US EPA

1357744 

Journal Article 

Review 

The interactions of tobacco smoking and other agents in cancer etiology 

Saracci, R 

1987 

Yes 

Epidemiologic Reviews
ISSN: 0193-936X
EISSN: 1478-6729 

JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH 

BALTIMORE 

NIOSH/00174779 

9 

175-193 

English 

3315716 

10.1093/oxfordjournals.epirev.a036301 

WOS:A1987K500500008 

http://epirev.oxfordjournals.org/content/9/1/175.long
Exit
 

The interactions of tobacco smoking with exposure to asbestos (1332214), ionizing radiation, occupational chemicals, and alcohol were reviewed and the significance for public health was discussed. The estimates used to determine the interaction were relative risks associated with the exposure, absolute interaction magnitude for single and combined agent exposure, and relative interaction magnitude as percent of the excess risk due to interaction. The results of most studies on asbestos and tobacco interactions appeared to be of the multiplicative type, where the combined effect of both agents was greater than simple additive interaction. Asbestos may act at different stages of the multistage carcinogenic process. The data on uranium miners exposed to radon (10043922) conformed to a multiplicative interaction, while the results from studies on Swedish nonuranium miners indicated smaller intermediate to additive interactions. An additive relation was found between tobacco smoking and occupational exposure in the smelting and refining of nickel ores. A multiplicative interaction was found in one, and an intermediate interaction between additive and multiplicative in two studies of arsenic (7440382) exposure in copper smelters. No definite relationship was established for tobacco smoking and exposure to chloromethylethers. An interaction between tobacco smoking and alcohol as the cause of cancer at several sites was reported in all reviewed studies. The author concludes that the implications for public health are that the impact of an interaction is best judged by the magnitude of interaction on the total excess risk due to exposure to two or more agents. The multiplicative relation appears to be the approximate upper limit for the magnitude of interaction between tobacco smoking with other agents. At low exposure levels the interaction effect relative to the total effect may be small. 

DCN-162550; Carcinogenicity; Cigarette smoking; Ionizing radiation; Asbestosis; Organic compounds; Occupational hazards; Alcohols; Health protection; Synergism