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Original article
Cancer incidence within a cohort occupationally exposed to asbestos: a study of dose–response relationships
  1. Bénédicte Clin1,2,
  2. Fabrice Morlais1,
  3. Guy Launoy1,
  4. Anne-Valérie Guizard3,
  5. Brice Dubois1,
  6. Véronique Bouvier1,
  7. Nelly Desoubeaux2,
  8. Marie-France Marquignon2,
  9. Claude Raffaelli4,
  10. Christophe Paris5,
  11. Françoise Galateau-Salle6,
  12. Lydia Guittet1,
  13. Marc Letourneux1,2
  1. 1Cancers and Populations, ERI3 INSERM, Faculty of Medicine, Caen University Hospital, Caen, France
  2. 2Occupational Health Department, Caen University Hospital, Caen, France
  3. 3Calvados General Cancer Registry, Caen, France
  4. 4Occupational Health Department, GISTAF, Condé sur Noireau, France
  5. 5U954 INSERM, Faculty of Medicine, Nancy University Hospital, Nancy, France
  6. 6Pathology Department, Caen University Hospital, Caen, France
  1. Correspondence to Dr Bénédicte Clin, Service de Santé au Travail et Pathologie Professionnelle (Occupational Health Department), C.H.U. (University Hospital) Côte de Nacre, 14033 CAEN Cedex, France; clin-b{at}


Objectives The aim of our study was to analyse the dose–response relationship between occupational asbestos exposure and risk of cancer.

Methods Our study was a retrospective morbidity study based on 2024 subjects occupationally exposed to asbestos, conducted over the period 1 January 1978 to 31 December 2004. Analysis of the dose–response relationship between occupational asbestos exposure, as a time-dependant variable, and risk of cancer was performed using a Cox model. In order to account for the effect of latency, we conducted the analysis with a lag of 10 years.

Results 285 cases of cancers were observed in our cohort. The relative risk of pleuro-peritoneal mesothelioma, lung cancer and colorectal cancer associated with asbestos exposure, adjusted for age as a time-dependant variable and for sex, was correlated with exposure intensity (or average exposure level, AEL). The risk of cancer, whatever the anatomical site, did not increase with the duration of exposure to asbestos.

Conclusion While confirming the established relationship between asbestos exposure and pleuropulmonary and peritoneal cancers, this study also suggests a causal relationship between asbestos exposure and colorectal cancer.

  • Asbestos
  • cancer
  • occupational exposure
  • dose-response relationship
  • colorectal cancer
  • epidemiology
  • exposure assessment
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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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