A case-referent study of lung tumors in non-asbestos textile workers

Our plain-English summary of A case-referent study of lung tumors in non-asbestos textile workers, by E. Paci, E. Buiatti, M. Geddes (American Journal of Industrial Medicine, 1987).

The study

• Authors: E. Paci, E. Buiatti, M. Geddes
• Journal: American Journal of Industrial Medicine
• Published: 1987;11(3):267-73
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000991).

Abstract

A case series in the Province of Florence showed an increased risk of mesothelioma in textile workers (nonasbestos) and a survey of working conditions confirmed potential exposure to asbestos. In order to investigate the risk in textile workers, including some specific job titles, a case-referent study on lung tumors was carried out. The lung cancer cases included 441 males with histologically confirmed primary lung cancer during the period 1980-1983. Referents included 1,075 males selected from two hospitals and matched for age, sex, and smoking habits. Those who had "ever worked" in the textile industry showed an adjusted odds ratio of 1.52 (95% C.I. 1-2.25) compared with other "industrial workers." This moderately increased risk is maintained in selected jobs in the textile industry. An analysis of the modifying effect of time factors showed an increased risk in the period of 15-35 years from the date of first employment in the industry. The results support the hypothesis that a probable risk of lung cancer in textile workers in the Prato area was related to asbestos exposure.

In plain English

This case-referent study asked whether men who had worked in the textile industry (non-asbestos) around Prato, near Florence, Italy, had a higher risk of lung cancer. An earlier study had found more mesothelioma among such workers, and a survey had suggested possible asbestos exposure. The cases were 441 men with histologically confirmed primary lung cancer admitted to a Florence hospital from 1980 to 1983. The 1,075 male referents came from two hospitals and were matched by sex, age and smoking habits. Nurses collected job histories by questionnaire. Men who had ever worked in the textile industry had an adjusted odds ratio of 1.52 (95% CI 1.01 to 2.25) compared with other industrial workers. Compared with all referents the odds ratio was 1.39 (0.94 to 2.05). Compared with industrial workers who had never worked in textiles, men with 15 to 24 years in the industry had an odds ratio of 2.35 (1.15 to 4.78). The authors concluded that their results suggested Prato textile workers had suffered continuing exposure to lung carcinogens during the past 30 years. They noted that causes other than asbestos could not be excluded.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Hospital-based case-referent (case-control) study
• Who was studied: The cases were 441 men with histologically confirmed primary lung cancer. They lived in the metropolitan area of Florence or the Prato area and were admitted to Santa Maria Nuova Hospital from 1980 to 1983. The referents were 1,075 men from two hospitals (Santa Maria Nuova and Prato), matched by sex, age and smoking habits.
• Exposure: The exposure was work in the textile industry (non-asbestos), measured two ways: as 'prevalent occupation' (the job held longest) or as 'ever worked occupation'. Textile workers were compared with all referents and with other 'industrial workers'. Jobs were grouped as rag-sorting, weaving and refining (possibly exposed to asbestos, according to a 1985 survey) and as dyeing.
• Main results:
  • Men who had 'ever worked' in the textile industry, compared with other industrial workers, had a base logistic model odds ratio of 1.52 (95% CI 1.01-2.25).
  • Men who had 'ever worked' in the textile industry, compared with all referents, had a base logistic model odds ratio of 1.39 (95% CI 0.94-2.05).
  • Men whose 'prevalent occupation' was textile work, compared with other industrial workers, had a base logistic model odds ratio of 1.43 (95% CI 0.92-2.22).
  • Clerical workers and dyers were then excluded as 'never exposed'. The remaining textile workers, compared with other industrial workers, had an adjusted odds ratio of 1.49 (95% CI 0.98-2.25).
  • Odds ratios by length of time worked in the textile industry were calculated against industrial workers who had never worked in textiles, with non-industrial 'others' excluded. Men who had worked 15-24 years had an adjusted odds ratio of 2.35 (1.15-4.78), from 16 cases and 21 referents. Men who had worked less than 15 years had 0.96 (0.47-1.93). Men who had worked 25-34 years had 1.88 (0.93-3.78). Men who had worked 35 years or more had 1.44 (0.79-2.62).
  • Men whose first textile employment was 15-24 years earlier and who had worked 15-24 years had an odds ratio of 3.00 (95% CI 1.12-8.00), from 8 cases and 10 referents. The comparison group was never-exposed industrial workers.
  • The authors reported that comparisons with the whole group of referents or with a subgroup did not show significant differences.
• The authors' conclusion: The authors concluded that their results suggest Prato textile workers suffered continuing exposure to lung carcinogens during the past 30 years. They said new cases among exposed workers are likely to appear in the future, even though asbestos was no longer used after the 1985 survey.
• Limitations the authors state:
  • Asbestos could explain the increased risk, but the authors stated that other industrial factors, or asbestos interacting with other dusts or fibers, cannot be excluded.
  • The referents were hospital patients. Whether a person is admitted to hospital could depend on socio-economic and cultural factors, which may affect how comparable the groups are.
  • Time since first employment and duration of work are strongly correlated and can easily be confused.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestos textiles, Lung cancer.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Cancer, Habit, Odds Ratio, Asbestos Exposure.

Related studies

• Malignant mesothelioma in non-asbestos textile workers in Florence — E. Paci, S. Dini, et al. (1987)
• An asbestos hazard in the reprocessed textile industry — M.M. Quinn, D. Kriebel, et al. (1987)
• Exposure-specific lung cancer risks in Chinese chrysotile textile workers and mining workers — X. Wang, S. Lin, et al. (2014)
• Follow-up study of chrysotile asbestos textile workers: cohort mortality and case-control analyses — J.M. Dement, D.P. Brown, et al. (1994)
• Lung cancer mortality in North Carolina and South Carolina chrysotile asbestos textile workers — L. Elliott, D. Loomis, et al. (2012)
• Lung cancer mortality among asbestos textile workers: a review and update — J.M. Dement, D.P. Brown (1994)

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