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Cancer in asbestos-exposed occupational cohorts: a meta-analysis

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Abstract

Objective: To examine existing asbestos-exposed occupational cohorts and apply a meta-analytic technique to determine the magnitude of association between exposure and lung cancer and to investigate other cancer sites that may be related to such an exposure.

Methods: We summarized the data from 69 asbestos-exposed occupational cohorts reporting on cancer morbidity and mortality. Data were extracted regarding numbers of deaths for each cancer, numbers of mesotheliomas, occupations and latency for respiratory, gastrointestinal, urinary and lymphohematopoietic cancers. For each cancer, we calculated a meta-SMR and examined heterogeneity of results using a chi-square test and by calculating a Z-statistic for each study. To examine the dose–response effect, we divided the studies into tertiles according to the percentage of mesothelioma deaths that served as a proxy estimation of asbestos exposure.

Results: Lung cancer data demonstrated meta-SMRs of 163 and 148 with and without latency, respectively, with significant heterogeneity of results even after stratification according to occupational groups. Stratification of lung cancer studies according to percentage of mesothelioma deaths showed a dose–response effect. Z-scores ranged from − 12.21 to + 29.49. Analysis for laryngeal cancer yielded meta-SMRs of 157 and 133 with and without latency, respectively, demonstrating homogeneous results across studies but accompanied by no evidence of a dose–response effect. Data for gastrointestinal cancers showed no evidence of a significant association and no dose–response effect. Kidney cancer demonstrated statistically non-significant meta-SMRs of 120 (95% CI 88–160) and 111 (95% CI 94–131) with and without latency respectively.

Conclusions: This meta-analysis demonstrates a wide variability of the association between occupational asbestos and lung cancer. There was a suggestion of an association between asbestos and laryngeal carcinoma and no clear association with other cancers.

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References

  1. Maclure M (1987) Asbestos and renal adenocarcinoma: a case-control study. Environ Res 42: 353-361.

    Google Scholar 

  2. Jarvholm B, Brisman J (1988) Asbestos associated tumors in car mechanics. Br J Ind Med 45: 645-646.

    Google Scholar 

  3. Wong O (1992) Chrysotile asbestos, mesothelioma, and garage mechanics. Am J Ind Med 21: 449-451.

    Google Scholar 

  4. Finkelstein MM (1989) Mortality rates among employees potentially exposed to chrysotile asbestos at two automotive parts factories. Can Med Assoc J 141: 125-130.

    Google Scholar 

  5. Liddell FD, McDonald AD, McDonald JC (1997) The 1891–1920 birth cohort of Quebec chrysotile miners and millers: development from 1904 and mortality to 1992. Ann Occup Hyg 41: 13-36.

    Google Scholar 

  6. McDonald JC, Liddell FD, Dufresne A, McDonald AD (1993) The 1891–1920 birth cohort of Quebec chrysotile miners and millers: mortality 1976–1980. Br J Ind Med 50: 1073-1081.

    Google Scholar 

  7. Peto J, Doll R, Hermon C, Binns W, Clayton R, Goffe T (1985) Relationship of mortality to measures of environmental asbestos pollution in an asbestos textile factory. Ann Occup Hyg 29: 305-355.

    Google Scholar 

  8. Enterline PE, Kendrick MA (1967) Asbestos-dust exposures at various levels and mortality. Arch Environ Health 15: 181-186.

    Google Scholar 

  9. Raffn E, Lynge E, Juel K, Korsgaard B (1989) Incidence of cancer and mortality among employees in the asbestos-cement industry in Denmark. Br J Ind Med 46: 90-96.

    Google Scholar 

  10. Raffn E, Lynge E, Korsgaard B (1993) Incidence of lung cancer by histological type among asbestos cement workers in Denmark. Br J Ind Med 50: 85-89.

    Google Scholar 

  11. Newhouse ML, Sullivan KR (1989) A mortality study of workers manufacturing friction materials: 1941–86. Br J Ind Med 46: 176-179.

    Google Scholar 

  12. Homa DM, Garabrant DH, Gillespie BW (1994) A meta-analysis of colorectal cancer and asbestos exposure. Am J Epidemiol 139: 1210-1222.

    Google Scholar 

  13. Newhouse ML, Berry G, Wagner JC (1985) Mortality of factory workers in east London 1933–80. Br J Ind Med 42: 4-11.

    Google Scholar 

  14. Wong O, Raabe GK (1996) Application of meta-analysis in reviewing occupational cohort studies. Occup Environ Med 53: 793-800.

    Google Scholar 

  15. Breslow N, Day N (1987) Statistical Methods in Cancer Research, vol. II: The Design and Analysis of Cohort Studies. Lyon: International Agency of Research on Cancer, pp. 71-72.

    Google Scholar 

  16. Greenland S (1993) A meta-analysis of coffee, myocardial infarction, and coronary death. Epidemiology 4: 366-374.

    Google Scholar 

  17. Nokso-Koivisto P, Pukkala E (1994) Past exposure to asbestos and combustion products and incidence of cancer among Finnish locomotive drivers. Occup Environ Med 51: 330-334.

    Google Scholar 

  18. Pang ZC, Zhang Z, Wang Y, Zhang H (1997) Mortality from a Chinese asbestos plant: overall cancer mortality. Am J Ind Med 32: 442-444.

    Google Scholar 

  19. Oksa P, Pukkala E, Karjalainen A, Ojajarvi A, Huuskonen MS (1997) Cancer incidence and mortality among Finnish asbestos sprayers and in asbestosis and silicosis patients. Am J Ind Med 31: 693-698.

    Google Scholar 

  20. Fletcher AC, Engholm G, Englund A (1993) The risk of lung cancer from asbestos among Swedish construction workers: self-reported exposure and a job exposure matrix compared. Int J Epidemiol 22: S29-S35.

    Google Scholar 

  21. Albin M, Jakobsson K, Attewell R, Johansson L, Welinder H (1990) Mortality and cancer morbidity in cohorts of asbestos cement workers and referents. Br J Ind Med 47: 602-610.

    Google Scholar 

  22. McDonald AD, Fry JS, Woolley AJ, McDonald JC (1984) Dust exposure and mortality in an American chrysotile asbestos friction products plant. Br J Ind Med 41: 151-157.

    Google Scholar 

  23. Moulin JJ, Wild P, Haguenoer J, et al. (1993) A mortality study among mild steel and stainless steel welders. Br J Ind Med 50: 234-243.

    Google Scholar 

  24. Rosler JA, Woitowitz HJ, Lange HJ, Woitowitz RH, Ulm K, Rodelsperger K (1994) Mortality rates in a female cohort following asbestos exposure in Germany. J Occup Med 36: 889-893.

    Google Scholar 

  25. Morinaga K, Hara I, Yasui I, Yokoyama K, Sera Y (1990) Twenty years' follow up study of asbestos workers [Japanese]. Sangyo Igaku 32: 265-268.

    Google Scholar 

  26. Hodgson JT, Jones RD (1986) Mortality of asbestos workers in England and Wales 1971–81. Br J Ind Med 43: 158-164.

    Google Scholar 

  27. Hughes JM, Weill H, Hammad YY (1987) Mortality of workers employed in two asbestos cement manufacturing plants. Br J Ind Med 44: 161-174.

    Google Scholar 

  28. Lash TL, Crouch EA, Green LC (1997) A meta-analysis of the relation between cumulative exposure to asbestos and relative risk of lung cancer. Occup Environ Med 54: 254-63.

    Google Scholar 

  29. Selikoff IJ, Seidman H (1991) Asbestos-associated deaths among insulation workers in the United States and Canada, 1967–1987. Ann NY Acad Sci 643: 1-14.

    Google Scholar 

  30. Frumkin H, Berlin J (1988) Asbestos exposure and gastrointestinal malignancy: review and meta-analysis [published erratum appears in Am J Ind Med 1988;14(4):493]. Am J Ind Med 14: 79-95.

    Google Scholar 

  31. Morgan RW (1991) Re: Meta-analysis of asbestos and gastrointestinal cancer [letter]. Am J Ind Med 19: 407-411.

    Google Scholar 

  32. Doll R, Peto J (1985) Effects On Health Of Exposure To Asbestos. London: Health and Safety Commision: Her Majesty's Stationery Office.

    Google Scholar 

  33. Newhouse ML, Wagner JC (1969) Validation of death certificates in asbestos workers. Br J Ind Med 26: 302-307.

    Google Scholar 

  34. Puntoni R, Vercelli M, Merlo F, Valerio F, Santi L (1979) Mortality among shipyard workers in Genoa, Italy. Ann NY Acad Sci 330: 353-377.

    Google Scholar 

  35. Giampalmo A, Canepa M, Quaglia AC (1976) Findings on the pathology of mesotheliomas and their morphological diagnosis [Italian]. Minerva Chir 31: 279-291.

    Google Scholar 

  36. Acheson ED, Gardner MJ, Pippard EC, Grime LP (1982) Mortality of two groups of women who manufactured gas masks from chrysotile and crocidolite asbestos: a 40-year follow-up. Br J Ind Med 39: 344-348.

    Google Scholar 

  37. Acheson ED, Gardner MJ, Winter PD, Bennett C (1984) Cancer in a factory using amosite asbestos. Int J Epidemiol 13: 3-10.

    Google Scholar 

  38. Alies-Patin A, Valleron A (1985) Mortality of workers in a French asbestos cement factory 1940–82. Br J Ind Med 42: 219-225.

    Google Scholar 

  39. Amandus H, Wheeler R (1987) The morbidity and mortality of vermiculite miners and millers exposed to tremolite-actinolite: Part II. Mortality. Am J Ind Med 11: 15-26.

    Google Scholar 

  40. Armstrong B, de Klerk N, Musk A, Hobbs M (1988) Mortality in miners and millers of crocidolite in western Australia. Br J Ind Med 45: 5-13.

    Google Scholar 

  41. Blasetti F, Bruno C, Comba P, Fantini F, Grignoli M (1990) Mortality study of workers employed in the contruction of railway cars in Collefero [Italian]. Med Lav 81: 407-413.

    Google Scholar 

  42. Clemmesen J, Hjalgrim-Jensen S (1981) Cancer incidence among 5686 asbestos-cement workers followed from 1943 through 1976. Ecotoxicol Environ Saf 5: 15-23.

    Google Scholar 

  43. Danielsen T, Langard S, Andersen A, Knudsen O (1993) Incidence of cancer among welders of mild steel and other shipyard workers. Br J Ind Med 50: 1097-1103.

    Google Scholar 

  44. Dement JM, Brown DP, Okun A (1994) Follow-up study of chrysotile asbestos textile workers: cohort mortality and case-control analyses. Am J Ind Med 26: 431-447.

    Google Scholar 

  45. Enterline PE, Hartley J, Henderson V (1987) Asbestos and cancer: a cohort followed up to death. Br J Ind Med 44: 396-401.

    Google Scholar 

  46. Finkelstein MM (1984) Mortality among employees of an Ontario asbestos-cement factory. Am Rev Respir Dis 129: 754-761.

    Google Scholar 

  47. Gardner MJ, Winter PD, Pannett B, Powell CA (1986) Follow up study of workers manufacturing chrysotile asbestos cement products. Br J Ind Med 43: 726-732.

    Google Scholar 

  48. Giaroli C, Belli S, Bruno C, et al. (1994) Mortality study of asbestos cement workers. Int Arch Occup Environ Health 66: 7-11.

    Google Scholar 

  49. Gurvich EB, Gladkova EV, Gutnikova OV, Kostiukovskaia AV, Kuzina LE, Saprykova V (1993) Epidemiology of chronic, precancerous and oncologic diseases in workers of asbestos and cement industry [Russian]. Med Tr Prom Ekol 5–6: 4-6.

    Google Scholar 

  50. Hilt B, Andersen A, Rosenberg J, Langard S (1991) Cancer incidence among asbestos-exposed chemical industry workers: an extended observation period. Am J Ind Med 20: 261-264.

    Google Scholar 

  51. Hobbs MS, Woodward SD (1980) The incidence of pneumoconiosis, mesothelioma and other respiratory cancer in men engaged in mining and milling crocidolite in Western Australia. IARC Sci Publ 30: 615-625.

    Google Scholar 

  52. Jones JS, Smith PG, Pooley FD, et al. (1980) The consequences of exposure to asbestos dust in a wartime gas-mask factory. IARC Sci Publ 30: 637-653.

    Google Scholar 

  53. Kolonel LN, Yoshizawa CN, Hirohata T, Myers BC (1985) Cancer occurrence in shipyard workers exposed to asbestos in Hawaii. Cancer Res 45: 3924-3928.

    Google Scholar 

  54. Lacquet LM, van der Linden L, Lepoutre J (1980) Reontgenographic lung changes, asbestosis and mortality in a Belgian asbestos-cement factory. IARC Sci Publ 30: 783-793.

    Google Scholar 

  55. Magnani C, Nardini I, Governa M, Serio A (1986) A cohort study of the personnel assigned to a state railroad repair shop [Italian]. Med Lav 77: 154-161.

    Google Scholar 

  56. Magnani C, Terracini B, Ivaldi C, Mancini A, Botta M (1996) Tumor mortality and from other causes in asbestos cement workers at the Casale Montferrato plant [Italian]. Med Lav 87: 133-146.

    Google Scholar 

  57. Mancuso TF, Coulter EJ (1963) Methodology in industrial health studies. Arch Environ Health 6: 210-226.

    Google Scholar 

  58. McDonald AD, Fry JS, Woolley AJ, McDonald JC (1982) Dust exposure and mortality in an American chrysotile textile plant. Br J Ind Med 40: 361-367.

    Google Scholar 

  59. McDonald AD, Fry JS, Woolley AJ, McDonald J (1983) Dust exposure and mortality in an American factory using chrysotile, amosite, and crocidolite in mainly textile manufacture. Br J Ind Med 40: 368-374.

    Google Scholar 

  60. Menegozzo M, Belli S, Bruno C, et al. (1993) Mortality due to causes correlatable to asbestos in a cohort of workers in railway car construction [Italian]. Med Lav 84: 193-200.

    Google Scholar 

  61. Meurman LO, Pukkala E, Hakama M (1994) Incidence of cancer among anthophyllite asbestos miners in Finland. Occup Environ Med 51: 421-425.

    Google Scholar 

  62. Neuberger MM, Kundi M (1990) Individual asbestos exposure: smoking and mortality — a cohort study in the asbestos cement industry. Br J Ind Med 47: 615-620.

    Google Scholar 

  63. Newhouse ML, Oakes D, Woolley AJ (1985) Mortality of welders and other craftsmen at a shipyard in NE England. Br J Ind Med 42: 406-410.

    Google Scholar 

  64. Ohlson CG, Klaesson B, Hogstedt C (1984) Mortality among asbestos-exposed workers in a railroad workshop. Scand J Work Environ Health 10: 283-291.

    Google Scholar 

  65. Ohlson CG, Hogstedt C (1985) Lung cancer among asbestos cement workers. A Swedish cohort study and a review. Br J Ind Med 42: 397-402.

    Google Scholar 

  66. Piolatto G, Negri E, La Vecchia C, Pira E, Decarli A, Peto J (1990) An update of cancer mortality among chrysotile asbestos miners in Balangero, northern Italy. Br J Ind Med 47: 810-814.

    Google Scholar 

  67. Raffn E, Villadsen E, Lynge E (1996) Colorectal cancer in asbestos cement workers in Denmark. Am J Ind Med 30: 267-272.

    Google Scholar 

  68. Robinson C, Lemen R, Wagoner JK (1979) Mortality patterns 1940–1975 among workers employed in an asbestos textile friction and packing products manufacturing facility. Dusts and Disease: Proceedings of the Conference on Occupational Exposures to Fibrous and Particulate Dust and Their Extension into the Environment. Pathotox Publishers Park Forest South Ill.: p. 131-143

  69. Rossiter CE, Coles RM (1980) HM Dockyard, Devonport: 1947 mortality study. IARC Sci Publ 30: 713-721.

    Google Scholar 

  70. Sanden A, Jarvholm B, Larsson S, Thiringer G (1992) The risk of lung cancer and mesothelioma after cessation of asbestos exposure: a prospective cohort study of shipyard workers. Eur Respir J 5: 281-285.

    Google Scholar 

  71. Seidman H, Selikoff IJ, Gelb SK (1986) Mortality experience of amosite factory workers: dose-response relationships 5 to 40 years after onset of short-term work exposure. Am J Ind Med 10: 479-514.

    Google Scholar 

  72. Slius-Cremer GK, Liddell FD, Logan WP, Bezuidenhout BN (1992) The mortality of amphibole miners in South Africa, 1946–1980. Br J Ind Med 49: 566-575.

    Google Scholar 

  73. Szeszenia-Dabrowska N, Wilczynska U, Szymczak W (1986) Risk of cancer in women occupationally exposed to asbestos dust [Polish]. Med Pr 37: 243-249.

    Google Scholar 

  74. Szeszenia-Dabrowska N, Wilczynska U, Kaczmarek T, Szymczak W (1991) Evaluation of the cancer risk among men exposed to occupational asbestos dust based on cohort studies [Polish]. Med Pr 42: 419-429.

    Google Scholar 

  75. Tarchi M, Orsi D, Comba P, et al. (1994) Cohort mortality study of rock salt workers in Italy. Am J Ind Med 25: 251-256.

    Google Scholar 

  76. Teta MJ, Ott MG (1988) A mortality study of a research, engineering and metal fabrication facility in western New York State. Am J Epidemiol 127: 540-551.

    Google Scholar 

  77. Thomas HF, Benjamin IT, Elwood PC, Sweetnam PM (1982) Further follow-up study of workers from an asbestos cement factory. Br J Ind Med 39: 273-276.

    Google Scholar 

  78. Tola S, Kalliomaki PL, Pukkala E, Asp S, Korkala ML (1988) Incidence of cancer among welders, platers, machinists and pipe fitters in shipyards and machine shops. Br J Ind Med 45: 209-218.

    Google Scholar 

  79. Ward EM, Ruder AM, Suruda A, et al. (1994) Cancer mortality patterns among female and male workers employed in a cable manufacturing plant during World War II. J Occup Med 36: 860-866.

    Google Scholar 

  80. Weiss W (1977) Mortality of a cohort exposed to chrysotile asbestos. J Occup Med 19: 737-740.

    Google Scholar 

  81. Woitowitz HJ, Lange HJ, Beierl L, et al. (1986) Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust. Int Arch Occup Environ Health 57: 161-171.

    Google Scholar 

  82. Meurman LO, Kiviluoto R, Hakama M (1974) Mortality and morbidity among the working population of anthophyllite asbestos miners in Finland. Br J Ind Med 31: 105-112.

    Google Scholar 

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Authors and Affiliations

  1. Exponent Health Group, 8201 Corporate Drive, Suite 680, Landover, MD, 20785, USA (

    Michael Goodman & Curtis D. Malloy

  2. Exponent Health Group, Menlo Park, CA, USA

    Robert W. Morgan & Ke Zhao

  3. Exponent Failure Analysis Associates, Menlo Park, CA, USA

    Rose Ray

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  1. Michael Goodman
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  2. Robert W. Morgan
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Correspondence to Michael Goodman.

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Goodman, M., Morgan, R.W., Ray, R. et al. Cancer in asbestos-exposed occupational cohorts: a meta-analysis. Cancer Causes Control 10, 453–465 (1999). https://doi.org/10.1023/A:1008980927434

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