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

Rafael Carel ¹, Ann C. Olsson ², David Zaridze ³, Neonila Szeszenia-Dabrowska ⁴, Peter Rudnai ⁵, Jolanta Lissowska ⁶, Eleonora Fabianova ⁷, Adrian Cassidy ⁸, Dana Mates ⁹, Vladimir Bencko ¹⁰, Lenka Foretova ¹¹, Vladimir Janout ¹², Joelle Fevotte ¹³, Tony Fletcher ¹⁴, Andrea 't Mannetje ¹⁵, Paul Brennan ² and Paolo Boffetta ^2*

¹ School of Public Health, The University of Haifa
² International Agency for Research on Cancer
³ Institute of Carcinogenesis, Cancer Research Center
⁴ Department of Epidemiology, Nofer Institute of Occupational Medicine
⁵ National Institute of Environmental Health
⁶ Cancer Center and Maria Sklodowska-Curie Institute of Oncology
⁷ Department of Occupational Health, Specialized State Institute
⁸ Roy Castle Lung Cancer Research Programme, University of Liverpool Cancer Research Centre
⁹ Institute of Hygiene, Public Health, Health Services and Management
¹⁰ Institute of Hygiene and Epidemiology, Charles University
¹¹ Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute
¹² Department of Preventive Medicine, Palacky University Faculty of Medicine
¹³ Institut Universitaire de Medecine du Travail, Universite Claude Bernard
¹⁴ Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine
¹⁵ Centre for Public Health Research, Massey University, New Zealand

^* To whom correspondence should be addressed. E-mail: boffetta{at}iarc.fr.

Accepted 6 October 2006

Abstract

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 multi-center case-control study was conducted in six Central and Eastern European countries and the UK, during the period 1998-2002. Comprehensive occupational and socio-demographic 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% confidence interval (CI) 0.73-1.15) in Central and Eastern Europe and 1.85 (95%CI 1.07-3.21) in the UK. Similar OR were found for exposure to amphibole asbestos. The OR for MMVF exposure was 1.23 (95%CI 0.88-1.71) 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 we found an increased risk of lung cancer following exposure to asbestos. Differences in fibre type and circumstances of exposure may explain our results.

Keywords: Asbestos, Europe, Lung neoplasms, Man-made Vitreous Fibre, Occupational Exposure

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