{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:43:42Z","timestamp":1793648622374,"version":"4.5.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["ZIA CP010125\u201328"],"award-info":[{"award-number":["ZIA CP010125\u201328"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Cancer Institute","award":["ZIA CP010125\u201328"],"award-info":[{"award-number":["ZIA CP010125\u201328"]}]}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Industrial facilities emit known lung carcinogens into air, but the association of these agents with lung cancer risk at environmental levels is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We sought to investigate industrial emissions and lung cancer risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a U.S. regulatory database to estimate airborne exposure to known and probable human carcinogens (n\u2009=\u200931) emitted from industrial sources (1987\u20131995) for 442,986 participants in the NIH-AARP Diet and Health Study. We estimated inverse distance\u2013 and wind-weighted average exposures within 1, 2, 5, and 10 km of the enrollment residence. Using Cox proportional hazards models adjusted for smoking and other confounders, we evaluated lung cancer risk overall and by major histologic subtype (adenocarcinoma, squamous cell carcinoma, small cell carcinoma) for levels (tertiles and medians) of exposure to each agent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Among agents with prior evidence of lung carcinogenicity, overall risk was elevated for cobalt (5-km hazard ratio (HR) for tertile3 (T3)\u2009=\u20091.19; 95% confidence interval [CI]\u2009=\u20091.10\u20131.29; p-trend\u2009\u2a7d\u20090.0001; 10-km HRT3\u2009=\u20091.15; 95% CI\u2009=\u20091.09\u20131.21; p-trend\u2009\u2a7d\u20090.0001) and beryllium (5-km HRT3\u2009=\u20091.20; 95% CI\u2009=\u20090.94\u20131.55; p-trend\u2009=\u20090.15; 10-km HRT3\u2009=\u20091.15; 95% CI\u2009=\u20091.01\u20131.31; p-trend\u2009=\u20090.02). We also observed associations with benzene and nickel. For agents without prior evidence, styrene was associated with risk at 1 km (HRT3\u2009=\u20091.22; 95% CI\u2009=\u20091.00\u20131.48; p-trend\u2009=\u20090.03). Diethyl sulfate, chromium, and lead were also associated with risk. Associations for cobalt, benzene, nickel, and diethyl sulfate were most apparent for squamous cell carcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our novel findings show that relatively high air emissions of numerous carcinogenic industrial agents near the home were associated with lung cancer risk unexplained by smoking. These and the stronger associations for squamous cell carcinoma highlight the potential role of industrial exposures in lung cancer development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202409-1738oc","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T22:51:26Z","timestamp":1746053486000},"page":"1241-1252","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":8,"title":["Carcinogenic Industrial Air Emissions and Lung Cancer Risk in a Cohort of 440,000 Americans"],"prefix":"10.1093","volume":"211","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5303-5109","authenticated-orcid":false,"given":"Jessica M.","family":"Madrigal","sequence":"first","affiliation":[{"name":"Occupational and Environmental Epidemiology Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared A.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Occupational and Environmental Epidemiology Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline N.","family":"Pruitt","sequence":"additional","affiliation":[{"name":"Occupational and Environmental Epidemiology Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M.","family":"Liao","sequence":"additional","affiliation":[{"name":"Metabolic Epidemiology Branch, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry I.","family":"Graubard","sequence":"additional","affiliation":[{"name":"Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary H.","family":"Ward","sequence":"additional","affiliation":[{"name":"Occupational and Environmental Epidemiology Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra T.","family":"Silverman","sequence":"additional","affiliation":[{"name":"Occupational and Environmental Epidemiology Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1294-1679","authenticated-orcid":false,"given":"Rena R.","family":"Jones","sequence":"additional","affiliation":[{"name":"Occupational and Environmental Epidemiology Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2026031105353708300_bib1","article-title":"Key statistics for lung cancer","year":"2023"},{"key":"2026031105353708300_bib2","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"2026031105353708300_bib3","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1016\/S1470-2045(13)70487-X","article-title":"The carcinogenicity of outdoor air pollution","volume":"14","author":"Loomis","year":"2013","journal-title":"Lancet Oncol"},{"key":"2026031105353708300_bib4","doi-asserted-by":"crossref","first-page":"759645","DOI":"10.1155\/2010\/759645","article-title":"Environmental exposure to emissions from petrochemical sites and lung cancer: the lower Mississippi interagency cancer study","volume":"2010","author":"Simonsen","year":"2010","journal-title":"J Environ Public Health"},{"key":"2026031105353708300_bib5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/ajim.4700020105","article-title":"Relationship between lung cancer and distance of residence from nonferrous smelter stack effluent","volume":"2","author":"Greaves","year":"1981","journal-title":"Am J Ind Med"},{"key":"2026031105353708300_bib6","doi-asserted-by":"crossref","first-page":"860","DOI":"10.3390\/ijerph14080860","article-title":"Residence in proximity of a coal-oil-fired thermal power plant and risk of lung and bladder cancer in North-Eastern Italy. A population-based study: 1995\u20132009","volume":"14","author":"Collarile","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"2026031105353708300_bib7","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/0013-9351(84)90093-8","article-title":"Lung cancer in relation to environmental pollutants emitted from industrial sources","volume":"34","author":"Brown","year":"1984","journal-title":"Environ Res"},{"key":"2026031105353708300_bib8","doi-asserted-by":"crossref","first-page":"1002597","DOI":"10.3389\/fpubh.2023.1002597","article-title":"Association of multi-criteria derived air toxics hazard score with lung cancer incidence in a major metropolitan area","volume":"11","author":"Zhu","year":"2023","journal-title":"Front Public Health"},{"key":"2026031105353708300_bib9","doi-asserted-by":"crossref","first-page":"463701","DOI":"10.1155\/2011\/463701","article-title":"Association between six environmental chemicals and lung cancer incidence in the United States","volume":"2011","author":"Luo","year":"2011","journal-title":"J Environ Public Health"},{"key":"2026031105353708300_bib10","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1476-072X-2-4","article-title":"Geographic boundaries in breast, lung and colorectal cancers in relation to exposure to air toxics in Long Island, New York","volume":"2","author":"Jacquez","year":"2003","journal-title":"Int J Health Geogr"},{"key":"2026031105353708300_bib11","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S1470-2045(06)70545-9","article-title":"Environmental exposure to cadmium and risk of cancer: a prospective population-based study","volume":"7","author":"Nawrot","year":"2006","journal-title":"Lancet Oncol"},{"key":"2026031105353708300_bib12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1476-072X-10-10","article-title":"Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study","volume":"10","author":"L\u00f3pez-Cima","year":"2011","journal-title":"Int J Health Geogr"},{"key":"2026031105353708300_bib13","year":"2023"},{"key":"2026031105353708300_bib14","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 100C: arsenic, metals, fibres, and dusts","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2012"},{"key":"2026031105353708300_bib15","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 100F: chemical agents and related occupations","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2012"},{"key":"2026031105353708300_bib16","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 120: benzene","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2018"},{"key":"2026031105353708300_bib17","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 131: cobalt, antimony compounds, and weapons-grade tungsten alloy","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2023"},{"key":"2026031105353708300_bib18","first-page":"83","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 35: Coal-tars and Derived Products","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"1985"},{"key":"2026031105353708300_bib19","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 112: some organophosphate insecticides and herbicides","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2017"},{"key":"2026031105353708300_bib20","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 115: some industrial chemicals","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2018"},{"key":"2026031105353708300_bib21","year":"2022"},{"key":"2026031105353708300_bib22","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1093\/jnci\/djae001","article-title":"Sociodemographic inequities in the burden of carcinogenic industrial air emissions in the United States","volume":"116","author":"Madrigal","year":"2024","journal-title":"J Natl Cancer Inst"},{"key":"2026031105353708300_bib23","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1093\/aje\/154.12.1119","article-title":"Design and serendipity in establishing a large cohort with wide dietary intake distributions: the National Institutes of Health\u2013American Association of Retired Persons Diet and Health Study","volume":"154","author":"Schatzkin","year":"2001","journal-title":"Am J Epidemiol"},{"key":"2026031105353708300_bib24","doi-asserted-by":"crossref","first-page":"108985","DOI":"10.1016\/j.envint.2024.108985","article-title":"Carcinogenic industrial air pollution and postmenopausal breast cancer risk in the National Institutes of Health AARP Diet and Health Study","volume":"191","author":"Madrigal","year":"2024","journal-title":"Environ Int"},{"key":"2026031105353708300_bib25","article-title":"Toxics Release Inventory (TRI) 2018 national analysis","year":"2020"},{"key":"2026031105353708300_bib26","article-title":"Agents classified by the IARC Monographs, Volumes 1\u2013138","year":"2025"},{"key":"2026031105353708300_bib27","doi-asserted-by":"crossref","DOI":"10.15620\/cdc:11481","volume-title":"Toxicological profile for benzene.","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"2007"},{"key":"2026031105353708300_bib28","volume-title":"Toxicological profile for cadmium.","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"2012"},{"key":"2026031105353708300_bib29","volume-title":"Toxicological profile for lead.","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"2020"},{"key":"2026031105353708300_bib30","volume-title":"Toxicological profile for styrene.","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"2010"},{"key":"2026031105353708300_bib31","volume-title":"Toxicological profile for cobalt.","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"2004"},{"key":"2026031105353708300_bib32","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1093\/aje\/kwk052","article-title":"Relaxing the rule of ten events per variable in logistic and Cox regression","volume":"165","author":"Vittinghoff","year":"2007","journal-title":"Am J Epidemiol"},{"key":"2026031105353708300_bib33","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1158\/1055-9965.EPI-12-1050","article-title":"A comparison of the polytomous logistic regression and joint Cox proportional hazards models for evaluating multiple disease subtypes in prospective cohort studies","volume":"22","author":"Xue","year":"2013","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2026031105353708300_bib34","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3390\/ijerph21020205","article-title":"Benzene exposure and lung cancer risk: a systematic review and meta-analysis of human studies","volume":"21","author":"Chiavarini","year":"2024","journal-title":"Int J Environ Res Public Health"},{"key":"2026031105353708300_bib35","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1093\/oxfordjournals.aje.a009127","article-title":"Risk of cancer and exposure to gasoline vapors","volume":"145","author":"Lynge","year":"1997","journal-title":"Am J Epidemiol"},{"key":"2026031105353708300_bib36","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1002\/(SICI)1097-0274(199808)34:2<144::AID-AJIM7>3.0.CO;2-X","article-title":"Associations between several sites of cancer and occupational exposure to benzene, toluene, xylene, and styrene: results of a case-control study in Montreal","volume":"34","author":"G\u00e9rin","year":"1998","journal-title":"Am J Ind Med"},{"key":"2026031105353708300_bib37","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1164\/rccm.202107-1770OC","article-title":"Traffic-related air pollution and lung cancer incidence: the California Multiethnic Cohort Study","volume":"206","author":"Cheng","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2026031105353708300_bib38","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1097\/JOM.0b013e318234e2d2","article-title":"Lung cancer risk attributable to occupational exposures in a multicenter case-control study in Central and Eastern Europe","volume":"53","author":"Olsson","year":"2011","journal-title":"J Occup Environ Med"},{"key":"2026031105353708300_bib39","first-page":"1669","article-title":"Occupational exposure to metal compounds and lung cancer. Results from a multi-center case-control study in Central\/Eastern Europe and UK","volume":"22","author":"Mannetje","year":"2011","journal-title":"Cancer Causes Control"},{"key":"2026031105353708300_bib40","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S1470-2045(09)70134-2","article-title":"A review of human carcinogens\u2013 Part C: metals, arsenic, dusts, and fibres","volume":"10","author":"Straif","year":"2009","journal-title":"Lancet Oncol"},{"key":"2026031105353708300_bib41","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1186\/1471-2458-13-330","article-title":"Cell-type specificity of lung cancer associated with low-dose soil heavy metal contamination in Taiwan: an ecological study","volume":"13","author":"Huang","year":"2013","journal-title":"BMC Public Health"},{"key":"2026031105353708300_bib42","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0232-1513(11)80084-8","article-title":"On the question of a carcinogenic action of cobalt-containing compounds","volume":"41","author":"Steinhoff","year":"1991","journal-title":"Exp Pathol"},{"key":"2026031105353708300_bib43","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0232-1513(87)80044-0","article-title":"Carcinogenicity studies on fibres, metal compounds, and some other dusts in rats","volume":"32","author":"Pott","year":"1987","journal-title":"Exp Pathol"},{"key":"2026031105353708300_bib44","first-page":"5251","article-title":"Comparative carcinogenic effects of nickel subsulfide, nickel oxide, or nickel sulfate hexahydrate chronic exposures in the lung","volume":"55","author":"Dunnick","year":"1995","journal-title":"Cancer Res"},{"key":"2026031105353708300_bib45","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/01.ede.0000199323.55534.fb","article-title":"Estimated effects of hydrazine exposure on cancer incidence and mortality in aerospace workers","volume":"17","author":"Ritz","year":"2006","journal-title":"Epidemiology"},{"key":"2026031105353708300_bib46","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 71: re-evaluation of some organic chemicals, hydrazine and hydrogen peroxide","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"1999"},{"key":"2026031105353708300_bib47","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1093\/ije\/dyx146","article-title":"Meta-analysis of occupational exposures in the rubber manufacturing industry and risk of cancer","volume":"46","author":"Boniol","year":"2017","journal-title":"Int J Epidemiol"},{"key":"2026031105353708300_bib48","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1289\/ehp.7511115","article-title":"Metabolism and toxicity of styrene","volume":"11","author":"Leibman","year":"1975","journal-title":"Environ Health Perspect"},{"key":"2026031105353708300_bib49","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/S1470-2045(18)30316-4","article-title":"Carcinogenicity of quinoline, styrene, and styrene-7, 8-oxide","volume":"19","author":"Kogevinas","year":"2018","journal-title":"Lancet Oncol"},{"key":"2026031105353708300_bib50","volume-title":"IARC monographs on the evaluation of carcinogenic risks to humans. Volume 54: occupational exposures to mists and vapours from strong inorganic acids and other industrial chemicals","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"1992"},{"key":"2026031105353708300_bib51","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1001\/jama.1975.03260240043024","article-title":"The respiratory effects of chloromethyl methyl ether","volume":"234","author":"Weiss","year":"1975","journal-title":"JAMA"},{"key":"2026031105353708300_bib52","doi-asserted-by":"crossref","first-page":"110986","DOI":"10.1016\/j.envres.2021.110986","article-title":"Evaluation of a commercial database to estimate residence histories in the Los Angeles Ultrafines Study","volume":"197","author":"Medgyesi","year":"2021","journal-title":"Environ Res"},{"key":"2026031105353708300_bib53","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/00001648-199001000-00010","article-title":"No adjustments are needed for multiple comparisons","volume":"1","author":"Rothman","year":"1990","journal-title":"Epidemiology"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/211\/7\/1241\/67295929\/ajrccm_211_7_1241.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/211\/7\/1241\/67295929\/ajrccm_211_7_1241.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T09:36:17Z","timestamp":1773221777000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/211\/7\/1241\/8513680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":53,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,1]]},"published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.202409-1738oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,7,1]]},"assertion":[{"value":"2024-09-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}