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Occupational cancer I


A. J. Darnton, D. M. McElvenny, J. T. Hodgson.Epidemiology and Medical Statistics Unit, Health and Safety Executive, UK

Introduction: Inhalation of asbestos fibres is known to cause two main kinds of cancer—mesothelioma and lung cancer. Although the vast majority of mesothelioma cases are generally accepted as being caused by asbestos, the number of asbestos related lung cancers cannot be determined directly because cases are not clinically distinguishable from those from other causes such as tobacco smoke. The aim of this study was to estimate the number of asbestos related lung cancers by modelling the relative lung cancer mortality among occupations within Great Britain in terms of smoking habits, mesothelioma mortality (as an index of asbestos exposure), and occupation type (as a proxy for socioeconomic factors).

Methods: Proportional mortality ratios for lung cancer and mesothelioma for the 20 year period 1980–2000 (excluding 1981) were calculated for occupational groups and smoking indicators were developed from three General Household Surveys carried out during the 1980s and 1990s. Poisson regression models were fitted and an estimate of the number of asbestos related lung cancers was produced by using the final model to estimate the number of lung cancer deaths in each occupation with no asbestos exposure and subtracting this from the predicted number of lung cancer deaths.

Results: The effect of asbestos exposure was weak in comparison to smoking habits and occupation type. The proportion of current smokers in occupational groups and average age started smoking were particularly important factors. Our estimate of the number of asbestos related lung cancers was between 2/3 and one death for every mesothelioma: equivalent to between 11 500 to 16 500 deaths during the period.

Conclusions: Asbestos related lung cancer is likely to have accounted for 2–3% of all lung cancer deaths among males in Great Britain …

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