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Cancer
0321 Association between occupational exposure to asbestos and cholangiocarcinoma: a population-based nested case–control study
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  1. Andrea Farioli1,
  2. Kurt Straif2,
  3. Giovanni Brandi3,
  4. Stefania Curti1,
  5. Kristina Kjaerheim4,
  6. Jan Ivar Martinsen4,
  7. Pär Sparen5,
  8. Laufey Laufey Tryggvadottir6,7,
  9. Elisabete Weiderpass5,
  10. Guido Biasco3,
  11. Francesco Saverio Violante1,
  12. Stefano Mattioli1,
  13. Eero Pukkala8,9
  1. 1Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
  2. 2International Agency for Research on Cancer, Lyon, France
  3. 3Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
  4. 4Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
  5. 5Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  6. 6Icelandic Cancer Registry, Reykjavik, Iceland
  7. 7Faculty of Medicine, University of Iceland, Reykjavik, Iceland
  8. 8Faculty of Social Sciences, University of Tampere, Tampere, Finland
  9. 9Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland

Abstract

Objective To investigate the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC) using data from the Nordic Occupational Cancer (NOCCA) cohort.

Methods We conducted a nested case-control study of 1458 intrahepatic CC (ICC) and 3972 extrahepatic (ECC) cholangiocarcinoma cases registered among subjects born 1920 or later in Finland, Iceland, Norway and Sweden. Five population controls were individually matched by birth year, gender, and country to each case. We applied the NOCCA job exposure matrix to job titles from national population censuses (1960, 1970, 1980/81, and 1990) to estimate the cumulative exposure to asbestos. We estimated odds ratios (OR) and 95% confidence intervals (CI) by conditional logistic regression models adjusted by printing industry work.

Results The risk of ICC was increased among workers with high cumulative exposure to asbestos: never exposed, OR=1.0 (reference category); 0.1–4.9 f/ml * years, OR=1.1 (95%CI 0.9–1.3); 5.0–9.9 f/ml * years, OR=1.3 (95%CI 0.9–2.1); 10.0–14.9 f/ml * years, OR=1.6 (95%CI 1.0–2.5);≥15.0 f/ml * years, OR 1.7 (95%CI 1.1–2.6). We did not observe an association between cumulative asbestos exposure and ECC.

Conclusions Our study supports the hypothesis that occupational exposure to asbestos is a risk factor for ICC, while we did not observe evidence of an association between exposure to asbestos and ECC. Further studies, such as pooled analysis of asbestos cohorts, are necessary to assess the strength of the association between asbestos and ICC and clarify the observed differences between ICC and ECC.

https://doi.org/10.1136/oemed-2017-104636.261

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