since-smoking cessation and lifetime work in other jobs that entailed exposure to lung carcinogens.ResultsEver having worked as a painter was associated with an increased risk of lung cancer in men (OR 1.30; 95% CI 1.13 to 1.50). The association was strongest for construction and repair painters and the risk was elevated for all histological subtypes, although more evident for small cell and squamous cell lung cancer than for adenocarcinoma and large cell carcinoma. There was evidence of interaction on the additive scale between smoking and employment as a painter (relative excess risk due to interaction >0).ConclusionsOur results by type/industry of painter may aid future identification of causative agents or exposure scenarios to develop evidence-based practices for reducing harmful exposures in painters.

BackgroundAn estimated ~110 million workers are exposed to welding fumes worldwide. An IARC working group (WG) re-evaluated the carcinogenicity of welding fumes in 2017, previously classified as possibly carcinogenic to humans (Group 2B) in 1990, based on limited evidence for lung cancer in humans. The WG conducted a meta-analysis of peer-reviewed epidemiologic studies reporting a relative risk for welding (fumes) and lung cancer, accounting for confounding by exposure to asbestos and tobacco smoking. MethodologyAfter comprehensive searches in PubMed, Web of Science and Google Scholar databases and reference lists of relevant publications, 23 case-control and 36 cohort and nested case-control studies met our inclusion criteria. We attempted to remove overlapping populations for calculating summary-RRs. ResultsThe summary-RRs were 1.29 (95% CI: 1.24–1.34; I2=47.5%) for “ever” compared with “never” being a welder or being exposed to welding fumes, 1.27 (95% CI: 1.22–1.32; I2=44.7%) among cohort and nested case-control studies, 1.50 (95% CI: 1.34–1.67; I2=39.9%) for case-control studies, 1.09 (95% CI: 0.98–1.20; I2=23%) adjusted for smoking and asbestos exposure, 1.15 (95% CI: 1.02–1.28), among “shipyard welders”, 1.00 (95% CI: 0.84–1.17) among “stainless-steel welders” and 1.31 (95% CI: 1.03–1.60) among “mild steel welders”. The summary-RR was higher for “gas welders” compared to “arc welders”, but not statistically significant. Increased risks were observed over time periods, occupational settings and geographic locations support an evaluation for an increased risk of lung cancer among welders, independent of exposure to asbestos and tobacco smoking.