Objective: To describe mortality among workers exposed to chrysotile asbestos and evaluate the relationship of lung cancer to asbestos fiber exposure.
Methods: Workers employed for at least 1 day between 1 January 1950 and 31 December 1973 in any of four plants in North Carolina, USA that produced asbestos textile products were enumerated. Vital status was ascertained through 31 December 2003. Historical exposures to asbestos fibers were estimated from work histories and 3578 industrial hygiene measurements taken 1935-1986. Mortality of the cohort was compared to that of the national population via standardized mortality ratios (SMRs). Exposure-response relations for lung cancer were examined within the cohort using Poisson regression to compute adjusted mortality rate ratios.
Results: Follow-up of 5770 workers included in the cohort resulted in 181,640 person-years of observation, with 2583 deaths from all causes and 277 from lung cancer. Mortality from all causes, all cancers and lung cancer was significant higher than expected, with SMRs of 1.45 for all causes, 1.34 for all cancer and 1.95 (95% CI 1.73-2.20) for lung cancer. SMRs for pleural cancer, mesothelioma and pneumoconiosis and were also elevated. The risk of lung cancer and asbestosis increased with cumulative fiber exposure (RR 1.102 per 100 fiber-year/ml, 95% CI 1.044-1.164. and RR 1.249 per 100 fiber-year/ml, 95% CI 1.186-1.316, respectively, for total career exposure).
Conclusions: This study of provides further evidence that exposure to chrysotile asbestos in textile manufacturing is associated with increased risk of lung cancer, asbestosis cancer of the pleura and mesothelioma.
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