ORIGINAL ARTICLE

Occupational exposure to asbestos and man-made vitreous fibres and risk of lung cancer: a multicentre case-control study in Europe

Rafael Carel^1,2, Ann C Olsson^1,3, David Zaridze⁴, Neonila Szeszenia-Dabrowska⁵, Peter Rudnai⁶, Jolanta Lissowska⁷, Eleonora Fabianova⁸, Adrian Cassidy⁹, Dana Mates¹⁰, Vladimir Bencko¹¹, Lenka Foretova¹², Vladimir Janout¹³, Joelle Fevotte¹⁴, Tony Fletcher¹⁵, Andrea ’t Mannetje^1,16, Paul Brennan¹, Paolo Boffetta¹

¹ International Agency for Research on Cancer, Lyon, France
² School of Public Health, The University of Haifa, Haifa, Israel
³ Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
⁴ Institute of Carcinogenesis, Cancer Research Center, Moscow, Russia
⁵ Department of Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
⁶ National Institute of Environmental Health, Budapest, Hungary
⁷ Cancer Center and Maria Sklodowska-Curie Institute of Oncology, Warsaw, Poland
⁸ Department of Occupational Health, Specialized State Health Institute, Banska Bystrica, Slovakia
⁹ Roy Castle Lung Cancer Research Programme, University of Liverpool Cancer Research Centre, University of Liverpool, UK
¹⁰ Institute of Hygiene, Public Health, Health Services and Management, Bucharest, Romania
¹¹ Institute of Hygiene and Epidemiology, Charles University, First Faculty of Medicine, Prague, Czech Republic
¹² Department of Cancer Epidemiology & Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
¹³ Department of Preventive Medicine, Palacky University Faculty of Medicine, Olomouc, Czech Republic
¹⁴ Institut Universitaire de Médecine du Travail, Université Claude Bernard, Lyon, France
¹⁵ Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, London, UK
¹⁶ Centre for Public Health Research, Massey University, Wellington, New Zealand

Correspondence to:
Dr P Boffetta
Gene-Environment Epidemiology Group, International Agency for Research on Cancer, 150 cours Albert Thomas, 69008 Lyon, France; boffetta{at}iarc.fr

Objectives: To investigate the contribution of occupational exposure to asbestos and man-made vitreous fibres (MMVF) to lung cancer in high-risk populations in Europe.

Methods: A multicentre case-control study was conducted in six Central and Eastern European countries and the UK, during the period 1998–2002. Comprehensive occupational and sociodemographic information was collected from 2205 newly diagnosed male lung cancer cases and 2305 frequency matched controls. Odds ratios (OR) of lung cancer were calculated after adjusting for other relevant occupational exposures and tobacco smoking.

Results: The OR for asbestos exposure was 0.92 (95% CI 0.73 to 1.15) in Central and Eastern Europe and 1.85 (95% CI 1.07 to 3.21) in the UK. Similar ORs were found for exposure to amphibole asbestos. The OR for MMVF exposure was 1.23 (95% CI 0.88 to 1.71) with no evidence of heterogeneity by country. No synergistic effect either between asbestos and MMVF or between any of them and smoking was found.

Conclusion: In this large community-based study occupational exposure to asbestos and MMVF does not appear to contribute to the lung cancer burden in men in Central and Eastern Europe. In contrast, in the UK the authors found an increased risk of lung cancer following exposure to asbestos. Differences in fibre type and circumstances of exposure may explain these results.

Abbreviations: IARC, International Agency for Research on Cancer; ISCO, International Standard Classification of Occupations; MMVF, man-made vitreous fibres; PAHs, polycyclic aromatic hydrocarbons; SIR, standardised incidence ratios

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