Objectives The purpose of this study was to study differences in incidence of malignant mesothelioma between the Nordic countries.
Method We used data from the ongoing Nordic Occupational Cancer Study (NOCCA). Occupational title by 3-digit level was obtained from the countries’ population and housing censuses in 1960, 1970, 1980 and 1990. A job-exposure matrix (JEM) was developed, including 25 carcinogens with specific exposure levels for 283 occupations for years 1945 to 1994, using national exposure databases and expert assessments. All mesothelioma cases (ICD-7 158 for peritoneum and 162.2 for pleura) in the Nordic countries 1961–2005 were identified through linkages with national cancer registers. We calculated Standardised Incidence Ratios (SIR) of mesothelioma for 53 occupations/occupational categories for men and women and linked with the NOCCA JEM.
Results A total of 7899 persons were diagnosed with mesothelioma in the Nordic cohort from 1961 to 2005, of which 24.3% were women. There was an increased significant SIR of mesothelioma among 15 of the 53 occupations/occupational categories for men, and for nine different occupations for women. The men’s excessed risk was observed in typical male-dominated occupations, highest for plumbers (SIR 4.64, 95% CI 4.09 to 5.24), with a total of 241 cases.
Conclusions We found great consistency among men between countries with occupations associated with asbestos exposure. For women, we found greater diversity between countries and risk assessment in occupations not associated with asbestos exposure. Unclear diagnosis of mesothelioma of the peritoneum and misclassification of occupation may be behind this.
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