Cancer incidence among 5686 asbestos-cement workers followed from 1943 through 1976

Our plain-English summary of Cancer incidence among 5686 asbestos-cement workers followed from 1943 through 1976, by J. Clemmesen, S. Hjalgrim-Jensen (Ecotoxicology and Environmental Safety, 1981).

The study

• Authors: J. Clemmesen, S. Hjalgrim-Jensen
• Journal: Ecotoxicology and Environmental Safety
• Published: 1981;5(1):15-23
• Cited by: 39 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. 000730).

In plain English

This study followed men who had worked at Dansk Eternit-Fabrik Ltd., an asbestos-cement factory in Aalborg, Denmark. Of 6372 men employed since 1943, 5686 had worked in jobs exposing them to asbestos. The factory used mainly chrysotile, with smaller amounts of amosite and crocidolite. The men were followed through the national cancer registry to December 1976 or death. Their cancer cases were compared with numbers expected for men in Danish provincial towns. Among exposed workers, 167 cancers were observed against 151.13 expected, an excess the authors called not significant. Nonexposed staff had 20 against 20.64. Exposed workers had 47 lung cancers against 27.31 expected (the table notes 3 mesotheliomas in this row). They also had 6 cancers of the larynx and trachea against 2.88, 14 stomach cancers against 9.72, and 14 prostate cancers against 7.67. Urinary system and skin cancers were below expectation. The authors saw no rising trend, which gave an impression of moderate risk, but concluded that some risk had existed. They considered the stomach excess medically doubtful and said the prostate excess needs confirmation.

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: Cohort study of cancer incidence (observed versus expected cases), using factory payrolls, population registers and the national cancer registry
• Who was studied: 6372 men employed at an asbestos-cement factory (Dansk Eternit-Fabrik Ltd., Aalborg, Denmark) since 1943, of whom 5686 were in jobs exposing them to asbestos; followed to December 1976 or death. Expected numbers were based on rates for men in Danish provincial towns.
• Exposure: Work in asbestos-cement production. 'Exposed' meant having at some time worked with asbestos cement, noncombustible boards, handling and storage of products or asbestos, transport, cleaning, repair or experimental procedures. The factory used chrysotile, with smaller amounts of crocidolite and amosite. Asbestos was replaced with cellulose during 1940-1945.
• Main results:
  • All cancer sites, exposed workers: 167 cases observed against 151.13 expected (ratio 1.11), not significant.
  • All cancer sites, nonexposed staff: 20 cases against 20.64 expected.
  • Lung, exposed workers: 47 cases against 27.31 expected, described as significant. The table row is labelled as including 3 mesotheliomas.
  • Exposed workers had fewer cases than expected for the urinary system (including bladder papilloma), 12 against 16.35, and for skin, 16 against 19.42.
  • Larynx (and trachea), exposed workers: 6 cases against 2.88 expected. The excess was significant at the 5% level only if the nonexposed staff were included.
  • Stomach, exposed workers: 14 cases against 9.72 expected, which the authors said should be significant. They judged it medically doubtful because 5 of the cases occurred within the first 5 years of employment.
  • Prostate, exposed workers: 14 cases against 7.67 expected, described as a significant excess without precedent.
  • Penis, exposed workers: a nonsignificant excess (2 cases against 0.67 expected in Table 6) that the authors said requires confirmation.
  • No rising trend was seen over the period observed.
• The authors' conclusion: The authors concluded that the lack of a rising trend suggested a moderate risk, but that the site-by-site analysis showed some risk had existed. They considered it probable that some laryngeal cancers in the cohort were related to asbestos exposure, and said this might also apply to stomach cancer.
• Limitations the authors state:
  • The prostate excess requires further confirmation before it can be accepted as generally valid.
  • The stomach cancer excess is medically doubtful because 5 cases occurred within the first 5 years of employment.
  • The larynx result rests on small numbers.
  • Smoking data, taken from workers at one of the cement factories in Aalborg, showed that workers smoked more often than other men in the city.
  • The fiber measurements were not time-weighted averages; they aimed to reflect the highest level at each job.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos-Cement.

Related studies

• Incidence of cancer and mortality among employees in the asbestos cement industry in Denmark — E. Raffn, E. Lynge, et al. (1989)
• Mortality and cancer morbidity in cohorts of asbestos cement workers and referents — M. Albin, K. Jakobsson, et al. (1990)
• Mortality of workers in a French asbestos cement factory 1940-82 — A.M. Alies-Patin, A.J. Valleron (1985)
• Incidence of lung cancer by histological type among asbestos cement workers in Denmark — E. Raffn, E. Lynge, et al. (1993)
• Cancer incidence among mild steel and stainless steel welders and other metal workers — K.S. Hansen, J.M. Lauritsen, et al. (1996)
• Cancer risk after cessation of asbestos exposure: a cohort study of Italian asbestos cement workers — C. Magnani, D. Ferrante, et al. (2008)

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