Increased Lung Cancer in Non-Smokers Linked to Workplace Exposure and Air Pollution

Increased Lung Cancer in Non-Smokers Linked to Workplace Exposure and Air Pollution

  • Date: Wednesday 15th May 2019
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A new study of lung cancer in non-smokers has identified exposure to carcinogens in the workplace and breathing in ambient air pollution as the two major contributors to the disease in the UK after exposure to second-hand cigarette smoke.

According to the paper published in the Journal of the Royal Society of Medicine, nearly 6,000 people who have never smoked die of lung cancer each year, more than the number who die of cervical cancer (900) or leukaemia (4,500).

This prevalence makes it the eighth most common form of cancer in the UK.

The research team estimates that exposure to second hand smoke accounts for 15% of cases in non-smokers, while exposure to occupational carcinogens (including asbestos) are responsible for 20.5% of lung cancers in non-smoking men and 4.3% in women.

In addition, exposure to outdoor pollution is responsible for 8% of cancers, or 480 deaths a year, followed by X-ray radiation (0.8% or 48 deaths) and radon exposure (0.5% or 30 deaths).

However, in common understanding, lung cancer is still seen as a “smokers’ disease”, with those who have never smoked therefore believing they are not at risk – which may lead them to delay discussing symptoms with their GP until the diseases is relatively advanced.

Lead author is professor Paul Cosford, medical director at Public Health England, who has himself been diagnosed with incurable lung cancer and is a non-smoker.

"For too long having lung cancer has only been thought of as a smoking related disease. This remains an important association but, as this this work shows, the scale of the challenge means there is a need to raise awareness with clinicians and policy makers of the other risk factors including indoor and outdoor air pollution.

"This is one reason why PHE published its review of the evidence and recommended specific actions local authorities can take to improve their air quality. By delivering on the promise of a clean air generation we can reduce the number of lung cancers among those who have never smoked."

One of his co-authors is professor Mick Peake, of the Centre for Cancer Outcomes at University College London Hospitals Cancer Collaborative, who said: "Drawing attention to the contribution of underlying risk factors to lung cancer in never-smokers presents opportunities to reinforce efforts to tackle other major public health challenges.

"For example, the impact of passive smoking and air pollution on lung cancers adds weight to the government's ambitions to improve air quality and the public, clinicians and policy makers must all be aware of this relationship."

Commenting on the study, Richard Steyn, an NHS surgeon and chair of the UK Lung Cancer Coalition, said that the only ways to reduce risk for non-smokers would be “avoiding passive smoke, areas of high air pollution and wearing protective breathing apparatus in specific occupations”.

He told The Guardian: “GPs and hospital doctors working in the NHS need to be more aware of the fact that lung cancer does occur in people who have never smoked and that as a disease in itself is more common than many other cancers that have a much higher profile, such as cancers of the cervix, ovary and the leukaemia’s.

“Many patients who have never smoked who develop lung cancer have their diagnosis delayed because of this lack of recognition so many of them have very advanced disease by the time they get to specialist care.”


Respiratory protection can be used to prevent the inhalation of dusts, fumes, vapours, mists and gasses whilst at work.  It is important to ensure that any Respiratory Protective Equipment (RPE) used is adequate and suitable for the individual carrying out the work.  This can be done by carrying out a Face Fit Test.  For more information on conducting qualitative face fit testing, contact our Customer Service Team on 01752 201616.

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