Asbestos and cancer: An overview of current trends in Europe.

Abstract

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.

Mesothelioma incidence seems to have leveled off in Sweden

“…3 Based on the historic trends in the incidence it has been estimated that the background rate without asbestos was at 1-2 per million, close to the Swedish female rates of 1 per million in the early period in our study. 15 This background would correspond to 20 male cases in a 5-year period, and 160 cases during the 8 5-year periods that our study covered. As the total number of male mesothelioma cases was 2190, 2,030 could be ascribed to asbestos up to year 2000.…”

Magnitude of asbestos-related lung cancer mortality in Italy

“…The epidemiology of asbestos-related lung cancer (LC) cannot be investigated directly because cases are not clinically distinguishable from those due to other causes. The magnitude of the association and the attributable risk have been estimated in cohorts of workers exposed to asbestos and from LC case -control studies (Albin et al, 1999), but few studies have investigated it in the general population because generalisation of these findings is problematic (De Vos, 1993;Darnton et al, 2006). Ratios ranging from 1 : 1 to 1 : 10 between mesothelioma and excess LC deaths due to asbestos exposure have been reported in different cohorts of exposed workers (Vineis and Simonato, 1991).…”

Geographic distribution of incident mesothelioma in Connecticut men, 1990–99

“…A review of European studies (including one in the area of Lund, Sweden) combining occupational histories with analyses of lung fiber content found that 62-85% of men with mesothelioma had probable occupational exposure to asbestos. 8 Perhaps in the Swedish study 1 the small number of male cases in agriculture/ gardening had less chance of a history (undocumented in the censuses) of occupational asbestos exposure than the small number of professionals and larger numbers of blue collar and non-asbestos manual workers (especially in urban areas). Otherwise, conjectures for the urban excess in Sweden vs. Connecticut would include differences in non-occupational asbestos exposure 1 (perhaps also in type and size of asbestos fibers) or in causes of mesothelioma other than asbestos.…”