Pooled analysis of European case-control studies on the interaction of occupational carcinogens in the development of lung cancer (Synergy)

Project No. FF-FP 0271


completed 11/2009


When assessing the relationship between occupational exposure and disease, it is important to note that carcinogenic hazardous substances often do not occur individually but in combination with other agents (such as asbestos and polycyclic aromatic hydrocarbons (PAH), quartz and radiation, or chromium and nickel). The assessment of health risks after multiple exposures, in particular of carcinogenic substances, is therefore of great importance for occupational health prevention and for the recognition of an occupational disease. However, the evaluation of occupational combination effects of carcinogenic substances is difficult, as extensive studies and reliable exposure assessments are required to study these effects reliably. Therefore, "SYNERGY" aimed at investigating the interaction of five model occupational carcinogens (hexavalent chromium (CrVI), nickel, PAH, quartz, and asbestos) and tobacco smoke in the development of lung cancer within the framework of population-based case-control studies.


Our research approach focused on earlier studies, which were pooled into a large data set, to create a sufficiently large database to carry out statistically robust analyses of the combined effects of the five model carcinogens. International population-based case-control studies on lung cancer that collected data on lifelong occupational exposures and smoking behaviour were included. The pooled study thus provides one of the world's most comprehensive epidemiological data bases for the analysis of occupational lung cancer risks.


On the IPA project web page

Last Update:

28 May 2019


Financed by:
  • Deutsche Gesetzliche Unfallversicherung e.V. (DGUV)
Research institution(s):
  • Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung - Institut der Ruhr-Universität Bochum (IPA)
  • IARC International Agency for Research on Cancer, Lyon, Frankreich (Projektleitung)
  • Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen
  • Clinica del Lavoro L. Devoto, Mailand
  • Department of Human Oncology and Center for Oncologic Prevention, Turin, Italien
  • Helmholtz-Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg
  • Institute for Risk Assessment Sciences (IRAS), Utrecht, Niederlande
  • Institut für Gefahrstoff-Forschung (IGF), Bochum
  • Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Essen
  • Karolinska Institutet (KI), Stockholm, Schweden
  • National Cancer Institute (NCI), Maryland, USA
  • Centre de recherche du CHUM, Université de Montréal, Kanada

-cross sectoral-

Type of hazard:

work-related diseases, dangerous substances


occupational disease, carcinogenic substances, prevention

Description, key words:

pooled analysis, occupational carcinogens, lung cancer, asbestos, polycyclic aromatic hydrocarbons (PAH), quartz, radiation, arsenic, nickel, chromium

Further information

Publications in the IPA database, keyword "synergy"