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Beckett EM, Abelmann A, Roberts B, Lewis RC, Cheatham D, Miller EW, Hall E, Pierce JS. An updated evaluation of reported no-observed adverse effect levels for chrysotile, amosite, and crocidolite asbestos for lung cancer and mesothelioma. Crit Rev Toxicol 2023; 53:611-657. [PMID: 38126124 DOI: 10.1080/10408444.2023.2283169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
This analysis updates two previous analyses that evaluated the exposure-response relationships for lung cancer and mesothelioma in chrysotile-exposed cohorts. We reviewed recently published studies, as well as updated information from previous studies. Based on the 16 studies considered for chrysotile (<10% amphibole), we identified the "no-observed adverse effect level" (NOAEL) for lung cancer and/or mesothelioma; it should be noted that smoking or previous or concurrent occupational exposure to amphiboles (if it existed) was not controlled for. NOAEL values ranged from 2.3-<11.5 f/cc-years to 1600-3200 f/cc-years for lung cancer and from 100-<400 f/cc-years to 800-1599 f/cc-years for mesothelioma. The range of best-estimate NOAELs was estimated to be 97-175 f/cc-years for lung cancer and 250-379 f/cc-years for mesothelioma. None of the six cohorts of cement or friction product manufacturing workers exhibited an increased risk at any exposure level, while all but one of the six studies of textile workers reported an increased risk at one or more exposure levels. This is likely because friction and cement workers were exposed to much shorter chrysotile fibers. Only eight cases of peritoneal mesothelioma were reported in all studies on predominantly chrysotile-exposed cohorts combined. This analysis also proposed best-estimate amosite and crocidolite NOAELs for mesothelioma derived by the application of relative potency estimates to the best-estimate chrysotile NOAELs for mesothelioma and validated by epidemiology studies with exposure-response information. The best-estimate amosite and crocidolite NOAELs for mesothelioma were 2-5 f/cc-years and 0.6-1 f/cc-years, respectively. The rate of peritoneal mesothelioma in amosite- and crocidolite-exposed cohorts was between approximately 70- to 100-fold and several-hundred-fold higher than in chrysotile-exposed cohorts, respectively. These findings will help characterize potential worker and consumer health risks associated with historical and current chrysotile, amosite, and crocidolite exposures.
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Affiliation(s)
| | | | | | | | | | | | - Ethan Hall
- Benchmark Risk Group, Grand Rapids, MI, USA
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Yano E. Adverse health effects of asbestos: solving mysteries regarding asbestos carcinogenicity based on follow-up survey of a Chinese factory. Environ Health Prev Med 2018; 23:35. [PMID: 30089452 PMCID: PMC6083519 DOI: 10.1186/s12199-018-0726-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/25/2018] [Indexed: 11/29/2022] Open
Abstract
The present review summarizes the results of several follow-up studies assessing an asbestos product manufacturing plant in Chongqing, China, and discusses three controversial issues related to the carcinogenicity of asbestos. The first issue is the amphibole hypothesis, which asserts that the carcinogenicity of asbestos is limited to amphiboles, such as crocidolite, but not serpentines, such as chrysotile. However, considering the possible multiple component of asbestos carcinogenicity in the presence of tobacco smoke or other carcinogens, chrysotile cannot be regarded as non-carcinogenic. Additionally, in a practical sense, it is not possible to assume "pure" chrysotile due to its ubiquitous contamination with tremolite, which is a type of amphibole. Thus, as the International Agency for Research on Cancer (IARC) assessed, all forms of asbestos including chrysotile should be regarded carcinogenic to humans (Group 1). The second issue is the chrysotile/tremolite paradox, which is a phenomenon involving predominant levels of tremolite in the lung tissues of individuals who worked in locations with negligible levels of tremolite due to the exclusive use of chrysotile. Four possible mechanisms to explain this paradox have been proposed but this phenomenon does not support the claim that amphibole is inert. The final issue discussed is the textile mystery, i.e., the higher incidence of cancer in asbestos textile plants compared to asbestos mines where the same asbestos was produced and the exposure levels were comparable. This phenomenon was first reported in North America followed by UK and then in the present observations from China. Previously, levels of fiber exposure were calculated using a universal converting coefficient to estimate the mass concentration versus fiber concentration. However, parallel measurements of fiber and mass concentrations in the workplace and exposed air indicated that there are wide variations in the fiber/mass ratio, which unjustifies the universal conversion. It is possible that contamination by airborne non-fibrous particles in mines with mass fiber conversion led to the overestimation of fiber concentrations and resulted in the textile mystery. Although the use and manufacturing of asbestos has been banned in Japan, more than 10 million tons of asbestos had been imported and the majority remains in existing buildings. Thus, efforts to control asbestos exposure should be continued.
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Affiliation(s)
- Eiji Yano
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
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A comparison of asbestos fiber potency and elongate mineral particle (EMP) potency for mesothelioma in humans. Toxicol Appl Pharmacol 2018; 361:127-136. [PMID: 30077661 DOI: 10.1016/j.taap.2018.07.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/26/2018] [Accepted: 07/04/2018] [Indexed: 11/20/2022]
Abstract
We analyzed the mesothelioma mortality in cohorts of workers exposed to crocidolite, amosite, and chrysotile to estimate asbestos fiber potency for mesothelioma, using the method of Hodgson and Darnton (2000). We relied on the original 17 cohort studies in their analysis, along with 3 updates of those studies and 3 new asbestos cohort studies published since 2000. We extended the analyses to examine the mesothelioma potency of tremolite in vermiculite from Libby, Montana, and for non-asbestiform elongate mineral particles (EMPs) in taconite iron ore, talc, and South Dakota gold mining. Mesothelioma potency (RMeso) was calculated as the percent of all expected deaths that were due to mesothelioma per fiber/cc-year of exposure.The RMeso was 0.0012 for chrysotile, 0.099 for amosite, and 0.451 for crocidolite: thus, the relative potency of chrysotile:amosite:crocidolite was 1:83:376, which was not appreciably different from the estimates by Hodgson and Darnton in 2000. The RMeso for taconite mining fibers was 0.069 which was slightly smaller than that for amosite. The RMeso for Libby fibers was 0.028 which was greater than that for chrysotile and less than that for amosite. Talc and gold mining EMPs were non-potent for mesothelioma. Although there are a number of methods for estimating fiber potency of asbestos and non-asbestiform EMPs, the method of Hodgson and Darnton provides a uniform method by which fiber potency can be compared across many fiber types. Our estimates of RMeso provide a useful addition to our knowledge of mesothelioma potency for different asbestos and non-asbestiform EMP fibers.
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Valenzuela M, Giraldo M, Gallo-Murcia S, Pineda J, Santos L, Ramos-Bonilla JP. Recent Scientific Evidence Regarding Asbestos Use and Health Consequences of Asbestos Exposure. Curr Environ Health Rep 2018; 3:335-347. [PMID: 27696225 DOI: 10.1007/s40572-016-0109-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To justify the continuous use of two million tons of asbestos every year, it has been argued that a safe/controlled use can be achieved. The aim of this review was to identify recent scientific studies that present empirical evidence of: 1) health consequences resulting from past asbestos exposures and 2) current asbestos exposures resulting from asbestos use. Articles with evidence that could support or reject the safe/controlled use argument were also identified. A total of 155 articles were included in the review, and 87 % showed adverse asbestos health consequences or high asbestos exposures. Regarding the safe/controlled use, 44 articles were identified, and 82 % had evidence suggesting that the safe/controlled use is not being achieved. A large percentage of articles with evidence that support the safe/controlled use argument have a conflict of interest declared. Most of the evidence was developed in high-income countries and in countries that have already banned asbestos.
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Affiliation(s)
- Manuela Valenzuela
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Margarita Giraldo
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Sonia Gallo-Murcia
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Juliana Pineda
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Laura Santos
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Juan Pablo Ramos-Bonilla
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia.
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Abstract
BACKGROUND AND SUMMARY Thousands of workers are engaged in textile industry worldwide. Textile industry involves the use of different kinds of dyes which are known to possess carcinogenic properties. Solvents used in these industries are also associated with different health related hazards including cancer. In previous studies on textile and iron industries, the authors have reported genotoxicity among them and observed occurrence of cancer deaths among textile industry workers. Thus, an attempt has been made to compile the studies on the prevalence of different types of cancers among textile industry workers. LITERATURE SEARCH A wide literature search has been done for compiling the present paper. Papers on cancer occurrence among textile industry workers have been taken from 1976 to 2015. A variety of textile dyes and solvents, many of them being carcinogenic, are being used worldwide in the textile industry. The textile industry workers are therefore, in continuous exposure to these dyes, solvents, fibre dusts and various other toxic chemicals. The present study evaluates the potential of different chemicals and physical factors to be carcinogenic agents among occupationally exposed workers by going through various available reports and researches. Papers were collected using different databases and a number of studies report the association of textile industry and different types of cancer including lung, bladder, colorectal and breast cancer. After going through the available reports, it can be concluded that workers under varied job categories in textile industries are at a higher risk of developing cancer as various chemicals used in the textile industry are toxic and can act as potential health risk in inducing cancer among them. Assessing the cancer risk at different job levels in textile industries may be found useful in assessing the overall risk to the workers and formulating the future cancer preventive strategies.
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Pira E, Romano C, Violante FS, Farioli A, Spatari G, La Vecchia C, Boffetta P. Updated mortality study of a cohort of asbestos textile workers. Cancer Med 2016; 5:2623-8. [PMID: 27457053 PMCID: PMC5055168 DOI: 10.1002/cam4.824] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/15/2016] [Accepted: 06/21/2016] [Indexed: 01/15/2023] Open
Abstract
Limited information is available on risk of peritoneal mesothelioma after asbestos exposure, and in general on the risk of cancer after cessation of asbestos exposure. We updated to 2013 the follow-up of a cohort of 1083 female and 894 male textile workers with heavy asbestos exposure (up to 100 fb/mL), often for short periods. A total of 1019 deaths were observed, corresponding to a standardized mortality ratio (SMR) of 1.68 (95% confidence interval [CI]: 1.57-1.78). SMRs were 29.1 (95% CI: 21.5-38.6) for peritoneal cancer, 2.96 (95% CI: 2.50-3.49) for lung cancer, 33.7 (95% CI: 25.7-43.4) for pleural cancer, and 3.03 (95% CI: 1.69-4.99) for ovarian cancer. For pleural and peritoneal cancer, there was no consistent pattern of risk in relation to time since last exposure, whereas for lung cancer there was an indication of a decline in risk after 25 years since last exposure. The findings of this unique cohort provide novel data for peritoneal cancer, indicating that - as for pleural cancer - the excess risk does not decline up to several decades after cessation of exposure.
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Affiliation(s)
- Enrico Pira
- Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy
| | - Canzio Romano
- Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy
| | - Francesco S Violante
- Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy
| | - Andrea Farioli
- Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy
| | - Giovanna Spatari
- Department of Environmental Science, Safety, Territory, Food and Health, Messina University, Messina, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Milan University, Milan, Italy
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
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Pierce JS, Ruestow PS, Finley BL. An updated evaluation of reported no-observed adverse effect levels for chrysotile asbestos for lung cancer and mesothelioma. Crit Rev Toxicol 2016; 46:561-86. [DOI: 10.3109/10408444.2016.1150960] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Baur X, Soskolne CL, Lemen RA, Schneider J, Woitowitz HJ, Budnik LT. How conflicted authors undermine the World Health Organization (WHO) campaign to stop all use of asbestos: spotlight on studies showing that chrysotile is carcinogenic and facilitates other non-cancer asbestos-related diseases. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2015; 21:176-9. [PMID: 25729927 PMCID: PMC4457129 DOI: 10.1179/2049396714y.0000000105] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The silicate mineral asbestos is categorized into two main groups based on fiber structure: serpentine asbestos (chrysotile) and amphibole asbestos (crocidolite, amosite, anthophyllite, tremolite, and actinolite). Chrysotile is used in more than 2 000 applications and is especially prevalent in the construction industry. Although its use is banned or restricted in more than 52 countries, an estimated 107 000 workers die from asbestos exposure each year, and approximately 125 million workers continue to be exposed. Furthermore, ambient exposures persist to which the public is exposed, globally. Today, the primary controversies regarding the use of asbestos are the potencies of different types of asbestos, as opposed whether or not asbestos causes morbidity and mortality. The asbestos industry has promoted and funded research based on selected literature, ignoring both clinical and scientific knowledge. In this piece, we highlight a prominent example of a conflicted publication that sought to undermine the World Health Organization (WHO) campaign to stop the use of all forms of asbestos, including chrysotile asbestos. Independent and rigorous scientific data provide sufficient evidence that chrysotile asbestos, like other forms of asbestos, is a cause of asbestos-related morbidity and premature mortality.
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Affiliation(s)
- Xaver Baur
- Division of Occupational Lung Diseases and Allergy, Institute for Occupational Medicine, Charite-University Medicine, Berlin, Germany
| | - Colin L Soskolne
- University of Alberta, Edmonton, Canada
- Faculty of Health, University of Canberra, Australia
| | - Richard A Lemen
- United States Public Health Service (ret.), Environmental and Occupational Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Joachim Schneider
- Institute and Outpatient Clinic for Occupational and Social Medicine, University of Giessen, Germany
| | - Hans-Joachim Woitowitz
- Institute and Outpatient Clinic for Occupational and Social Medicine, University of Giessen, Germany
| | - Lygia Therese Budnik
- Institute for Occupational and Social Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, University of Hamburg, Germany
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Graham MA, Roggli VL. Medicolegal Aspects of Asbestos I — Malignant Mesothelioma and Lung Cancer. Acad Forensic Pathol 2013. [DOI: 10.23907/2013.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Inhalation of asbestos fibers can cause a variety of conditions, benign and malignant, of the lungs and pleura. Illnesses and deaths in which asbestos may have had a causal or contributory role are often the subject of litigation. Forensic pathologists (FP) can become involved in some of these cases in their capacity of a medical examiner or coroner, autopsy pathologist or as an expert retained by one or more parties involved in litigation. FP input may be sought to address issues such as diagnosis, assessment of exposure, and attribution. This review will discuss medicolegal issues that surround lung and mesothelial tumors that can be caused by the inhalation of asbestos fibers.
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Affiliation(s)
| | - Victor L. Roggli
- St. Louis University and Chief Medical Examiner for the City of St. Louis, MO
- Duke University - Pathology, Durham, NC (VR)
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Wang X, Yano E, Lin S, Yu ITS, Lan Y, Tse LA, Qiu H, Christiani DC. Cancer mortality in Chinese chrysotile asbestos miners: exposure-response relationships. PLoS One 2013; 8:e71899. [PMID: 23991003 PMCID: PMC3749214 DOI: 10.1371/journal.pone.0071899] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/05/2013] [Indexed: 11/19/2022] Open
Abstract
Objective This study was conducted to assess the relationship of mortality from lung cancer and other selected causes to asbestos exposure levels. Methods A cohort of 1539 male workers from a chrysotile mine in China was followed for 26 years. Data on vital status, occupation and smoking were collected from the mine records and individual contacts. Causes and dates of death were further verified from the local death registry. Individual cumulative fibre exposures (f-yr/ml) were estimated based on converted dust measurements and working years at specific workshops. Standardized mortality ratios (SMRs) for lung cancer, gastrointestinal (GI) cancer, all cancers and nonmalignant respiratory diseases (NMRD) stratified by employment years, estimated cumulative fibre exposures, and smoking, were calculated. Poisson models were fitted to determine exposure-response relationships between estimated fibre exposures and cause-specific mortality, adjusting for age and smoking. Results SMRs for lung cancer increased with employment years at entry to the study, by 3.5-fold in ≥10 years and 5.3-fold in ≥20 years compared with <10 years. A similar trend was seen for NMRD. Smokers had greater mortality from all causes than nonsmokers, but the latter also had slightly increased SMR for lung cancer. No excess lung cancer mortality was observed in cumulative exposures of <20 f-yrs/ml. However, significantly increased mortality was observed in smokers at the levels of ≥20 f-yrs/ml and above, and in nonsmokers at ≥100 f-yrs/ml and above. A similarly clear gradient was also displayed for NMRD. The exposure-response relationships with lung cancer and NMRD persisted in multivariate analysis. Moreover, a clear gradient was shown in GI cancer mortality when age and smoking were adjusted for. Conclusion There were clear exposure-response relationships in this cohort, which imply a causal link between chrysotile asbestos exposure and lung cancer and nonmalignant respiratory diseases, and possibly to gastrointestinal cancer, at least for smokers.
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Affiliation(s)
- Xiaorong Wang
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
- * E-mail: (XW); (EY)
| | - Eiji Yano
- School of Public Health, Teikyo University School of Medicine, Tokyo, Japan
- * E-mail: (XW); (EY)
| | - Sihao Lin
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Ignatius T. S. Yu
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Yajia Lan
- Huaxi School of Public Health, Sichuan University, Chengdu, China
| | - Lap Ah Tse
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Hong Qiu
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - David C. Christiani
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
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A retrospective cohort study of cancer mortality in employees of a Russian chrysotile asbestos mine and mills: Study rationale and key features. Cancer Epidemiol 2013; 37:440-5. [DOI: 10.1016/j.canep.2013.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 02/27/2013] [Accepted: 03/02/2013] [Indexed: 11/23/2022]
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13
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Affiliation(s)
- Leslie Stayner
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois, Chicago, Illinois 60612-4392;
| | - Laura S. Welch
- CPWR, The Center for Construction Research and Training, Silver Spring, Maryland 20910
| | - Richard Lemen
- Retired, US Public Health Service, Canton, Georgia 30115
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Cause-specific mortality in relation to chrysotile-asbestos exposure in a Chinese cohort. J Thorac Oncol 2012; 7:1109-14. [PMID: 22617242 DOI: 10.1097/jto.0b013e3182519a60] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The carcinogenic potency of chrysotile asbestos remains a contentious topic, and more data are needed to address this issue. We examine cause-specific mortality, especially lung cancer, and its association with chrysotile-asbestos exposure in a Chinese cohort. METHODS A cohort of 577 workers from a chrysotile-textile plant was followed prospectively from 1972 to 2008. Occupational history, exposure information, and smoking data were obtained from company records and personal interviews; vital status and causes of death were ascertained from death registries and hospitals. Workers were classified into three exposure levels on the basis of exposure assessments of different workshops. Standardized Mortality Ratios (SMRs) were calculated in terms of exposure levels and other indices. RESULTS Among 259 identified deaths, 53 died from lung cancer, with an SMR of 4.08 (95% confidence interval 3.12, 5.33), and 96 from all cancers with an SMR of 2.09 (1.71, 2.55). In addition, two deaths from mesothelioma were observed. Increased mortality from respiratory diseases was also observed (SMR 3.38, 95% confidence interval 2.72, 4.21). Asbestos-exposure levels, exposure years, and birth cohorts showed a clear trend of risk for lung cancer and respiratory diseases. CONCLUSION The current analysis indicated that exposure to chrysotile asbestos was closely associated with excess mortality from lung cancer and respiratory diseases.
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McCormack V, Peto J, Byrnes G, Straif K, Boffetta P. Estimating the asbestos-related lung cancer burden from mesothelioma mortality. Br J Cancer 2012; 106:575-84. [PMID: 22233924 PMCID: PMC3273352 DOI: 10.1038/bjc.2011.563] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 11/21/2011] [Accepted: 11/23/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Quantifying the asbestos-related lung cancer burden is difficult in the presence of this disease's multiple causes. We explore two methods to estimate this burden using mesothelioma deaths as a proxy for asbestos exposure. METHODS From the follow-up of 55 asbestos cohorts, we estimated ratios of (i) absolute number of asbestos-related lung cancers to mesothelioma deaths; (ii) excess lung cancer relative risk (%) to mesothelioma mortality per 1000 non-asbestos-related deaths. RESULTS Ratios varied by asbestos type; there were a mean 0.7 (95% confidence interval 0.5, 1.0) asbestos-related lung cancers per mesothelioma death in crocidolite cohorts (n=6 estimates), 6.1 (3.6, 10.5) in chrysotile (n=16), 4.0 (2.8, 5.9) in amosite (n=4) and 1.9 (1.4, 2.6) in mixed asbestos fibre cohorts (n=31). In a population with 2 mesothelioma deaths per 1000 deaths at ages 40-84 years (e.g., US men), the estimated lung cancer population attributable fraction due to mixed asbestos was estimated to be 4.0%. CONCLUSION All types of asbestos fibres kill at least twice as many people through lung cancer than through mesothelioma, except for crocidolite. For chrysotile, widely consumed today, asbestos-related lung cancers cannot be robustly estimated from few mesothelioma deaths and the latter cannot be used to infer no excess risk of lung or other cancers.
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Affiliation(s)
- V McCormack
- Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France
| | - J Peto
- Faculty of Epidemiology and Population Health, Department of Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - G Byrnes
- Biostatistics Group, Section of Genetics, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France
| | - K Straif
- Section of IARC Monographs, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France
| | - P Boffetta
- Institute for Translational Epidemiology and Tisch Cancer Institute, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574, USA
- International Prevention Research Institute, Lyon, France
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