Asbestos exposure, smoking habits, and cancer incidence among production and maintenance workers in an electrochemical plant

Hilt, Bjørn; Langård, Sverre; Andersen, Aage; Rosenberg, J

doi:10.1002/ajim.4700080608

Cited by 38 publications

(13 citation statements)

References 15 publications

(6 reference statements)

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“…Seven were conducted in asbestos products workers, two of chrysotile,25 26 two amosite,27 34 one crocidolite and chrysotile1 and two of unstated asbestos type 3033 One study was of workers in a nitric acid production plant,29 one of asbestos sprayers and of patients with asbestosis and silicosis,31 and three of insulation workers 3235 36 The remaining seven studies were case-control, in railway workers,20 industrial areas,16 and shipbuilding areas 14…”

Section: Resultsmentioning

confidence: 99%

Relation between exposure to asbestos and smoking jointly and the risk of lung cancer

2001

Occup Environ Med

119

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Objectives-To review evidence about the joint relation of exposure to asbestos and smoking on the risk of lung cancer to answer three questions: (1) does asbestos increase risk in non-smokers; (2) are the data consistent with an additive model; and (3) are the data consistent with a multiplicative model? Methods-Analysis of 23 studies reporting epidemiological evidence on the joint relation. Comparison of risk of lung cancer in subjects unexposed to asbestos or smoking, exposed to asbestos only, to smoking only, or to both. Estimation of the relative risk associated with asbestos exposure in non-smokers and of statistics testing for additivity and multiplicativity of risk. Results-Eight of the 23 studies provided insuYcient data on the risk of lung cancer in non-smokers to test for possible eVects of asbestos. Asbestos exposure was associated with a significantly (p<0.05) increased risk in non-smokers in six of the remaining studies and with a moderately increased, but not significant, increase in a further six. In two of the three studies that found no increase, asbestos exposure was insuYcient to increase risks in smokers. In 30 of 31 data sets analysed, risk in the combined exposure group was greater than predicted by the additive model. There was no overall departure from the multiplicative model, the proportional increase in risk of lung cancer with exposure to asbestos being estimated as 0.90 (95% confidence interval (95% CI) 0.67 to 1.20) times higher in smokers than non-smokers. For two studies significant (p<0.05) departures from a multiplicative relation were found in some, but not all, analyses. Reasons are presented why these may not indicate true model discrepancies. Conclusions-Asbestos exposure multiplies risk of lung cancer by a similar factor in non-smokers and smokers. The extent to which it multiplies risk varies between studies, no doubt depending on the type of asbestos involved, and the nature, extent, and duration of exposure. (Occup Environ Med 2001;58:145-153) Keywords: lung neoplasms; smoking; asbestos Lung cancer incidence is clearly increased by both smoking and exposure to asbestos, but the joint relation is not well defined. Suppose that risks are 1 unit for a non-smoker unexposed to asbestos, A units for a non-smoker exposed to asbestos, and S units for an unexposed smoker. Various possible models predict risk in a smokers exposed to asbestos. In the additive model the excess risks add to give a predicted risk of 1+(A-1)+(S-1)=A+S-1 units. In the multiplicative model the two proportional increases multiply to give AS units. In the intermediate model the risk lies between A+S-1 and AS units; in the supermultiplicative model it exceeds AS. Note that to test the models only requires data on the relative, not absolute, risks and also that the models, if correct, should apply equally to risk diVerences relating to high versus low exposure as to those relating to exposed versus unexposed.We examine studies investigating the relation of lung cancer to both agents to answer thre...

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Section: Resultsmentioning

confidence: 99%

Relation between exposure to asbestos and smoking jointly and the risk of lung cancer

2001

Occup Environ Med

119

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“…There is heavy industry in some parts of the county, and previous investigations have shown that asbestos has been extensivelyused in many workplaces since the turn of the century (5,7,8,10,12,21). The county has 18municipalities, and on 31 December 1981 there were 80 435 male and 81 612 female inhabitants.…”

Section: Study Populationmentioning

confidence: 99%

Asbestos-related findings in chest radiographs of the male population of the county of Telemark, Norway--a cross-sectional study.

Hilt¹,

Lien²,

Lund‐Larsen³

et al. 1986

Scand J Work Environ Health

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S. Asbestos-related findings in chest radiographs of the male population of the county of Telemark, Norway -A cross-sectional study. Scand J Work Environ Health 12 (1986) 567-573. In order to investigate the prevalence of asbestos-related diseases, a cross-sectional population study was conducted among 28 216 men aged 40 years in nine municipalities of the county of Telemark, Norway. In a primary radiographic screening 10 x IO-cm chest radiographs were taken of 21 483 persons. In two independent readings of the radiographs, pleural changes were observed in 6.9 and 8.5 % of the study subjects. Radiographic findings in the primary screening led to 1 431 subjects being selected for a reexamination. On the basis of occupational histories and 40 x 4O-cm chest radiographs, it was concluded that 470 of these subjects (2.2 010 of the screened population) had radiographic changes consistent with an asbestos-related disorder. Among these, 86 had lung fibrosis (82 in combination with pleural plaques) and 384 had pleural plaques only. There were marked differences in the occurrence of asbestos-related disorders between the seven urban and two rural communities studied, and agreement was observed between the occurrence of such disorders and the degree and duration of the reported asbestos exposure. The study presents evidence that asbestos-related disorders may be more prevalent in the general male population than has been recognized earlier.

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“…Durin g the last few years several cases of asbestosrelated diseases have been observed among the county population (6,7,9,11,13). Therefore, it seemed of interest to study the extent of previous occupational asbestos exposure among all inhabitants in the county.…”

mentioning

confidence: 99%

Previous asbestos exposure and smoking habits in the county of Telemark, Norway--a cross-sectional population study.

Hilt¹,

Langård²,

Lund‐Larsen³

et al. 1986

Scand J Work Environ Health

Self Cite

View full text Add to dashboard Cite

Asbestos exposure, smoking habits, and cancer incidence among production and maintenance workers in an electrochemical plant

Cited by 38 publications

References 15 publications

Relation between exposure to asbestos and smoking jointly and the risk of lung cancer

Relation between exposure to asbestos and smoking jointly and the risk of lung cancer

Asbestos-related findings in chest radiographs of the male population of the county of Telemark, Norway--a cross-sectional study.

Previous asbestos exposure and smoking habits in the county of Telemark, Norway--a cross-sectional population study.

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