Asbestosis Lung Cancer And Mesothelioma Rates As A Result Of Occupational Asbestos Exposure

As many are already aware, asbestos exposure has been linked to a number of life threatening diseases

. Most exposure related illnesses result from the inhalation of tiny asbestos particles or fibers. One interesting study that examined the rate of disease in miners is called, Relation between asbestosis and bronchial cancer in amphibole asbestos miners by G K Sluis-Cremer, B N Bezuidenhout - Br J Ind Med 1989;46:537-540 - Epidemiology Research Unit, Medical Bureau of Occupational Disease, Johannesburg, Republic of South Africa. Here is an excerpt: Abstract - In a necropsy series of 339 amphibole asbestos miners heavy smoking, age, and the presence of asbestosis were significantly associated with the presence of bronchial cancer. Of the 35 cases of bronchial cancer, 24 were associated with asbestosis. Eleven cases of bronchial cancer occurred in men without asbestosis; all were smokers. Standardised proportional mortality rates indicated no excess of bronchial cancer in 302 exposed men without asbestosis whereas these rates were progressively raised in men with slight or moderate/severe asbestosis. Of the four exposure variables introduced separately into a logistic regression model, "years of exposure" made a small but significant contribution; "residence time" marginally failed to achieve a 5% level of significance. Two other exposure variables tested including cumulative fibre exposure (fibre years) made no significant contribution. In the absence of asbestosis at necropsy a bronchial cancer in a man exposed to asbestos is unlikely to be due to asbestos.

Another interesting study is called, A cohort study on mortality among wives of workers in the asbestos cement industry in Casale Monferrato, Italy. By C Magnani, B Terracini, C Ivaldi, M Botta, P Budel, A Mancini, R Zanetti Br J Ind Med 1993; 50:779-784 - Here is an excerpt Abstract - The study investigates mortality from cancer and other diseases in a cohort of wives of asbestos cement workers in Casale Monferrato (northwest Italy). After the exclusion of women with an occupational record in the asbestos cement industry, the cohort comprised 1964 women. Their domestic exposure was estimated according to their husbands' periods of employment in the plant: 1740 had a period of domestic exposure whereas the remaining 224 married an asbestos cement worker only after he definitely stopped his activity in the asbestos cement plant; these have, therefore, been considered as unexposed.

The cohort of wives was constructed entirely through official records in the town offices and is both exhaustive and unaffected by recall bias. At the end of follow up (1988) 1669 women were alive, 270 were dead and 25 (1.2%) were untraced. Main mortality analyses were only up to age 79 to reduce the misclassification of causes of death. Expected mortality was based on local rates. Mortality analyses were limited to the period 1965-88 due to the availability of local rates: in that period 210 deaths occurred among women with domestic exposure v 229.1 expected. There were four deaths from pleural tumours (one diagnosed as mesothelioma at necropsis) and six from lung cancer v. 0.5 and 4.0 expected respectively. Two further cases of mesothelioma were diagnosed by histological examination after the end of follow up. None of the three wives with histologically diagnosed mesothelioma had been engaged in industrial activities. Corresponding information for the other three cases could not be traced.

A third study is called, Asbestosis: a marker for the increased risk of lung cancer among workers exposed to asbestos. By Weiss W. - Chest. 1999 Feb;115(2):536-49. Here is an excerpt: Abstract - This review examines the hypothesis that excess lung cancer risk in worker cohorts exposed to asbestos occurs only among those with asbestosis. The adequately designed studies in the literature support this hypothesis. The summary relative risk for lung cancer was 1.00 in seven cohorts with no deaths from asbestosis. In addition, there is a high correlation between asbestosis rates and lung cancer rates in 38 cohorts in contrast to a poor correlation between cumulative exposure data and lung cancer relative risks in eight cohorts with adequate data. The evidence indicates that asbestosis is a much better predictor of excess lung cancer risk than measures of exposure and serves as a marker for attributable cases.

If you found any of these excerpts interesting, please read the studies in their entirety. We all owe a great debt to these fine researchers.

by: Mont Wrobleski

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