Asbestos and cancer: An overview of current trends in Europe

Our plain-English summary of Asbestos and cancer: An overview of current trends in Europe, by M. Albin, C. Magnani, S. Krstev, et al (Environmental Health Perspectives, 1999).

The study

• Authors: M. Albin, C. Magnani, S. Krstev, E. Rapiti, I. Shefer
• Journal: Environmental Health Perspectives
• Published: 1999;107 Suppl 2(Suppl 2):289-98
• Type of article: Review
• Cited by: 92 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

This review assesses the contribution of occupational asbestos exposure to the occurrence of mesothelioma and lung cancer in Europe. Available information on national asbestos consumption, proportions of the population exposed, and exposure levels is summarized. Population-based studies from various European regions on occupational asbestos exposure, mesothelioma, and lung cancer are reviewed. Asbestos consumption in 1994 ranged, per capita, between 0. 004 kg in northern Europe and 2.4 kg in the former Soviet Union. Population surveys from northern Europe indicate that 15 to 30% of the male (and a few percent of the female) population has ever had occupational exposure to asbestos, mainly in construction (75% in Finland) or in shipyards. Studies on mesothelioma combining occupational history with biologic exposure indices indicate occupational asbestos exposure in 62 to 85% of the cases. Population attributable risks for lung cancer among males range between 2 and 50% for definite asbestos exposure. After exclusion of the most extreme values because of methodologic aspects, most of the remaining estimates are within the range of 10 to 20%. Estimates of women are lower. Extrapolation of the results to national figures would decrease the estimates. Norwegian estimates indicate that one-third of expected asbestos-related lung cancers might be avoided if former asbestos workers quit smoking. The combination of a current high asbestos consumption per capita, high exposure levels, and high underlying lung cancer rates in Central Europe and the former Soviet Union suggests that the lung cancers will arise from the smoking-asbestos interaction should be a major concern.

In plain English

This 1999 article was a review of how much occupational asbestos exposure contributed to mesothelioma and lung cancer in Europe. The authors summarized data on asbestos consumption and exposure levels and reviewed population-based European studies. Per-capita consumption in 1994 ranged between 0.004 kg in Northern Europe and 2.4 kg in the former Soviet Union. Mean concentrations above 1 f/ml were still found in Central Europe and the former Soviet Union. Estimates of the share of men ever exposed at work ranged from 14 to 36%. Estimates for women were "about one magnitude lower". Studies combining work histories with lung fiber analyses indicated occupational exposure in 62 to 85% of mesothelioma cases. Estimates of the share of lung cancer attributable to asbestos ranged from 1.8% (U.K.) to 53% (Italy). After outliers were excluded, eight studies of men gave 5.7 to 19% for definite exposure. A Norwegian estimate suggested about one-third of expected asbestos-related lung cancers could be prevented if exposed current smokers quit. The authors called the outlook for Central Europe and Russia alarming. They noted that most studies covered areas above national averages and only men.

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: Review (overview of European data and published population-based studies)
• Who was studied: European countries and regions. Reviewed studies came mainly from Italy, the U.K., Sweden, Norway, Finland, the Netherlands and France, and covered lung cancer and mesothelioma cases and controls, mostly men.
• Exposure: Occupational asbestos exposure, including mining, manufacturing (mainly asbestos cement) and downstream use such as construction and shipyards. The article lists chrysotile, amosite, crocidolite, anthophyllite and tremolite.
• Main results:
  • Per-capita asbestos consumption in 1994 ranged between 0.004 kg (Northern Europe) and 2.4 kg (former Soviet Union).
  • Mean concentrations above 1 f/ml were still found in asbestos production and use in Central Europe and the former Soviet Union.
  • Estimates of the proportion of men with occupational asbestos exposure ranged from 14 to 36%. Estimates for women were about one magnitude lower.
  • Mesothelioma: studies combining occupational history with lung fiber analyses indicated occupational asbestos exposure in 62 to 85% of cases.
  • Lung cancer: across the reviewed studies, population attributable risk estimates ranged from 1.8% (U.K.) to 53% (Italy).
  • Lung cancer in men, outliers excluded: eight studies gave population attributable risks for definite asbestos exposure between 5.7 and 19%. Six of them gave 14 to 19%. Estimates covering both sexes ranged from 6.7 to 14%.
  • The population-based studies, where downstream exposures prevail, gave higher lung cancer risk estimates than expected from mining and manufacturing cohort studies.
  • A Norwegian estimate covered 3250 expected asbestos-associated lung cancer cases in 1995 to 2015. It found that approximately one-third could be prevented if exposed current smokers quit smoking.
• The authors' conclusion: The authors concluded that future asbestos-related lung cancer depends on consumption and exposure levels, underlying lung cancer rates and smoking. They called the outlook for Central Europe and Russia alarming. They noted that reducing smoking does not prevent mesothelioma.
• Limitations the authors state:
  • Most reviewed studies were done in areas with above-average lung cancer incidence or asbestos exposure, and were restricted to males.
  • Exposure was usually self-reported or reported by next of kin, which likely lacks precision.
  • National estimates are hard to derive from regional studies.
  • No dose-response studies for lung cancer were available for downstream use.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Mesothelioma, Lung Cancer, Occupational Exposure, Occupational History, Population Attributable Fraction (PAF).

Related studies

• Occupational diseases in Poland--an overview of current trends — N. Szeszenia-Dąbrowska, U. Wilczyńska (2013)
• Pleural mesothelioma incidence in Europe: evidence of some deceleration in the increasing trends — F. Montanaro, F. Bray, et al. (2003)
• A cross-country comparative overview of the asbestos situation in ten Asian countries — K. Takahashi, A. Karjalainen (2003)
• Mesothelioma risk and environmental exposure to asbestos: past and future trends in Japan — K. Azuma, I. Uchiyama, et al. (2009)
• Occupational exposures and colorectal cancers: a quantitative overview of epidemiological evidence — E. Oddone, C. Modonesi, et al. (2014)
• Mesothelioma mortality in Europe: impact of asbestos consumption and simian virus 40 — K. Leithner, A. Leithner, et al. (2006)

Browse more research in Environmental Health Perspectives, or return to medical research.