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Zhang Y, Mi M, Zhu N, Yuan Z, Ding Y, Zhao Y, Lu Y, Weng S, Yuan Y. Global burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in 204 countries and territories, from 1990 to 2019: results from the global burden of disease study 2019. Ann Med 2023; 55:2206672. [PMID: 37155297 PMCID: PMC10167889 DOI: 10.1080/07853890.2023.2206672] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Occupational-related cancers are a substantial global health issue. The largest proportion of occupational-related cancers is tracheal, bronchus, and lung (TBL) cancer. This study aimed to explore the geographical and temporal trends in occupational carcinogens related to TBL cancer. METHODS Data on TBL cancer attributable to occupational carcinogens were collected from the Global Burden of Disease Study 2019. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs), and corresponding average annual percentage change (AAPC) were evaluated and stratified by geographic location, socio-demographic index (SDI) quintiles, age, and sex. RESULTS Globally, ASRs of deaths and DALYs in TBL cancer attributable to occupational carcinogens showed a downward trend (AAPC = - 0.69%, - 1.01%) while increases were observed in the low, low-middle, and middle SDI quintiles. Although males accounted for 82.4% and 81.5% of deaths and DALYs in 2019, respectively, it showed an upward trend of ASRs in females (AAPC = 0.33%, 0.02%). Occupational exposure to asbestos, silica and diesel engine exhaust were the top three causes of age-standardized TBL cancer deaths and DALYs. Over the past three decades, the percentage of age-standardized TBL cancer deaths and DALYs attributable to occupational asbestos and silica exposure decreased by 18.24, 6.71 and 20.52%, 4.00% globally, but increased significantly in lower SDI regions, while the burden attributable to occupational diesel engine exhaust exposure increased by 32.76, 37.23% worldwide. CONCLUSIONS Occupational exposure remains an important risk factor for TBL cancer. The burden of TBL cancer attributable to occupational carcinogens showed obvious heterogeneity which decreased in higher SDI but increased in lower SDI regions. The burden of males was significantly higher than females, but the females showed an increasing trend. Occupational exposure to asbestos was the main causes of the burden. Therefore, effective prevention and control measures tailored to local conditions are necessary.
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Affiliation(s)
- Yan Zhang
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Mi Mi
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Ning Zhu
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhijun Yuan
- Department of Radiation Oncology, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuwei Ding
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Yingxin Zhao
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Yier Lu
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Shanshan Weng
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Ying Yuan
- Department of Medical Oncology, Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou, Zhejiang, China
- Cancer Center, Zhejiang University, Hangzhou, Zhejiang, China
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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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De Matteis S, Consonni D, Lubin JH, Tucker M, Peters S, Vermeulen RC, Kromhout H, Bertazzi PA, Caporaso NE, Pesatori AC, Wacholder S, Landi MT. Impact of occupational carcinogens on lung cancer risk in a general population. Int J Epidemiol 2012; 41:711-21. [PMID: 22467291 DOI: 10.1093/ije/dys042] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Exposure to occupational carcinogens is an important preventable cause of lung cancer. Most of the previous studies were in highly exposed industrial cohorts. Our aim was to quantify lung cancer burden attributable to occupational carcinogens in a general population. METHODS We applied a new job-exposure matrix (JEM) to translate lifetime work histories, collected by personal interview and coded into standard job titles, into never, low and high exposure levels for six known/suspected occupational lung carcinogens in the Environment and Genetics in Lung cancer Etiology (EAGLE) population-based case-control study, conducted in Lombardy region, Italy, in 2002-05. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in men (1537 cases and 1617 controls), by logistic regression adjusted for potential confounders, including smoking and co-exposure to JEM carcinogens. The population attributable fraction (PAF) was estimated as impact measure. RESULTS Men showed an increased lung cancer risk even at low exposure to asbestos (OR: 1.76; 95% CI: 1.42-2.18), crystalline silica (OR: 1.31; 95% CI: 1.00-1.71) and nickel-chromium (OR: 1.18; 95% CI: 0.90-1.53); risk increased with exposure level. For polycyclic aromatic hydrocarbons, an increased risk (OR: 1.64; 95% CI: 0.99-2.70) was found only for high exposures. The PAFs for any exposure to asbestos, silica and nickel-chromium were 18.1, 5.7 and 7.0%, respectively, equivalent to an overall PAF of 22.5% (95% CI: 14.1-30.0). This corresponds to about 1016 (95% CI: 637-1355) male lung cancer cases/year in Lombardy. CONCLUSIONS These findings support the substantial role of selected occupational carcinogens on lung cancer burden, even at low exposures, in a general population.
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Affiliation(s)
- Sara De Matteis
- Unit of Epidemiology, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and EPOCA Research Centre, Department of Occupational and Environmental Health, Università degli Studi di Milano, Milan, Italy
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Fazzo L, De Santis M, Minelli G, Bruno C, Zona A, Marinaccio A, Conti S, Comba P. Pleural mesothelioma mortality and asbestos exposure mapping in Italy. Am J Ind Med 2012; 55:11-24. [PMID: 22025020 DOI: 10.1002/ajim.21015] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2011] [Indexed: 11/05/2022]
Abstract
BACKGROUND An epidemic of asbestos-related diseases is ongoing worldwide. Mortality from malignant pleural neoplasms in Italy was analyzed, to estimate the health impact of asbestos at national and local level. METHODS Mortality from ICD-9 code 163 was considered, in the time-window 1995-2002, using National Bureau of Statistics data. National and regional standardized rates and municipal Standardized Mortality Ratios (SMR) were calculated. Municipal clusters were identified by applying Spatial Scan Statistics procedure. Relative risks (RR) express the ratio of risk within the cluster to the risk outside the cluster. RESULTS The national standardized annual mortality rate was 1.9 per 100,000. Significant clusters corresponded to asbestos-cement industries (Casale Monferrato: RR = 11.63), shipyards (Monfalcone, RR = 7.43), oil refineries (Falconara, RR = 2.52), petrochemical industries (Priolo, RR = 3.81). CONCLUSIONS The present study confirms malignant pleural neoplasms mortality as a suitable indicator of asbestos exposure at geographic level. In addition to asbestos-cement industries and shipyards, other industrial settings are associated with pleural neoplasm mortality.
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Affiliation(s)
- Lucia Fazzo
- Environmental Epidemiology Unit, Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy.
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