Facteurs de risques professionnels des cancers du poumon et des voies aéro-digestives supérieures Etude ICARE (Investigations sur les Cancers Respiratoires et l'Environnement professionnel) – ICARE 

The objectives are to study the role in the occurrence of lung and head and neck cancers of some suspected occupational risk factors, particularly man-made vitreous fibers, and to identify new occupational carcinogens. The study is a multi-center, population-based case-control study, and will include 3000 lung cancer cases, 3000 head and neck cancer cases, and 3000 controls (common to all cancer sites). Cases are identified in collaboration with the FRANCIM network of cancer registries, in 10 French departments covered by a cancer registry, which overall gather about 13 % of the French population (7,6 millions inhabitants). Controls are selected using random digit dialing, in the same départements as the cases, with stratification for age and sex. Subjects are interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumptions, residential history and a detailed description of occupational history. Biological samples (buccal cells for constitutional DNA) are also collected for study subjects. In addition to man-made vitreous fibers, the main occupational exposures of interest are asbestos, formaldehyde, polycyclic aromatic hydrocarbons, some chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes about 60 substances. Exposure assessment will be conducted in collaboration with industrial hygienists. Data collection is expected to end in June 2006. The large number of subjects should allow to uncover exposures associated with low to moderate increase in risks, and to evaluate risks associated with infrequent and/or widely dispersed exposures. It will be possible to study joint effects of exposure to different occupational risk factors, and to examine the interactions between occupational exposures and the major risk factors for the cancer sites of interest (tobacco smoking and alcohol drinking). The large number of subjects and the special efforts devoted to exposure assessment will offer a unique opportunity to study interactions between genetic risk factors and occupational exposures. Estimates of the attributable risk to occupational exposures will be provided for the cancer sites of interest in the French population.