Occupation and risk of malignant pleural mesothelioma: A case-control study in Spain

Abstract

Background The association of mesothelioma and asbestos exposure is well known, but some data suggest that probably many people are still being exposed to asbestos without knowing it. Methods Between 1993 and 1996, 132 cases (77% males) of histologically con®rmed malignant pleural mesothelioma and 257 controls, residents in two provinces of Spain (Barcelona and Ca Âdiz), were interviewed. They were classi®ed according to their probability and intensity of occupational asbestos exposure by a panel of industrial hygienists, based on a detailed occupational history. Results Age and sex-adjusted odds ratio (OR) for the highest probability of exposure to asbestos was 13.2 (95% con®dence interval 6.4±27.3), and 27.1 (9.28±79.3) for high intensity. A dose±response trend was observed for both, probability and intensity. Overall, 61% of cases and 42% of controls had ever worked in an occupation with risk of asbestos exposure, with an OR of 2.59 (1.60±4.22). In our population 62% of cases could be attributed to occupational asbestos exposure. Conclusion A high risk of pleural mesothelioma due to occupational asbestos exposure is con®rmed, but there is still a sizeable proportion for which no evidence of occupational exposure was found. Most of these cases could be due to other sources of asbestos exposure, mainly domestic or environmental.

Malignant mesothelioma - German mesothelioma register 1987-1999

“…In more than 70% of cases, occupational asbestos exposure was established [98,65,2]. The highest pulmonary asbestos burden and the shortest latency period was shown, as in other studies [13,74], to be in workplaces in the asbestos and insulation industries, and in shipyards.…”

“…The age distribution in our study shows a maximum between 54 and 62 years [80,91,2]. There are no differences in age distribution between men and women.…”

“…In other similar collectives of occupationally exposed persons [98,83] the number of female patients is comparably low (8%). Some other studies [60,48,2] report higher percentages of women (12.8 to 23%). Our data reveal a higher percentage of female patients in the collective without elevated pulmonary asbestos burdens.…”

The interpretation of occupational epidemiologic data in regulation and litigation: Studies of auto mechanics and petroleum workers

“…Teschke et al (1997) reported a higher percentage of interviews by family members for cases than controls (33.3 vs. 13.6%). Similarly, Agudo et al (2000) reported that 55.3% cases and 99.6% controls were interviewed in their study. A potential concern is that family members might not be able to recall all the jobs of the study subjects (cases or controls), especially jobs of very short duration and that jobs including those involving brake exposure might have been underreported.…”

“…In the Agudo et al study,22.0% interviews were provided by the subjects' spouses. Agudo et al (2000) cited a validation study by Bond et al (1988), which shows that "information on number of areas and usual work area assignment provided by the spouse performed quite well when compared with the subject itself." In the Agudo et al study, the agreement between the subjects' and the spouses' recalls was very high ( D 0.79).…”