Mortality among shipbreaking workers in Taiwan—A retrospective cohort study from 1985 to 2008

Wu, Wei; Lu, Yao; Lin, Yu Jen; Yang, Ya-Hui; Shiue, Huei Sheng; Hsu, Jin Huei; Li, Chung‐Yi; Yang, Chun Yuh; Liou, Saou Hsing; Wu, Trong Neng

doi:10.1002/ajim.22135

Cited by 20 publications

(26 citation statements)

References 27 publications

(61 reference statements)

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“…As shown in Table , analysis of five studies with data of cumulative or duration of exposure among asbestos‐exposed workers yielded an SMR of 2.09 (95% CI: 1.46–3.00, Figure ), with no evidence of heterogeneity ( I 2 = 0.0%, P = 0.583).…”

Section: Resultsmentioning

confidence: 95%

“…A flow chart of literature search and study selection process is presented in supplementary files (http://onlinelibrary.wiley.com/doi/10.1111/dote.12341/suppinfo). Totally, 20 independent cohort studies were collected in this meta‐analysis. One study reported findings from two distinct cohorts, and thus we analyzed data on 21 distinct populations.…”

Section: Resultsmentioning

confidence: 99%

“…SMR estimates reported by the individual studies ranged from 0.63 to 2.32. Six studies were conducted in Asia, seven in Europe, four in United States and three in Oceania. Five studies were conducted only in male cohort, and one cohort included only female.…”

Section: Resultsmentioning

confidence: 99%

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Esophagus cancer and occupational exposure to asbestos: results from a meta-analysis of epidemiology studies

Li¹,

Tang

Wang³

2015

Dis Esophagus

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The relationship between occupational asbestos exposure and esophagus cancer (EC) is not fully understood. We performed a meta-analysis to quantitatively assess the association. We systematically searched databases of PubMed, EMBASE, and Web of Science for studies with quantitative estimates of asbestos exposure and EC mortality. Pooled standardized mortality ratios (SMRs) and their corresponding 95% confidence intervals (CIs) were calculated. Twenty cohort studies on EC and asbestos exposure were included in this meta-analysis. Overall, occupational exposure to asbestos was associated with an excess risk of EC (SMR = 1.24, 95% CI: 1.13-1.38, P < 0.001), with little evidence of heterogeneity among studies (I(2) = 0.0%, P = 0.682). Being male, exposure to chrysotile or mixed asbestos, working at textile industry, long study follow-up (≥20 years), Asia, Europe and America cohorts with larger cohort size (>500), and high-exposure group all contribute to significantly higher SMR. Publication bias was not detected (Egger's test P-value = 0.374). This meta-analysis suggested that occupational asbestos exposure might be associated with an increased risk of EC in male. High-exposure level of asbestos could contribute to significantly higher risk of EC mortality.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

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Esophagus cancer and occupational exposure to asbestos: results from a meta-analysis of epidemiology studies

Li¹,

Tang

Wang³

2015

Dis Esophagus

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“…A growing amount of scientific evidence suggests that all forms of asbestos cause lung and laryngeal cancers, malignant mesothelioma, and may cause ovarian, gastrointestinal cancers [ 2 , 5 , 6 ]. Studies of shipbreaking or shipyard workers potentially exposed to asbestos showed a persistent increased mortality for lung cancer [ 7 – 10 ]. A retrospective study of shipyard Coast Guard workers reported Standardized Mortality Ratio (SMR) of 1.26 for lung cancer and 5.07 for mesothelioma [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another cohort mortality study in Genoa shipyard workers also observed significantly increased SMR of 1.77 for lung cancer [ 8 ]. Meanwhile, our previous studies showed that an elevated mortality of lung cancer and overall cancers were observed in shipbreaking workers in comparison with general population [ 7 ]. Although cancer mortality has been widely accepted as the important measure of progress against cancer, it has been considered subject to more distortion than incidence.…”

Section: Introductionmentioning

confidence: 99%

Cancer Attributable to Asbestos Exposure in Shipbreaking Workers: A Matched-Cohort Study

Lin

et al. 2015

PLoS ONE

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PurposeLong-term follow-up studies of asbestos-related cancer in shipbreaking workers are lacking. This study examines the relationship between cancer incidence and asbestos exposure among former Taiwan shipbreaking workers.MethodsA total of 4,427 shipbreaking workers and 22,135 population-based matched controls were successfully followed in this study. The study cohort was linked to the Taiwan Cancer Registry for new cancer cases. The adjusted hazard ratio (aHR) for cancer was calculated for the shipbreaking workers with Total Exposure Potential Scores (TEP) for asbestos.ResultsFollow-up generated 109,932 person-years, with 940 deaths and 436 cancer cases, among 4,427 shipbreaking workers from 1985 to 2008. The high asbestos exposure group also had a statistically significant increase in the risk of overall cancer (aHR= 1.71; 95% CI: 1.42-2.05), esophagus cancer (aHR= 2.31; 95% CI: 1.00-5.41), liver and intrahepatic bile duct cancer (aHR= 1.60; 95% CI: 1.08-2.36), and trachea, bronchus, and lung cancer (aHR= 3.08; 95% CI: 1.80-5.25). Mesothelioma cases were found in the high asbestos exposure group. Moreover, overall cancer, esophagus cancer, and trachea, bronchus, and lung cancer were seen in a dose-dependent relationship with asbestos exposure.ConclusionsThis study presented the elevated trend of asbestos exposure with cancer incidence for overall cancer, esophagus cancer, and trachea, bronchus, and lung cancer among shipbreaking workers. Those workers previously exposed to asbestos should receive persistent monitoring in order to early detect adverse health outcomes.

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Ship breaking or scuttling? A review of environmental, economic and forensic issues for decision support

Devault

Beilvert

Winterton

2016

Environ Sci Pollut Res

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In a globalized world, the world trade fleet plays a pivotal role in limiting transport costs. But, the management of obsolete ships is an acute problem, with most Ship Recycling Facilities (SRF) situated in developing countries. They are renowned for their controversial work and safety conditions and their environmental impact. Paradoxically, dismantlement is paid for by the shipowners in accordance with international conventions therefore it is more profitable for them to sell off ships destined for scrapping. Scuttling, the alternative to scrapping, is assessed in the present review to compare the cost/benefit ratios of the two approaches. Although scrapping provides employment and raw materials - but with environmental, health and safety costs - scuttling provides fisheries and diving tourism opportunities but needs appropriate management to avoid organic and metal pollution, introduction of invasive species and exacerbation of coastal erosion. It is also limited by appropriate bottom depth, ship type and number. The present review inventories the environmental, health, safety, economic, and forensic aspects of each alternative.

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Mortality among shipbreaking workers in Taiwan—A retrospective cohort study from 1985 to 2008

Abstract: Those employed in shipbreaking industries experienced an increase in mortality from all causes. The increased SMR for lung cancer was probably related to asbestos, metals, and welding fume exposure.

Cited by 20 publications

References 27 publications

Esophagus cancer and occupational exposure to asbestos: results from a meta-analysis of epidemiology studies

Esophagus cancer and occupational exposure to asbestos: results from a meta-analysis of epidemiology studies

Cancer Attributable to Asbestos Exposure in Shipbreaking Workers: A Matched-Cohort Study

Ship breaking or scuttling? A review of environmental, economic and forensic issues for decision support

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