Mineral dust is classified by International Agency for Research on Cancer (IARC) as carcinogenic to humans because it is thought to cause lung cancer. Studies show strong associations between asbestos or other mineral dusts (OMD) exposure and respiratory health risk. The aim of the study was to examine the relationship between airflow obstruction (AFO) and cumulative occupational exposure to mineral dust, using the Finnish Job Exposure Matrix (FINJEM), in a population historically at high risk of lung cancer. The quantitative estimation of cumulative exposure to asbestos and OMD were calculated using the FINJEM from the data obtained at the baseline assessment in the Wythenshawe Respiratory Health Study (WRHS). The study was a population-based observational cohort study comprises all patients, aged 50- 75, registered with a General Practitioner (GP) practices in Wythenshawe District, Manchester. Among 257 study subjects who were assessed at baseline, 165 (64.2%) reported that they have been exposed to any occupational hazards, 56 (21.8% subcohort exposed) to asbestos and 42 (16.3% subcohort exposed) to OMD. There was a significant positive correlation between occupational exposure to OMD (Pearson correlation coefficient, r = 0.47, p = 0.01). They were 5 times higher risk to get airflow obstruction among those who have been exposed to low level of asbestos compared to non-exposed, after adjustment for gender, age and smoking (adjusted Odds Ratio (aOR) = 5.76, 95% Confidence Interval (CI) = 1.37 – 24.1). However, no significant association was found between level of exposure to OMD and airflow obstruction. It is suggested that workplace exposure to mineral dusts is sufficient to produce measurable airflow obstruction evidence of occupational respiratory ill-health. The findings from this study supports the FINJEM could be used in epidemiological study and a potential cost-effective exposure assessment particularly in examining the relationship between cumulative occupational exposures with respiratory ill-health

Manual work is associated with increased lung cancer risk possibly because of increased exposure to occupational and other carcinogens, reduced use of health care services and/or a less healthy lifestyle. The aim of this study was to examine whether the association between manual work and lung cancer risk has changed over time. Three separate retrospective studies were carried out over a 10-year period (1996-1997, 1998-2000 and 2003-2005) in patients attending a bronchoscopy clinic to investigate lung cancer risk in an area of Manchester characterised by high deprivation and unemployment. Cases (n=321) were patients newly diagnosed with a tumour of the lung, trachea or bronchus and controls (n=542) were patients free of tumours at the time of, and prior to, examination. Patients were interviewed using the same structured questionnaire for associations between risk factors and lung cancer examined. The study population in all three studies was similar with little difference in smoking history. In each study smoking was associated with lung cancer risk. Lung cancer risk was higher in manual workers (compared to managers and other professionals) in the first (OR 2.50, 95% CI 1.20 – 5.05) and second study (OR 2.73, 95% CI 0.97 – 7.70) but not the third (OR 0.97, 95% CI 0.58 – 1.61). However, the summary odds ratio (meta-OR) for lung cancer in manual worker was 1.81 (95% 1.75 – 1.87) after controlling for sex, age and smoking. This study suggested that even after taking into account known occupational and environmental causes of cancer, there was a residual cancer risk associated with manual work, high risk working populations of lung cancer. However this appears to have attenuated recently for as yet unknown reasons.

Introduction: Although smoking is the most important cause of lung cancer, occupational factors can also play an important role. Worldwide, approximately 10% of lung cancer deaths in men (88,000 deaths) and 5% in women (14,300 deaths) were attributable to exposure to occupational carcinogens, referred to the report on the global burden of disease due to occupational carcinogens Methods: We examined the risks associated with occupational exposures in a case-referent study of lung cancer that was carried out between November 1998 to March 2000. Cases were patients attended a bronchoscopy clinic at the North West Lung Centre, Wythenshawe Hospital in Manchester during that period who were subsequently found to have lung cancer. Referents were patients found not to have lung cancer at bronchoscopy. Results: There were 121 subjects in the study (39 cases, 82 referents). Smoking status was significantly associated with lung cancer risk: the odds ratio of having lung cancer in ever smokers (vs never smokers) was 3.21 (95% CI: 1.02 - 10.07). There were also significant association between number of cigarettes smoked (p = 0.01) and years smoked (p = 0.04) with lung cancer risk. Years of exposure to occupational carcinogens was also associated with the development of lung cancer (p = 0.02). Workers who were exposed for 45 years or more, had an increase risk when compared to those who had worked for less than 17 years (OR, 95% CI = 2.54, 1.12 – 6.34). Job category was found to be borderline significant with lung cancer risk. The adjusted odds ratio of having lung cancer among unskilled manual job worker (vs management, professional & associate professional) was 4.75 (95% CI: 1.06 - 21.4). Conclusion: This study shows an exposure to occupational carcinogens was associated with an elevated lung cancer risk. Unskilled manual job workers had a higher lung cancer risk compared with other categories, such as management, professional & associate professional.

Background: Waterpipe tobacco smoking has becoming popular especially among young people worldwide. Smokers are attracted by its sweeter, smoother smoke, social ambience and the misconception of reduced harm. The objective of this study was to systematically review the effects of waterpipe tobacco policies and practices in reducing its prevalence. Materials and Methods: A systematic review was conducted electronically using the PubMed, OVID, Science Direct, Proquest and Embase databases. All possible studies from 1980 to 2013 were initially screened based on titles and abstracts. The selected articles were subjected to data extraction and quality rating. Results: Three studies met the inclusion criteria and were eligible for this review. Almost all of the waterpipe tobacco products and its accessories did not comply with the regulations on health warning labelling practices as stipulated under Article 11 of WHO FCTC. In addition, the grisly new warning labels for cigarettes introduced by Food and Drug Administration did not affect hookah tobacco smoking generally. Indoor air quality in smoking lounges was found to be poor and some hookah lounges were operated without smoke shop certification. Conclusions: Our findings revealed the availability of minimal information on the practices in controlling waterpipe smoking in reducing its prevalence. The lack of comprehensive legislations or practices in controlling waterpipe smoking warrants further research and policy initiatives to curb this burgeoning global epidemic, especially among the vulnerable younger population.