Trends and disparities in tracheal, bronchus, and lung cancer attributable to occupational carcinogens in the United States: A cross-state comparative analysis over three decades.

e22517 Background: Tracheal, Bronchus, and Lung Cancer (TBL) are the primary causes of death and disability in the United States, accounting for nearly 25% of all neoplasm-related deaths. Among various risk factors, occupational exposure (OE) to carcinogens is a growing concern. Methods: Using Standardized global burden of disease methodologies, we estimated death, disability adjusted life years (DALYs), years lived with disability (YLDs), due to TBL cancer attributable to OC stratified by age, sex, year and location across the USA from 1990-2021. Results: From 1990-2021, the annual percentage change (APC) showed a general decline, with total number of deaths decreasing by -0.35%, DALYs by -0.86%, and YLDs by -0.17%. At the regional level, notable variations were observed: Alaska experienced the highest increase in death APC due to arsenic exposure +0.97%, while all states showed a decrease attributable to asbestos. Nevada recorded the highest increase in death APC from beryllium exposure (+0.09%) with a general increasing trend across all states. Both Wyoming and Nevada observed a +0.02% increase due to cadmium exposure. South Dakota saw a +0.17% increase due to chromium, and Alabama recorded a +0.43% increase from diesel engine exhaust. A declining trend was noted for nickel across all states. Utah had a +0.23% increase due to exposure to polycyclic aromatic hydrocarbons (PAH), and Alaska showed a significant rise of +1.19% from silica exposure. Age-wise, those 55 and older saw reductions in APC for deaths (-0.28%), DALYs (-0.75%), and YLDs (-0.09%). The 20-54 year age group noted more pronounced declines in death (-2.87%), DALYs (-2.95%), and YLDs (-2.28%). Gender analysis revealed that females had increased APC for deaths (+0.92%), DALYs (+0.35%), and YLDs (+1.15%), while males exhibited a declining trend. Conclusions: The study demonstrates an overall reduction in health burdens from 1990-2021, marked by declines in deaths, DALYs, and YLDs. Despite these gains, regional and demographic disparities highlight the continued impact of OE, particularly in states like Alaska and Nevada, and among different age groups and genders. These findings stress the need for targeted policies and improved safety standards to address persistent occupational health risks and achieve equitable health outcomes. Annual percentage of change in total number of deaths, DALYs and YLDs due to TBL cancer attributable to occupational carcinogens from 1990-2021. TBL cancer Attributable to OC APC (%), (1990-2021)Deaths APC (%),(1990-2021), (DALYs) APC (%),(1990-2021), (YLDs) Arsenic -0.43 -0.67 +0.05 Asbestos -0.35 -0.93 -0.22 Beryllium +0.04 -0.19 +0.55 Cadmium -0.35 -0.59 +0.13 Chromium -0.24 -0.48 +0.25 Diesel engine exhaust +0.11 -0.13 +0.61 Nickel -0.55 -0.79 -0.08 Polycyclic aromatic hydrocarbons (PAH) -0.18 -0.42 +0.32 Silica -0.59 -0.83 -0.12