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Original research
Pleural plaques and risk of lung cancer in workers formerly occupationally exposed to asbestos: extension of follow-up
  1. Justine Gallet1,
  2. François Laurent2,3,4,
  3. Christophe Paris5,6,
  4. Bénédicte Clin7,8,9,
  5. Antoine Gislard10,
  6. Isabelle Thaon11,
  7. Soizick Chammings12,
  8. Celine Gramond1,
  9. Guy Ogier13,
  10. Gilbert Ferretti14,15,
  11. Pascal Andujar16,17,
  12. Patrick Brochard1,
  13. Fleur Delva1,18,
  14. Jean-Claude Pairon16,17,
  15. Aude Lacourt1
  1. 1Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
  2. 2Université de Bordeaux, Faculté de Médecine, F-33000 Bordeaux, France
  3. 3Service d’imagerie médicale radiologie diagnostique et thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
  4. 4Centre de recherche cardiothoracique de Bordeaux, INSERM U1045, F-33000 Bordeaux, France
  5. 5Service de santé au travail et pathologie professionnelle, CHU Rennes, F-35000 Rennes, France
  6. 6Institut de recherche en santé, environnement et travail, INSERM U1085, F-35000 Rennes, France
  7. 7Service de santé au travail et pathologie professionnelle, CHU Caen, F-14000 Caen, France
  8. 8Faculté de médecine, Université de Caen Normandie, F-14000 Caen, France
  9. 9U1086 « ANTICIPE », INSERM, F-14000 Caen, France
  10. 10Centre de consultations des pathologies professionnelles, CHU Rouen, F-76000 Rouen, France
  11. 11Centre de consultations des pathologies professionnelles, CHRU Nancy, Université de Lorraine, F-54000 Nancy, France
  12. 12Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, CHI Créteil, F-94010 Créteil, France
  13. 13Echelon régional du service médical, Assurance maladie, F69000 Lyon, France
  14. 14Service de radiologie diagnostique et thérapeutique, CHU Grenoble, F-38000 Grenoble, France
  15. 15Université de Grenoble Alpes, F-38700 La Tranche, France
  16. 16INSERM, IMRB, Université Paris Est Créteil, F-94010 Créteil, France
  17. 17Service de Pathologies Professionnelles et de l'Environnement, CHI Créteil, F-94010 Créteil, France
  18. 18Service Santé Travail Environnement, CHU Bordeaux, F-33000, France
  1. Correspondence to Fleur Delva, Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, CHU Bordeaux GH Pellegrin, Bordeaux, Aquitaine, France; fleur.delva{at}chu-bordeaux.fr

Abstract

Background Occupational asbestos exposure is associated with pleural plaques (PP), a benign disease often seen as a marker of past exposure to asbestos and lung cancer. The association between these two diseases has not been formally proved, the aim of this study was to evaluate this association in the asbestos-related disease cohort (ARDCO) cohort.

Methods ARDCO is a French multicentric cohort including workers formerly occupationally exposed to asbestos from 2003 to 2005. CT scan was performed to diagnose PP with double reading and lung cancer (incidence and mortality) was followed through health insurance data and death certificates. Cox models were used to estimate the association between PP and lung cancer adjusting for occupational asbestos exposure (represented by cumulative exposure index, time since first exposure and time since last exposure) and smoking status.

Results A total of 176 cases (of 5050 subjects) and 88 deaths (of 4938 subjects) of lung cancer were recorded. Smoking status was identified as an effect modifier. Lung cancer incidence and mortality were significantly associated with PP only in non-smokers, respectively, HR=3.13 (95% CI 1.04 to 9.35) and HR=16.83 (95% CI 1.87 to 151.24) after adjustment for age, occupational asbestos exposure and smoking status.

Conclusions ARDCO study was the first to study this association considering equal asbestos exposure, and more specifically, our study is the first to test smoking as an effect modifier, so comparison with scientific literature is difficult. Our results seem to consolidate the hypothesis that PP may be an independent risk factor for lung cancer but they must be interpreted with caution.

  • asbestos
  • occupational health
  • respiratory system

Data availability statement

No data are available.

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Footnotes

  • Contributors JG performed literature review, all statistical analysis and drafted the first version ofthis manuscript.Conception or design of the work was done by CP, BC, PB, J-CP and AL. Acquisition and interpretation of data was done by CP, BC, AG, FL, IT, SC and GO. AL supervised all aspects of this manuscript. All coauthors participated in the drafting, revision and correction of the final text. J-CP is the guarantor of the paper.

  • Funding This study was supported by the French Ministry of Labour and Social Relations; the French National Health Insurance (Occupational Risk Prevention Department); the French Agency for Food, Environmental and Occupational Health & Safety, Grant number: ANSES Grant 07-CRD-51 and EST 2006/1/43 and EST 2009/68.

  • Competing interests None declared.

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