Public Health Significance of Smoking-Asbestos Interactions (original) (raw)
International journal of occupational medicine and environmental health, 2015
Occupational exposure to asbestos is associated with increased mortality which, however, has not been thoroughly validated in a general population. We have aimed at exploring whether this association may be confirmed within a population-based setting after adjustment for confounders. Furthermore, the impact of tobacco consumption on the association between occupational exposure to asbestos and mortality is assessed. We used data from 2072 (224 exposed) male participants of the Study of Health in Pomerania. Information on exposure to asbestos is based on a selfreport. Median follow-up time was 11.3 years. All-cause mortality and cause-specific mortality of exposed and non-exposed men were compared using mortality rate ratios, Kaplan-Meier analyses and multivariable Cox regression. During the follow-up, 52 (23.2%) exposed and 320 (17.3%) non-exposed participants deceased. Exposed subjects had increased hazard ratios (HR) for all-cause mortality (HR=1.48, 95% CI: 1.1-2), benign lung di...
Survival in cohorts of asbestos cement workers and controls
Occupational and Environmental Medicine, 1996
Objectives-To measure the impact on survival of being exposed to asbestos cement dust. Methods-Survival of 866 asbestos cement workers and 755 controls was studied with Cox's proportional hazards regression models with age as the basic time variable. The effect of cumulative exposure up to the age of 40 was investigated in an internal analysis of 635 asbestos cement workers who had dose estimates. Results-The death risk was higher for the asbestos cement workers than for the controls with a hazard ratio (HR) of 1-15 (95% confidence interval was 1 00 to 1.31). The increased risk found seemed to be confined to the period 20-40 years from start of employment. The estimates of the cohort effect were almost unaffected by adjustment for smoking habits. The estimates of the exposure effect rose with increasing dose (< 4 fibre-years/ml (f-y/ml): HR = 100, 4-9.9 f-y/ml: HR = 1-06, > 10 f-y/ml: HR = 1*35, for
La Medicina del lavoro
This review assesses the contribution of occupational asbestos exposure to the occurrence of mesothelioma and lung cancer in Europe. Available information on national asbestos consumption, proportions of the population exposed, and exposure levels is summarized. Population-based studies from various European regions on occupational asbestos exposure, mesothelioma, and lung cancer are reviewed. Asbestos consumption in 1994 ranged, per capita, between 0.004 kg in northern Europe and 2.4 kg in the former Soviet Union. Population surveys from northern Europe indicate that 15 to 30% of the male (and a few percent of the female) population has ever had occupational exposure to asbestos, mainly in construction (75% in Finland) or in shipyards. Studies on mesothelioma combining occupational history with biologic exposure indices indicate occupational asbestos exposure in 62 to 85% of the cases. Population attributable risks for lung cancer among males range between 2 and 50% for definite asbestos exposure. After exclusion of the most extreme values because of methodologic aspects, most of the remaining estimates are within the range of 10 to 20%. Estimates of women are lower. Extrapolation of the results to national figures would decrease the estimates. Norwegian estimates indicate that one-third of expected asbestos-related lung cancers might be avoided if former asbestos workers quit smoking. The combination of a current high asbestos consumption per capita, high exposure levels, and high underlying lung cancer rates in Central Europe and the former Soviet Union suggests that the lung cancers will arise from the smoking-asbestos interaction should be a major concern.
Mortality Experience in an Historical Cohort of Chrysotile Asbestos Textile Workers
2000
Introduction and aims The issue of whether exposure to chrysotile asbestos causes lung cancer, mesothelioma and non- malignant diseases was investigated in an historical cohort in Grugliasco, Italy, where the largest Italian asbestos textile factory had been in operation until 1986. In this urban area there are important mortality differences by social class. Methods The study cohort comprised 1,653 asbestos
Mortality among long-term employees of an Ontario asbestos-cement factory
British journal of industrial medicine, 1983
Mortality was studied among a group of 328 employees of an Ontario asbestos-cement factory who had been hired before 1960 and who had been employed for a minimum of nine years. The group of 87 men who had worked in the rock wool/fibre glass operations, or who had been otherwise minimally exposed to asbestos, had mortality rates similar to those of the general Ontario population, while the group of asbestos-exposed employees had all-cause mortality rates double those of the Ontario population, mortality rates due to malignancies five times higher than expected, and deaths attributed to lung cancer eight times more frequent than expected. According to the best evidence available, 10 of 58 deaths among the production workers were due to malignant mesothelioma and 20 to lung cancer. The men dying of mesothelioma were younger than the men dying of lung cancer with mean ages at death of 51 and 64 years respectively. An exposure model was constructed on the basis of the available air sampl...
Change in Prevalence of Asbestos-Related Disease Among Sheet Metal Workers 1986 to 2004*
CHEST Journal, 2007
Between 1986 and 2004, 18,211 individuals were examined. The mean age of this cohort was 57.9 years, and the participants had worked for a mean (؎ SD) duration of 32.9 ؎ 6 years in the sheet metal trade. Twenty-three percent of participants were current smokers, 49% were former smokers, and 28% were never-smokers. A total of 9.6% of participants (1,745 participants) had findings that were consistent with parenchymal disease (International Labor Organization [ILO] score, > 1/0); 60% of those with an ILO score > 1/0 were classified as 1/0, 34% as 1/1 to 1/2, and 6% as > 2/1. A total of 21% of participants (3,827 participants) had pleural scarring. There was a lower prevalence of nonmalignant asbestos-related disease among those who began to work after 1970, when compared to workers who began to work before 1949; those who began to work between 1950 and 1969 had a prevalence between the other two groups. The strongest predictor of both parenchymal and pleural disease on a chest radiograph was the calendar year in which the worker began sheet metal work; work in a shipyard was also an important risk. The results of this study suggest that the efforts to reduce asbestos exposure in the 1980s through strengthened Occupational Safety and Health Administration regulation have had a positive public health impact.
Mortality among asbestos-exposed workers in a railroad workshop
Scandinavian Journal of Work, Environment & Health, 1984
OHLSON C-G, KLAESSON B, HOGSTEDT C. Mortality among asbestos-exposed workers in a railroad workshop. Scand J Work Environ Health 10 (1984) 283-291. The mortality experience of a cohort of 3 297 railroad maintenance shopworkers exposed to asbestos was investigated. The study period was 1951-1980, and the vital status was assessed for 99.6 % of the men. Individual estimates of cumulative asbestos exposure were based on detailed records on work tasks and divisions. Dust measurements were scanty in earlier decades, and estimates of average fiber levels were therefore based on information on the amount and kind of asbestos used, job descriptions, and interviews with older workers. The overall mortality was lower than expected from the national death rates (standardized mortality ratio = 82). The mortality from lung cancer increased as cumulative exposure increased in consistent dose-response relationships. Employment times of less than 30 years in workplaces with moderate levels of mainly chrysotile asbestos was not associated with any apparent increase in the risk of lung cancer. A subgroup exposed for more than 30 years in workplaces repairing steam engines, where amphiboles were used as well, had a standardized mortality ratio of 192 for lung cancer. This figure mav be an underestimation due to healthy worker selection and fewer smokers than normal. The "true" standardized mortality ratio was estimated to be about 300. Five cases of mesothelioma were observed.
Asbestos-Related Disease among Sheet-Metal Workers
Annals of the New York Academy of Sciences, 1991
Numerous studies have documented the health effects of asbestos on miners, textile workers, paperworkers, railroad workers, and construction workers. Nicholson' estimates that there will be 125,000 cancer deaths due to asbestosrelated diseases from 1985-2009; Lilienfield* projects 130,000 such deaths from 1985-2009. Asbestosis has been a significant cause of morbidity among highly exposed worker^.^.^ This paper reports the preliminary results of a survey for
Asbestos fibreyears and lung cancer: a two phase case-control study with expert exposure assessment
Occupational and Environmental Medicine, 2002
Aims: To assess the cumulative effect of asbestos on lung cancer risk where the exposure is assessed by an expert rating. Methods: 1678 male cases and controls were enrolled in a population based matched case-control study, focused on occupational risk factors, carried out in West Germany. The exposure to asbestos was computed as lifelong working hours. For a validation subsample of 164 matched pairs from this study the intensity of asbestos exposure was further assessed by a panel of experts in order to obtain an estimate of the cumulative exposure on a time by intensity scale (fibreyears). The information on duration of asbestos exposure in the original study was combined with the fibreyears following the two phase case control study paradigm. Results: The number of exposed subjects in the validation subsample was 75 cases and 71 controls. The percentage of subjects with a cumulative exposure <1, 1 to <10, and >10 fibreyears was 16%, 15%, and 15% for the cases and 18%, 16%, and 9% respectively for the controls. The smoking adjusted odds ratios for the fibreyears based on an unconditional logistic regression were 0.81, 1.02, and 1.60 respectively with increasing exposure categories (not significant). The coefficient (beta) for a log transformed trend was 1.156. Applying the two phase paradigm, these odds ratios became 0.86, 1.33, and 1.94; the latter reached significance and the beta coefficient was 1.178. Conclusions: The two phase paradigm allowed us to obtain a more precise estimate of the effect of asbestos on lung cancer. Results are consistent with a doubling of the lung cancer risk with 25 fibreyears asbestos exposure.
Tyler asbestos workers: mortality experience in a cohort exposed to amosite
Occupational and Environmental Medicine, 1998
Objectives-To examine the causes of death among 1130 former workers of a plant in Tyler, Texas dedicated to the manufacture of asbestos pipe insulation materials. This cohort is important and unusual because it used amosite as the only asbestiform mineral in the production process. High level exposure of such a specific type was documented through industrial hygiene surveys in the plant.