OBJECTIVES: This study was undertaken to determine whether exposureat work to environmental tobacco smoke is associated with anincreased risk of lung cancer. METHODS: Data from 14 studiesproviding information on lung cancer and exposure to environmentaltobacco smoke at work were examined. Six quality criteria weredeveloped for determining usable data. A meta-analysis was performedto obtain a combined risk for those data that met the qualityrestrictions. RESULTS: Five studies met the quality standards.Their combined relative risk was 1.39 (95% confidence interval[CI] = 1.15, 1.68) based on 835 lung cancer cases. In variousmeta-analyses prepared by tobacco industry employees or consultants,no increase in risk was found. The main reason for this differenceis that the earlier analysts failed to find errors in 2 underlyingstudies that resulted in overweighting of the odds ratios fromthose studies, both of which were less than unity. CONCLUSIONS:When appropriate cognizance is taken of the quality of datainputs, the increase in lung cancer risk from workplace exposureto environmental tobacco smoke is about the same as that fromhousehold exposure.
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