Asbestos-Related Lung Cancer: A Hospital-Based Case-Control Study in Indonesia

Abstract

Indonesia has limited data on asbestos-related diseases despite abundant use. This study investigated the risk of occupational asbestos exposure for lung cancer development, utilizing a hospital-based case-control study. Subjects were patients who received a thoracic CT scan at Persahabatan Hospital, Jakarta. The cases had primary lung cancer confirmed by histology, the controls were negative for lung cancer. The cumulative occupational asbestos exposure was calculated by multiplying the exposure intensity by the years of exposure. The exposure intensity was obtained by adopting the weighted arithmetic mean value of asbestos exposure from a job-exposure matrix developed in Korea. The primary data analysis was based on logistic regression. The study included 696 subjects, with 336 cases and 360 controls. The chance of lung cancer for subjects exposed to asbestos was doubled (OR = 2.04, 95% CI = 1.21–3.42) compared with unexposed, and subjects with a cumulative asbestos exposure of 10 fiber-years or more even showed an OR of 3.08 (95% CI = 1.01–9.46). The OR of the combined effect between smoking and asbestos was 8.7 (95% CI = 1.71–44.39); the interaction was consistent with an additive and multiplicative risk model. Asbestos exposure is associated with a higher chance of lung cancer. Improved policies are needed to protect the population from asbestos hazards.

Excess Risk of Lung Cancer Among Agriculture and Construction Workers in Indonesia

“…For 17 months between May 2018 and September 2019, we performed a case-control study at the National Respiratory Hospital in Jakarta, Indonesia. The recruitment of cases and controls in this study followed a protocol similar to what was utilized in a previously published study by the same authors on asbestos-related lung cancer in a hospital-based case-control study in Indonesia [18]. The study population consisted of all patients aged 35 years old or older who received a thoracic computerized tomography (CT) scan for a range of indications including lung infection, mediastinal mass, lung nodule or mass, trauma, and evaluation of pleural diseases.…”

Lung cancer and occupational exposure: hospital-based case-control study

“…In addition to silica, exposure to asbestos fibers is highlighted as a potential risk factor for lung cancer. A recent hospital-based case-control study supports the association of asbestos exposure and lung cancer, in which the most frequent occupation was technical workers in construction industry, followed by car mechanics and the rest in other industries that handle materials containing asbestos (19) .…”

Occupational and environmental asbestos exposure and the risk of lung cancer in Korea: A case-control study in South Chungcheong Province of Korea

“…Especially in the case of occupational exposure, information was limited in our study because there was insufficient data on the mean asbestos concentrations at each work site. However, given the limited information about the actual asbestos exposure levels in many previous studies, the exposure probability using the exposure duration and the distance from exposure sources can be used as valid proxy indicators to estimate exposure [ 33 ]. In addition, participants may have given exaggerated information about their exposure because of their awareness of the purpose of the study.…”