Journal of Occupational and Environmental Medicine

Our medical research library holds 109 studies published in Journal of Occupational and Environmental Medicine (1995–2026). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 94 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 2 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: Lippincott Williams & Wilkins
• Published: 1995 to the present, United States
• Language: English
• ISSN: 1076-2752 (print), 1536-5948 (electronic)
• Continues: Journal of Occupational Medicine
• Its record in the NLM Catalog

2020s

• Mortality Update of a US Cohort of Workers in Petrochemical and Refinery Operations. M. Korre, E.M. Gallagher, M.A. Bach, et al. 2026;68(9):740-755. PubMed · Publisher · Free full text

  Abstract

  Objective: This study updates mortality trends of over 214,000 men and women working in various petrochemical and refinery operations of a US-based company through December 31, 2020.

  Methods: Standardized mortality ratios (SMRs) and 95% confidence intervals were calculated for 112 possible causes of death studied.

  Results: SMRs for malignant mesothelioma are highest among men hired during the 1940s and 1950s. Increased SMRs are observed for Parkinson's disease and brain cancer in some subgroups with no consistent occupational pattern. Decreasing mortality trends observed for asbestosis, leukemias, motor neuron diseases, brain cancer in upstream men, and breast cancer among non-White women.

  Conclusions: Updates of the mortality surveillance of this large, established cohort are useful in evaluating the chronic health status of this workforce. Additional follow-up time provides the statistical power to clarify earlier findings.

  Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of the American College of Occupational and Environmental Medicine.

• Asbestos Exposure in Low-Middle Income Communities of Cartagena, Colombia: A Survey of Knowledge, Practices, and Environmental Contamination. G. Villamizar, A. Frank, P. Bizzi Junqueira, et al. 2025;67(10):e708-e719. PubMed · Publisher · Free full text

  Abstract

  Objective: The aim of the study was to assess community knowledge, practices, and environmental risks associated with residential asbestos exposure in low-middle income neighborhoods of Cartagena, Colombia.

  Methods: In a cross-sectional survey, 305 residents from 30 asbestos-affected neighborhoods completed questionnaires on asbestos knowledge and practices. Environmental samples (roofing, dust, and water) were analyzed for asbestos fibers.

  Results: Asbestos-cement roofing was present in 87.5% of homes. While 55.8% recognized asbestos hazards, 52% routinely disturbed asbestos materials, and informal disposal was common. Socially embedded practices, such as repurposing asbestos sheets and improper disposal were common. Asbestos fibers were found in 90% of dust samples and 85% of rainwater samples.

  Conclusions: Residential asbestos exposure remains a major health risk in these communities. Mitigation requires not only education but also improved policies for safe removal and replacement of asbestos materials.

  Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.

• Use of Geological Maps in Detecting Asbestos-Related Diseases; A New Region in Anatolia. H. Ogun, A. Kansu, Z.E. Kansu, et al. 2024;66(9):e407-e412. PubMed · Publisher

  Abstract

  Objective: To examine the potential relationship between the presence of asbestos-related diseases (ARDs) in the region of Kastamonu, Turkey.

  Methods: The places of birth of patients with ARDs and control subjects diagnosed between 2008 and 2019 and identified in a tertiary hospital in Istanbul. Soil samples were taken from plaster surfaces and quarries. The analysis was done with transmission electron microscopy.

  Results: ARDs was detected in 55(17.9%) of 307 participants. Patients had a mean age of 68 ± 11 years. Residential proximity to ophiolites increased ARD incidence by 6.2% per kilometer ( P = 0.003). Birthplaces were identified as being inside an ophiolitic unit, or if they were not, the Google Earth software was used to determine the beeline distance between the settlement's center and the edge of the closest ophiolitic unit. The appropriate threshold for this case is 12.75 km, with 75% sensitivity and 87% specificity.

  Conclusion: ARDs due to naturally occurring asbestos (NOA) are present in hitherto unknown places. Geological maps including ophiolites can help locate these places.

  Copyright © 2024 American College of Occupational and Environmental Medicine.

• Comorbidities and Causes of Death of Patients With Asbestosis. E. Keskitalo, J. Salonen, H. Nurmi, et al. 2023;65(4):349-353. PubMed · Publisher

  Abstract

  Objective: Comorbidities are common and affect the prognosis of patients with interstitial lung diseases, but few previous studies have investigated patients with asbestosis.

  Methods: We collected comorbidities and death causes of 116 patients with asbestosis treated in Oulu University Hospital. Causes of death were confirmed by autopsy in 68% of the cases.

  Results: The most common comorbidities of asbestosis patients were pleural plaques (96%) and coronary artery disease (CAD; 67%). The prevalence of rheumatoid arthritis was 8.6%. The most common underlying causes of death were asbestosis (36%), CAD (24%), and lung cancer (LC) (10%). CAD and LC were associated with shorter survival in adjusted analyses.

  Conclusions: Patients with asbestosis have multiple comorbidities. Prevention and treatment of CAD and LC may influence the prognosis of asbestosis patients.

  Copyright © 2022 American College of Occupational and Environmental Medicine.

• Response to the Letter to the Editor From Jeffrey Brent, MD, PhD. Re: Mesothelioma Associated With the Use of Cosmetic Talc. J. Moline. 2023;65(5):e361. Comment · Letter PubMed · Publisher

• Low Levels of Exposure to Libby Amphibole Asbestos and Localized Pleural Thickening: Erratum. 2022;64(10):896. PubMed · Publisher

• Mortality of 196,826 Men and Women Working in U.S.-Based Petrochemical and Refinery Operations: Update 1979 to 2010. N.C. Wojcik, E.M. Gallagher, M.S. Alexander, et al. 2022;64(3):250-262. PubMed · Publisher · Free full text

  Abstract

  Objective: To describe mortality trends of men and women working in various petrochemical and refinery operations of a U.S.-based company.

  Methods: The cohort consists of full-time employees with at least 1 day of service during 1979 through 2010. Standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated for 111 possible causes of death studied.

  Results: SMRs for malignant mesothelioma and asbestosis were highest for the 1940s decade of hire. Increased SMRs were observed for malignant melanoma and motor neuron disease with no obvious work patterns. Decreasing mortality patterns were observed for aplastic anemia and acute nonlymphocytic leukemia.

  Conclusions: Mortality surveillance of this large established cohort aids in assessing the chronic health status of the workforce. Identifying methods for incorporating job-exposure matrices and nonoccupational risk factors could further enhance interpretations for some findings such as motor neuron disease.

  Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.

• Past Asbestos Exposure in Rolling Stock Manufacturing in the Absence of Environmental Monitoring: An Original Method. S. Silvestri, C. Ciapini, A. Innocenti. 2022;64(10):e635-e640. PubMed · Publisher

  Abstract

  Objective: The aim of this study is the reconstruction of asbestos exposure in absence of environmental monitoring data, to use the results in a cohort study of railway rolling stock workers.

  Methods: To reconstruct past exposures, the production data (number of rolling stock and asbestos content) and working methods were reconstructed with former employees and company documentation, literature data, and author expertise.

  Results: The result of the work is a job/exposure matrix from 1956 to 1979, when sprayed asbestos was used as insulator of the metal bodies. Annual exposure estimate varies from 0.08 to 4.9 fb/mL depending on the specific jobs. Thirty-one mesotheliomas with occupational exposure, one with environmental and one with family exposures, were identified.

  Conclusions: The originality of the study consists on the use of company production data to establish frequency duration of asbestos exposure.

  Copyright © 2022 American College of Occupational and Environmental Medicine.

• Updated Standardized Mortality Ratio Evaluation of Disease Risks of Shipyard Workers Exposed to Low Dose Ionizing Radiation. X.G. Tao, F.C. Curriero, E.M. Chee, et al. 2022;64(4):e224-e230. PubMed · Publisher

  Abstract

  Objective: To examine the risk of diseases among industrial workers with low and fractionated radiation exposures.

  Method: The 372,047 US male shipyard radiation and non-radiation workers were followed for 54 years and compared with US men using standardized mortality ratio (SMR) method.

  Results: SMRs for both radiation and non-radiation workers had lower risks of death from all causes (0.74; 95% confidence interval [CI] 0.74 to 0.75 and 0.77; 95% Cl 0.77 to 0.78, respectively) and from all cancers (0.92; 95% CI 0.91 to 0.93 and 0.90; 95% CI 0.89 to 0.91, respectively) compared with US men. Asbestos-related diseases including pleural cancers, mesothelioma, and asbestosis, but not lung cancers, were statistically higher in both radiation and non-radiation workers compared with the US men.

  Conclusion: US shipyard male radiation and non-radiation workers did not show any elevated mortality risks that might be associated with radiation exposure.

  Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.

• Effect of Asbestos Exposure on the Frequency of EGFR Mutations and ALK/ROS1 Rearrangements in Patients With Lung Adenocarcinoma: A Multicentric Study. S. Yilmaz, N.Y. Demirci, S. Metintas, et al. 2021;63(3):238-243. PubMed · Publisher

  Abstract

  Objective: The aim of this study is to investigate the effect of asbestos exposure on cancer-driver mutations.

  Methods: Between January 2014 and September 2018, epidermal growth factor receptor (EGFR), anaplastic lymphoma receptor tyrosine kinase (ALK), and c-ros oncogene 1 receptor tyrosine kinase gene (ROS1) alterations, demographic characteristics, asbestos exposure, and asbestos-related radiological findings of 1904 patients with lung adenocarcinoma were recorded.

  Results: The frequencies of EGFR mutations, ALK, and ROS1 rearrangements were 14.5%, 3.7%, and 0.9%, respectively. The rates of EGFR mutations and ALK rearrangements were more frequent in asbestos exposed non-smokers (48.7% and 9%, respectively). EGFR mutation rate was correlated to female gender and not-smoking, ALK rearrangement rate was correlated to younger age, not-smoking, and a history of asbestos exposure.

  Conclusions: The higher rate of ALK rearrangements in asbestos-exposed lung adenocarcinoma cases shows that asbestos exposure may most likely cause genetic alterations that drive pulmonary adenocarcinogenesis.

  Copyright © 2020 American College of Occupational and Environmental Medicine.

• Authors' Response to "Evidence Does Not Support Exposure to Cosmetic Talc as a Cause of Malignant Mesothelioma". J. Moline, K. Bevilacqua, R.E. Gordon. 2020;62(2):e85-e86. Letter · Comment PubMed · Publisher

• Evidence Does Not Support Exposure to Cosmetic Talc as Cause of Malignant Mesothelioma. S.J. Geyer. 2020;62(2):e83-e84. Letter · Comment PubMed · Publisher

• Follow-Up of the Libby, Montana Screening Cohort: A 17-Year Mortality Study. T.C. Larson, L. Williamson, V.C. Antao. 2020;62(1):e1-e6. PubMed · Publisher · Free full text

  Abstract

  Objective: To evaluate mortality patterns among participants in a community-based screening program for asbestos-related disease.

  Methods: We calculated standardized mortality ratios (SMRs) and stratified results by exposure group (three occupational exposure groups, household contacts and residents without occupational asbestos exposure) and by radiographic abnormality presence.

  Results: All-cause mortality (15.8%; 1,429/8,043) was statistically lower than expected. Asbestosis was statistically elevated in all exposure groups. Lung cancer was moderately associated with vermiculite miner/miller employment. Mesothelioma was elevated in that same exposure group and among residents. Systemic autoimmune disease mortality was also elevated. Radiographic parenchymal abnormalities were associated with lung cancer mortality.

  Conclusion: In addition to asbestos-related mortality in occupational exposure groups, this initial follow-up of this cohort also shows elevated mortality for some asbestos-related causes in non-occupational exposure groups.

• Follow-Up of the Libby, Montana Screening Cohort: A 17-Year Mortality Study: Likely Underestimation of Nonmalignant Asbestos-Related Disease. A. Miller, G.M. Loewen, J. Szeinuk. 2020;62(5):e233-e234. Letter · Comment PubMed · Publisher

• Mesothelioma Associated With the Use of Cosmetic Talc. J. Moline, K. Bevilacqua, M. Alexandri, et al. 2020;62(1):11-17. PubMed · Publisher

  Abstract

  Objective: To describe 33 cases of malignant mesothelioma among individuals with no known asbestos exposure other than cosmetic talcum powder.

  Methods: Cases were referred for medico-legal evaluation, and tissue digestions were performed in some cases. Tissue digestion for the six cases described was done according to standard methodology.

  Results: Asbestos of the type found in talcum powder was found in all six cases evaluated. Talcum powder usage was the only source of asbestos for all 33 cases.

  Conclusions: Exposure to asbestos-contaminated talcum powders can cause mesothelioma. Clinicians should elicit a history of talcum powder usage in all patients presenting with mesothelioma.

• Response to 'Follow-Up of the Libby, Montana Screening Cohort: A 17-year Mortality Study: Likely Underestimation of Nonmalignant Asbestos-Related Disease'. T.C. Larson, L. Williamson, V.C. Antao. 2020;62(5):e235. Letter · Comment PubMed · Publisher · Free full text

• Serous Ovarian Cancer Caused by Exposure to Asbestos and Fibrous Talc in Cosmetic Talc Powders-A Case Series. J.E. Steffen, T. Tran, M. Yimam, et al. 2020;62(2):e65-e77. PubMed · Publisher

  Abstract

  Objective: Asbestos is a known cause of ovarian cancer. We report 10 cases of serous ovarian cancer among users of Johnson & Johnson (J&J) asbestos-containing "cosmetic" talc products.

  Methods: We conducted an asbestos exposure assessment during talc application and analyzed surgical tissues and talc containers for asbestos and talc.

  Results: Talc was found in all cases and tremolite and/or anthophyllite asbestos was found in 8/10 cases. The asbestos fibers found in the "cosmetic" talc containers matched those found in tissues. We estimated inhaled asbestos dose ranged from 0.38 to 5.18 fiber years.

  Conclusion: We provide evidence that the inhaled dose of asbestos/fibrous talc from "cosmetic" talc use causes ovarian cancer. The unique combination of the types of asbestiform minerals detected in cancerous tissue and "cosmetic" talc is a fingerprint for exposure to asbestos-containing talc.

2010s

• Laryngeal Lavage: A Potential Method of Evaluation of Amphibole Fiber Exposure. M. Germine, J.H. Puffer. 2019;61(6):525-528. PubMed · Publisher

  Abstract

  Objective: Our objective is to propose a simple procedure for evaluating potential recent heavy exposure to tremolite.

  Methods: One day after an accidental exposure to tremolite in rock dust, sputum was sampled; 3 months later a laryngeal lavage was taken. The sputum was examined with scanning electron microscopy (SEM); the lavage was examined with transmission electron microscopy (TEM).

  Results: The sputum was found to contain abundant tremolite while the lavage contained very thin, high aspect-ratio fibers, many in the "Stanton Fiber" range. The abundance of tremolite from the larynx suggests accumulation. The thin fibers exhibit splitting from thicker fibers that were in the lungs.

  Conclusions: Laryngeal lavage may be an important index of asbestos exposure and is a less complex and more diagnostic alternative to bronchoalveolar lavage or sputum sampling.

• Mortality for Mesothelioma and Lung Cancer in a Cohort of Asbestos Cement Workers in BARI (Italy): Time Related Aspects of Exposure. F. Cuccaro, A.M. Nannavecchia, S. Silvestri, et al. 2019;61(5):410-416. PubMed · Publisher

  Abstract

  Objective: In this cohort mortality study we used an exposure index to evaluate individual cumulative exposure as proxy of asbestos dose and we evaluated change in cancer mortality pattern after long time since the end of exposure.

  Methods: We calculated standardized mortality ratios (SMRs) for several causes of death stratified by latency, cumulative exposure, and time since last exposure (TSLE).

  Results: Latency: we observed a peak and then a decrease in SMR for lung, pleural, and peritoneal cancer. Cumulative Exposure: We observed a peak and then a decrease in SMR for lung and pleural cancer, not for peritoneal cancer. TSLE: Pleural cancer SMR peaked at 20 to 29 years, then decreased, peritoneal cancer SMR reached a plateau after 20 years and lung cancer mortality was in excess in each class.

  Conclusions: We found different patterns in mortality in the main asbestos-related tumors.

• Mortality Update of a Cohort of Canadian Petroleum Workers. A.R. Schnatter, N.C. Wojcik, G. Jorgensen. 2019;61(3):225-238. PubMed · Publisher · Free full text

  Abstract

  Objective: This study updates the mortality experience of over 25,000 workers in a large Canadian petroleum company through December 31, 2006.

  Methods: Standardized mortality ratios were generated for all-cause and specific cause mortality.

  Results: All cause and all cancer mortality were favorable compared with the general Canadian population. Cancers of previous interest were largely consistent with expectation. There is a continuing excess of mesothelioma, which is of similar magnitude as the previous update, although based on larger numbers. This excess is mostly attributable to men who died in their 50s and 60s and who worked in the refining sector.

  Conclusion: Most causes of death show mortality rates lower than the Canadian general population. Given the excess of mesothelioma observed, this study supports ongoing vigilance in asbestos exposure control programs, as refineries continue to remove asbestos from their facilities.

• An Occupational Legacy: Malignant Mesothelioma Incidence and Mortality in Wisconsin. C.D. Tomasallo, K.Y. Christensen, M. Raymond, et al. 2018;60(12):1143-1149. PubMed · Publisher

  Abstract

  Objectives: The aim of the study was to describe mesothelioma occurrence in Wisconsin from 1997 to 2013 by usual industry and occupation (I&O), including occupations generally considered low risk.

  Methods: Population-based rates and standardized incidence and mortality ratios were calculated. Two case-control analyses were designed to compare mesothelioma incidence and mortality in specific I&O groups with occurrence of (1) brain and central nervous system cancers and (2) other causes of death, using logistic regression.

  Results: Mesothelioma incidence and mortality were elevated in Wisconsin (SIRadj = 1.20 [1.13 to 1.28]; SMRadj = 1.30 [1.22 to 1.38]). Certain industry (construction, manufacturing) and occupation (construction and extraction) groups were associated with increased odds of mesothelioma, with some evidence of increased risk among teachers.

  Conclusions: Forty years after the Occupational and Safety Health Act, mesothelioma incidence and mortality remain elevated in Wisconsin, with increased risk continuing for certain I&O groups.

• Asbestos Exposures, Mesothelioma Incidence and Mortality, and Awareness by General Practitioners in the Molise Region, Central Italy. G. Ripabelli, M. Tamburro, D. Di Tella, et al. 2018;60(2):e90-e97. PubMed · Publisher

  Abstract

  Objective: The aim of this study was to evaluate environmental asbestos sources, mesothelioma incidence and mortality, and awareness on asbestos-related diseases (ARDs) by general practitioners (GPs) in Molise Region.

  Methods: The contaminated sites in three towns were identified by census; mesothelioma incidence (2000 to 2012) and mortality (2003 to 2013) was achieved from local registries; GPs were interviewed on practiced population's exposures and ARDs diagnosis.

  Results: About 54.3% of visited sites were contaminated (71.2% by friable asbestos) and 38.8% was extremely damaged. Over above time-periods, 32 mesothelioma cases (62.5% males, 25% in people aged 70 to 75 years) and 27 deaths (90% males, 69 ± 10 years, 70.4% pleural mesothelioma) have been reported. A total of 122 GPs were interviewed who had diagnosed 40 mesothelioma and 28 asbestosis cases.

  Conclusion: There is the need of remediation/removal interventions for contaminated sites and of strategies to increase GPs awareness on asbestos risks for better patients' management.

• Asbestos Fiber Concentrations in the Lungs of Brake Repair Workers: An Updated Analysis Using Several Regression Methods to Handle Nondetectable Measurements. Y. Liu, G.M. Marsh, V.L. Roggli. 2018;60(7):661-671. PubMed · Publisher

  Abstract

  Objectives: The aim of the study was to reanalyze an updated database of lung asbestos fiber levels for 21 brake repair workers who died of mesothelioma using robust maximum likelihood-based regression methods to address nondetectable measurements.

  Methods: We applied bivariate normal regression to address the doubly left-censored situation where both the lung fiber concentration of noncommercial (TAA) and commercial amphiboles (AC) were subject to detection limits. For the single left-censored situation, we applied censored normal regression to study the relationship between duration of employment (DOE) and TAA.

  Results: We found a statistically significant positive relationship between TAA and AC (β = 0.49, 95% confidence interval [CI], 0.11 to 0.86) and a not statistically significant relationship between DOE and TAA (β = 0.02, 95% CI, -0.03 to 0.06).

  Conclusions: Our results provide additional support for the conclusion that exposure to commercial amphibole asbestos, and not chrysotile, is related to the occurrence of mesothelioma among some brake workers.

• Libby Amphibole Disease: Pulmonary Function and CT Abnormalities in Vermiculite Miners. A. Miller, J. Szeinuk, C.W. Noonan, et al. 2018;60(2):167-173. PubMed · Publisher · Free full text

  Abstract

  Objective: This article describes radiologic and pulmonary function findings among miners exposed to Libby amphibole. Computed tomography (CT) permits the detection of the characteristic thin, lamellar pleural thickening (LPT).

  Methods: Individuals who worked at the mine for a minimum of 6 months had chest CT and pulmonary function tests.

  Results: Pleural thickening was noted in 223 (87%) of the 256 miners, parenchymal abnormalities in 49 (19%). LPT, found in 151 (68%), was associated with low values of forced vital capacity and diffusion capacity and significantly lower values in all pulmonary function tests when associated with parenchymal abnormalities.

  Conclusion: Eighty-seven percent of miners exposed to Libby Amphibole had pleural abnormalities on CT. LPT alone, and more so with parenchymal abnormalities, resulted in decreased pulmonary function. The importance of this easily missed LPT is demonstrated by its high frequency and significant functional effects.

• Systematic Review and Meta-Analysis of Selected Cancers in Petroleum Refinery Workers. A.R. Schnatter, M. Chen, E.A. DeVilbiss, et al. 2018;60(7):e329-e342. Meta-analysis · Systematic review PubMed · Publisher

  Abstract

  Objective: We studied the risk of 11 cancers of a priori interest in petroleum refinery workers.

  Methods: Iterative searches identified 36 studies for the 11 cancer sites. Statistical heterogeneity and publication bias were assessed to enhance interpretation of meta-relative risks.

  Results: Statistical heterogeneity was marked for mesothelioma, but was largely due to study quality. Higher quality studies showed a meta-relative risk (RR) of 3.22, (95% prediction interval 1.45 to 7.23). Melanoma (meta-RR = 1.23) and acute lymphoid leukemia (meta-RR = 1.51), showed results consistent with higher risk, but both were driven by one or two studies. Eight other cancer outcomes showed summary meta-RR's consistent with unity.

  Conclusions: Most cancer outcomes are consistent with background risk in refinery workers. This work has clarified an excess mesothelioma risk, conditional on study quality stratification. Continued surveillance is warranted for melanoma and ALL.

• Temporal Patterns of Exposure to Asbestos and Risk of Asbestosis: An Analysis of a Cohort of Asbestos Textile Workers. A. Farioli, F.S. Violante, C. La Vecchia, et al. 2018;60(6):536-541. PubMed · Publisher · Free full text

  Abstract

  Objective: The aim of the study was to assess the risk of asbestosis death based on the temporal pattern of exposure to asbestos.

  Methods: We followed up a cohort of asbestos textile workers, employed in 1946 to 1984, until November 2013. We measured the duration of the employment, the time since last employment (TSLE), the age, and the year of first employment. Hazard ratios (HR) were estimated through multivariable Cox regression models.

  Results: We observed 51 asbestosis deaths among 1823 workers. The HR of asbestosis death increased with exposure duration (HR 2.4 for ≥15 years compared with <5 years, P trend = 0.014) and declined with TSLE (HR 0.3 for ≥25 compared with <5 years, P = 0.004). The risk of asbestosis mortality strongly declined for exposure starting after 1968.

  Conclusions: The risk of asbestosis death strongly declines in the decades after cessation of the exposure.

• Mortality of Talc Miners and Millers From Val Chisone, Northern Italy: An Updated Cohort Study. E. Pira, M. Coggiola, C. Ciocan, et al. 2017;59(7):659-664. PubMed · Publisher

  Abstract

  Objective: The aim of this study was to update the analysis of mortality of a cohort of talc miners and millers in Northern Italy.

  Methods: We analyzed the mortality during 1946 to 2013 of 1722 male workers in an asbestos-free talc mine (1166 miners and 556 millers) employed during 1946 to 1995.

  Results: The overall standardized mortality ratio (SMR) was 1.24 [95% confidence interval (95% CI) 1.17 to 1.32]; no deaths were observed from pleural cancer; mortality from lung cancer was not increased. Mortality from pneumoconiosis was increased (SMR 26.62; 95% CI 20.71 to 33.69), in particular among miners, and was associated with duration of employment and time since first employment.

  Conclusions: We confirmed the lack of association between exposure to asbestos-free talc, lung cancer, and mesothelioma. Increased mortality from pneumoconiosis among miners is attributable to past exposure to silica.

• Low Wages as Occupational Health Hazards. J.P. Leigh, R. De Vogli. 2016;58(5):444-7. Editorial PubMed · Publisher

  Abstract

  The history of occupational medicine has been characterized by ever-widening recognition of hazards, from fires in 1911 to asbestos in the 1960s, to job strain in the 1990s. In this essay, we argue for broadening the recognition further to include low wages. We first review possible mechanisms explaining the effects of wages on health or health behaviors. Mechanisms involve self-esteem, job satisfaction, deprivation, social rank, the "full" price of bad health, patience, and the ability to purchase health-producing goods and services. Second, we discuss empirical studies that rely on large, typically national, data sets and statistical models that use either instrumental variables or natural experiments and also account for other family income. Finally, we draw implications for laws governing minimum wages and labor unions.

• Comment on "HRCT/CT and Associated Spirometric Effects of Low Libby Amphibole Asbestos Exposure" by Lockey et al (2015). G. Tao, K. Zu, L.E. Kerper, et al. 2015;57(7):e80. Letter · Comment PubMed · Publisher

• HRCT/CT and associated spirometric effects of low Libby amphibole asbestos exposure. J.E. Lockey, K. Dunning, T.J. Hilbert, et al. 2015;57(1):6-13. PubMed · Publisher

  Abstract

  Objective: Evaluate the relationship between cumulative fiber exposure and high-resolution or conventional chest computed tomography (HRCT/CT) changes and spirometry of workers with Libby amphibole asbestos exposure.

  Methods: Of the original 1980 cohort (n = 513), 431 were living and asked to participate. Images were evaluated for localized pleural thickening (LPT), diffuse pleural thickening (DPT), and parenchymal changes.

  Results: A total of 306 participants provided either HRCT/CT scans (n = 191) or chest radiographs (n = 115). Of the 191 with HRCT/CT, 52.9% had pleural changes and 13.1% had parenchymal changes. Those with LPT only, LPT and/or DPT, or DPT and/or parenchymal changes had mean 6.1, 8.0, and 18.0 loss in percent predicted forced vital capacity, respectively.

  Conclusions: Exposure to vermiculite containing amphibole fibers is associated with pleural and parenchymal HRCT/CT changes at low cumulative fiber exposure; these changes are associated with spirometric decrements.

• Response to Comment on "HRCT/CT and Associated Spirometric Effects of Low Libby Amphibole Asbestos Exposure" by Lockey et al (2015). J.E. Lockey, K. Dunning, T.J. Hilbert, et al. 2015;57(7):e80-2. Letter · Comment PubMed · Publisher

  Summary

  In this letter, Lockey and colleagues replied to a comment by Tao et al. that questioned the methods of their cross-sectional study of Libby amphibole asbestos (LAA) exposure, HRCT/CT findings and lung function. The comment focused on the finding that localized pleural thickening (LPT) alone was linked to lower lung function. The authors stated that 84.4% of subjects had spirometry within 24 hours of HRCT/CT and 93.5% within 3 years. A sensitivity analysis that removed eight subjects tested 6 to 7 years before HRCT/CT gave similar results: percent predicted FVC −6.1% versus −6.5%, and FEV1 −4.3% versus −4.5%. They explained that participants with LPT on HRCT/CT but diffuse pleural thickening (DPT) on chest radiograph on the same side were classed a priori as having DPT, and that this affected only one participant in the LPT-only analysis. They noted that analyses had also been done in participants with no reported asbestos exposure. They stated that zero pack-years were kept in the models by adding a small constant. They also noted that the Clark et al. study cited by Tao et al. reported non-significant losses in lung function with LPT. In new analyses of 141 participants, adjusted for pack-years and body mass index, LPT only was associated with significant changes of −5.3 and −6.8 in percent predicted total lung capacity and diffusing capacity. The authors concluded that their findings were not a result of methodological limitations.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Clinical aspects of asbestos-related diseases--what are the unresolved topics?. D.E. Banks. 2014;56 Suppl 10:S8-S12. Review PubMed · Publisher

  Abstract

  Objective: Despite awareness of the health risks associated with asbestos fiber inhalation and the decline in U.S. utilization (about 0.1% of the yearly peak amount), illnesses associated with exposure persist. Those with disease typically describe excessive exposures in the remote past, yet excessive exposures can occur today, most likely related to careless asbestos abatement procedures. The intent is to address unanswered questions associated with asbestos exposure.

  Methods: The author summarizes clinical information addressing the case definition of asbestosis, the world-wide rate of mesothelioma, and clinical follow-up for those with exposure.

  Results: The author describes information relevant to issues which remain unresolved.

  Conclusion: Perhaps somewhat surprisingly, even though there have been a great number of manuscripts reporting on the health risks of asbestos exposure, there remain unanswered questions regarding the pathogenesis of this disease.

• Continued spirometry changes after cessation of exposure in asbestos-cement workers. B. Swiątkowska, W. Sobala, Z. Szubert, et al. 2014;56(4):403-8. PubMed · Publisher

  Abstract

  Objective: To assess further progression of spirometry parameters among former asbestos-cement plant workers.

  Methods: The following parameters were assessed: forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the ratio (FEV1/FVC) using a linear regression model with mixed effects.

  Results: The analysis included 3005 individuals. Spirometrically defined restrictive ventilatory defects were registered in 21.6% of the patients, obstructive defects in 8.3%, whereas mixed changes in 7%. Current smokers had significantly lower levels of FEV1, FVC, and FEV1/FVC and a steeper decline compared with nonsmokers. More rapid progression was also observed along with increasing termination of exposure. Having higher exposure was associated with a slower decline in FEV1 and FEV1/FVC ratios.

  Conclusions: This report indicates that asbestos-cement workers with higher cumulative exposure still had lower mean levels of spirometric parameters, despite cessation of asbestos exposure many years ago.

• Exploring the usefulness of occupational exposure registries for surveillance: the case of the Ontario Asbestos Workers Registry (1986-2012). A.J. Koné Pefoyo, L. Genesove, K. Moore, et al. 2014;56(10):1100-10. PubMed · Publisher · Free full text

  Abstract

  Objective: The ongoing presence of asbestos in products used across workplaces in Canada reinforces the importance of occupational exposure surveillance. This study evaluates the usefulness of the Ontario Asbestos Workers Registry.

  Methods: The study includes 30,829 workers aged 15 to 80 years. Researchers reported on the data quality and analyzed the proportions of workers exposed by industry, and standardized rates by geographic areas and over time.

  Results: The incidence of exposure started to decrease around 1990; but about 2000 workers were still exposed annually until 2006. Results showed large geographical disparities. Unexpectedly, workers from industries other than construction reported exposure.

  Conclusions: The Ontario Asbestos Workers Registry is a useful but challenging source of information for the surveillance of asbestos exposure in Ontario. The registry could benefit from well-defined surveillance objectives, a clear exposure definition, systematic enforcement, regular data analyses, and results dissemination.

• Mesothelioma in occupational cohort studies: methodological considerations. N.C. Wojcik, A.R. Schnatter, W.W. Huebner. 2014;56(1):47-51. PubMed · Publisher

  Abstract

  Objective: This article describes effective strategies for the identification and valid assessment of mortality due to mesothelioma.

  Methods: We manually reviewed all death certificates for mention of mesothelioma for all International Classification of Diseases (ICD) revisions. We tested the accuracy of our ascertainment method by comparing New Jersey death certificate data from our health status registry with histologically confirmed cases from the New Jersey State Cancer Registry.

  Results: We found reasonably good agreement between death certificate diagnoses and histologically confirmed cases, κ coefficient 0.86 (95% confidence interval, 0.76 to 0.95). Most mesothelioma deaths in our test and North American cohorts were coded to unspecified anatomical sites.

  Conclusions: Limiting ascertainment to pleura and peritoneum ICD codes underestimates mesothelioma deaths. Reviewing all ICD codes that could contain mesothelioma is the only effective method for complete capture of mesothelioma diagnoses.

• Occupational asbestos exposure and risk of pleural mesothelioma, lung cancer, and laryngeal cancer in the prospective Netherlands cohort study. N.S. Offermans, R. Vermeulen, A. Burdorf, et al. 2014;56(1):6-19. PubMed · Publisher

  Abstract

  Objective: To study the association between occupational asbestos exposure and pleural mesothelioma, lung cancer, and laryngeal cancer, specifically addressing risk associated with the lower end of the exposure distribution, risk of cancer subtypes, and the interaction between asbestos and smoking.

  Methods: Using the Netherlands Cohort Study (n = 58,279 men, aged 55 to 69 years), asbestos exposure was estimated by linkage to job-exposure matrices. After 17.3 years of follow-up, 132 pleural mesothelioma, 2324 lung cancer, and 166 laryngeal cancer cases were available.

  Results: The multivariable-adjusted model showed overall positive associations between all levels of asbestos exposure and mesothelioma, lung cancer, and laryngeal cancer. Lung adenocarcinoma and glottis cancer showed only a positive association after prolonged higher asbestos exposure (hazard ratio per 10 years increment, 1.43 [95% confidence interval, 1.06 to 1.93] and 1.95 [95% confidence interval, 1.36 to 2.80], respectively). There was no statistically significant interaction between asbestos and smoking.

  Conclusions: Asbestos levels encountered at the lower end of the exposure distribution may be associated with an increased risk of pleural mesothelioma, lung cancer, and laryngeal cancer.

• Occupational risk factors for chronic respiratory disease in a New Zealand population using lifetime occupational history. A. Hansell, R.E. Ghosh, S. Poole, et al. 2014;56(3):270-80. PubMed · Publisher

  Abstract

  Objectives: To investigate associations between respiratory disease and occupational exposures in a New Zealand urban population, the Wellington Respiratory Survey.

  Methods: Multiple regression analyses in a population sample of 1017 individuals aged 25 to 74 years with spirometry and questionnaire information, including a lifetime occupational history.

  Results: Chronic bronchitis symptoms were associated with self-reported exposure to hairdressing, paint manufacturing, insecticides, welding, detergents and with ALOHA Job Exposure Matrix-assessed gases/fumes exposure. The strongest association was for hairdressing (odds ratio 6.91; 95% confidence interval: 2.02 to 23.70). Cumulative exposure to mineral dust and gases/fumes was associated with higher FEV₁% (forced expiratory volume in the first second of expiration) predicted. Analyses were limited by relatively small numbers of cases.

  Conclusions: Increased risks of objectively defined respiratory disease, which have been previously documented, were not seen. Nevertheless, the study suggested increased risk of respiratory symptoms with various occupational exposures as well as likely healthy worker effect.

• The risk of lung cancer after cessation of asbestos exposure in construction workers using pleural malignant mesothelioma as a marker of exposure. B. Järvholm, E. Aström. 2014;56(12):1297-301. PubMed · Publisher · Free full text

  Abstract

  Objective: To study the risk of lung cancer in heavily asbestos-exposed workers after the exposure to asbestos has ended.

  Methods: Lung cancer was studied in a cohort of 189,896 Swedish construction workers through a linkage with the Swedish Cancer Registry. Asbestos exposure was estimated by the incidence of malignant mesothelioma in the occupational group.

  Results: There were in total 2835 cases of lung cancer. Workers with heavy exposure to asbestos had an increased risk of lung cancer (relative risks = 1.74; 95% confidence interval, 1.25 to 2.41) before exposure ended and a similar risk to those with low exposure 20 years after the exposure had ceased (relative risks = 0.94; 95% confidence interval, 0.77 to 1.15).

  Conclusions: Workers with heavy exposure to asbestos have a similar risk of lung cancer as persons with low or no exposure 20 years after the exposure has ended.

• Asbestos-related radiographic findings among household contacts of workers exposed to Libby vermiculite: impact of workers' personal hygiene practices. T.J. Hilbert, A. Franzblau, K.K. Dunning, et al. 2013;55(11):1300-4. PubMed · Publisher

  Abstract

  Objective: To explore the potential impact of worker hygiene by determining the prevalence of radiographic changes consistent with asbestos exposure among household contacts of workers exposed to Libby vermiculite that contained amphibole fibers.

  Methods: Workers and household contacts had chest radiographs and completed questionnaires regarding hygiene and potential exposure pathways.

  Results: Participants included 191 household contacts of 118 workers. One household contact (0.5%) had localized pleural thickening, and three (1.6%) had irregular opacities at profusion category 1/0 or greater. Worker radiographs demonstrated pleural changes in 45% and irregular opacities at profusion category 1/0 or greater in 8%.

  Conclusions: Libby vermiculite-exposed workers demonstrated an elevated prevalence of pleural and interstitial chest radiographic changes. There was, however, no increased prevalence of similar changes among household contacts, likely because of personal hygiene measures taken by the majority of workers.

• Comparison of x-ray films and low-dose computed tomographic scans: demonstration of asbestos-related changes in 2760 nuclear weapons workers screened for lung cancer. A. Miller, S.A. Widman, J.A. Miller, et al. 2013;55(7):741-5. PubMed · Publisher

  Abstract

  Objective: Increased availability and technical improvements of computed tomographic (CT) scanning encourages its use for detecting asbestos-related disease. We compared low-dose scans and x-ray films in 2760 workers potentially exposed to asbestos, to assess their ability to detect interstitial lung disease (ILD) and pleural thickening (PT).

  Methods: A total of 2760 nuclear workers received radiography and CT scanning (2006 to 2009). X-ray films were read by a B reader for ILD and PT and CT scans by a thoracic radiologist, using a protocol for nodules, ILD, and PT.

  Results: Of the 2760 workers, 271 showed circumscribed PT on CT scans, and 73 on x-ray films, 54 (74%) of which were confirmed on CT scans; 76 showed ILD on CT scans, and 15 on x-ray film, 10 (67%) of which were confirmed on CT scans.

  Conclusions: Radiographic readings of PT and ILD were generally confirmed on CT scans. Computed tomographic scans detected three to five times more cases; the majority were minor.

• Low levels of exposure to libby amphibole asbestos and localized pleural thickening. K.Y. Christensen, T.F. Bateson, L. Kopylev. 2013;55(11):1350-5. Review PubMed · Publisher

  Abstract

  Objective: To explore the relationship between low levels of exposure to Libby amphibole asbestos (LAA) and pleural abnormalities, specifically localized pleural thickening (LPT).

  Methods: Three studies presenting the risks associated with quantitative LAA exposure estimates were reviewed, paying particular attention to lower exposure ranges.

  Results: Studies reviewed were conducted among workers exposed to LAA at mining and milling operations in Libby, Montana, at a vermiculite processing facility in Marysville, Ohio, and community residents exposed to LAA from a vermiculite processing facility in Minneapolis, Minnesota. Pleural abnormalities were evaluated using radiographs. Despite differences in study populations and design, each study found that cumulative inhalation LAA exposure was associated with increased risk of LPT even at low levels of exposure.

  Conclusions: Inhalation exposure to LAA is associated with increased risk of LPT even at the lowest levels of exposure in each study.

• Risk of lung cancer associated with occupational exposure to mineral wools: updating knowledge from a french population-based case-control study, the ICARE study. F. Guida, S. Paget-Bailly, F. Lamkarkach, et al. 2013;55(7):786-95. PubMed · Publisher

  Abstract

  Objectives: To assess the risk of lung cancer associated with exposure to mineral wools (MWs), while taking into account smoking, asbestos, and crystalline silica exposures.

  Methods: The analyses were restricted to men (1350 cases and 1912 controls). Lifelong occupational history was collected. MWs and asbestos exposures were assessed, using task-exposure matrices and silica exposure, a job-exposure matrix.

  Results: We observed consistent not-significant increased risks of lung cancer of the same order of magnitude among workers exposed to high levels of MWs (odds ratio, 1.4; 95% confidence interval: 0.9 to 2.2; for highest quartile of the Cumulative Exposure Index).

  Conclusions: These results do not allow to draw firm conclusion about a carcinogenic effect of MWs on the lung, but they cannot exclude it. Given the high number of potentially exposed workers, it will be necessary to replicate them in a future further removed from the asbestos ban.

• Association between cumulative fiber exposure and respiratory outcomes among Libby vermiculite workers. T.C. Larson, V.C. Antao, F.J. Bove, et al. 2012;54(1):56-63. PubMed · Publisher

  Abstract

  Objective: To examine the association between cumulative fiber exposure and health outcomes in workers (n = 336) with Libby amphibole exposure.

  Methods: Exposure-response relationships were explored by the use of logistic regression, with cumulative fiber exposure modeled in categories and as a continuous variable.

  Results: The use of spline functions with lifetime cumulative fiber exposure as a continuous variable showed that the odds of localized pleural thickening were significantly elevated at less than 1 f/cc-y. Odds of parenchymal abnormalities, restrictive spirometry, and chronic bronchitis were also significantly elevated at 108, 166, and 24 f/cc-y, respectively.

  Conclusions: The odds of several pulmonary health outcomes are correlated with cumulative exposure to Libby amphibole. That relatively low-lifetime cumulative exposures are associated with localized pleural thickening has implications for the non-cancer-risk assessment for Libby amphibole.

• Biopersistence of refractory ceramic fiber in human lung tissue and a 20-year follow-up of radiographic pleural changes in workers. J.E. Lockey, V.L. Roggli, T.J. Hilbert, et al. 2012;54(7):781-8. PubMed · Publisher

  Abstract

  Objective: The biopersistence of refractory ceramic fiber (RCF) in human lung tissue is unknown and may contribute to an association between cumulative fiber exposure and radiographic changes.

  Methods: Lung tissue fiber was analyzed for a case series of 10 RCF workers and a 20-year longitudinal chest radiograph study of 1323 workers was conducted.

  Results: Within lung tissue, RCF comprised 14% to 100% of fibers 5 μm or more in length and was identified up to 20 years after RCF employment. Among workers with no reported asbestos exposure, cumulative exposure of more than 63 to 110 and more than 110 fiber-months/cm was associated with radiographic pleural changes of 8.5% (odds ratio, 7.2; 95% confidence interval, 1.4 to 36.8) and 11.6% (odds ratio, 10.3; 95% confidence interval, 2.1 to 49.9), respectively.

  Conclusions: Refractory ceramic fiber can persist in human lung tissue for up to 20 years and may contribute to the significant association between cumulative fiber exposure and radiographic pleural changes.

• Mesothelioma associated with commercial use of vermiculite containing Libby amphibole. K.K. Dunning, S. Adjei, L. Levin, et al. 2012;54(11):1359-63. PubMed · Publisher

  Abstract

  Objectives: To describe asbestos-related mortality among manufacturing workers who expanded and processed Libby vermiculite that contained amphibole fiber.

  Methods: Standardized mortality ratio was calculated for 465 white male workers 31 years after last Libby vermiculite exposure.

  Results: Two workers died from mesothelioma, resulting in a significantly increased standardized mortality ratio of 10.5 (95% confidence interval, 1.3 to 38.0). These workers were in the upper 10th percentile of cumulative fiber exposure, that is, 43.80 and 47.23 fiber-years/cm, respectively. One additional worker with cumulative fiber exposure of 5.73 fiber-years/cm developed mesothelioma but is not deceased. There were no other significantly increased standardized mortality ratios.

  Conclusions: Workers expanding and processing Libby vermiculite in a manufacturing setting demonstrated an increased risk for the development of mesothelioma following exposure to the amphibole fiber contained within this vermiculite ore source.

• Occupational exposures and cancer of the larynx-systematic review and meta-analysis. S. Paget-Bailly, D. Cyr, D. Luce. 2012;54(1):71-84. Meta-analysis · Systematic review PubMed · Publisher

  Abstract

  Objective: To review epidemiologic data on occupational exposures and laryngeal cancer.

  Methods: We performed a systematic literature search and a series of meta-analyses for agents with at least 10 available studies with homogenous exposure.

  Results: We analyzed 99 publications. Significantly increased meta-relative risks (meta-RRs) were obtained considering exposure to polycyclic aromatic hydrocarbons (meta-RR 1.29; 95% confidence interval [CI] 1.10 to 1.52), engine exhaust (meta-RR 1.17; 95% CI 1.05 to 1.30), textile dust (meta-RR 1.41; 95% CI 1.09 to 1.83), and working in the rubber industry (meta-RR 1.39; 95% CI 1.13 to 1.71). Exposures to wood dust, formaldehyde, and cement dust were not significantly associated with laryngeal cancer. In regards of the epidemiologic available data, we could not conclude on the role of solvents.

  Conclusion: Further studies should overcome past limitations in terms of exposure characterization, adjustment for confounding, and sample size.

• Erionite in road gravel associated with interstitial and pleural changes--an occupational hazard in western United States. P.H. Ryan, M. Dihle, S. Griffin, et al. 2011;53(8):892-8. PubMed · Publisher

  Abstract

  Objective: To determine the rate of chest radiographic abnormalities among residents of North Dakota potentially exposed to road gravel containing the fibrous mineral erionite.

  Methods: Participants (n = 34) completed a questionnaire, chest radiograph, and high resolution computed tomography scan to assess the rate of interstitial and pleural changes consistent with fibrous mineral exposure.

  Results: Interstitial, pleural, or both changes typically associated with asbestos exposure were observed by high resolution computed tomography in seven (21%) individuals. The primary exposure pathway for six of these was from gravel pits, road maintenance, or both. Three participants (8.8%) demonstrated bilateral localized pleural changes with calcification; two of these also had accompanying interstitial changes. All three reported extensive work in gravel pits, road maintenance, or both.

  Conclusions: These results indicate that occupational exposure to erionite contained within road gravel in the United States represents a potential health hazard.

  Clinical Significance: This study identifies chest radiographic changes among residents of North Dakota occupationally exposed to road gravel containing erionite. Public health officials and physicians in affected areas should be aware of the potential health effects of erionite exposure. Precautionary measures should be taken to limit occupational exposure to gravel containing erionite.

• Risk and significance of chest radiograph and pulmonary function abnormalities in an elderly cohort of former nuclear weapons workers. M.A. Mikulski, P.G. Hartley, N.L. Sprince, et al. 2011;53(9):1046-53. PubMed · Publisher

  Abstract

  Objective: To estimate prevalence and risk factors for International Labour Organization radiographic abnormalities, and assess relationship of these abnormalities with spirometry results in former Department of Energy nuclear weapons workers.

  Methods: Participants were offered chest x-ray (CXR) and lung function testing. Three occupational medicine physicians read CXRs.

  Results: Forty-five (5.9%) of 757 screened workers were found to have isolated parenchymal abnormalities on CXR and this rate is higher than that in many Department of Energy studies. Parenchymal and pleural and isolated pleural abnormalities were found in 19 (2.5%) and 37 (4.9%) workers, respectively, and these rates are lower than those in other Department of Energy studies to date. Lung function impairment was associated with radiographic abnormalities.

  Conclusions: This study found an elevated rate of parenchymal abnormalities compared to other DoE populations but the effect of age or other causes could not be ruled out.

  (C)2011The American College of Occupational and Environmental Medicine

• An estimate of cancers attributable to occupational exposures in France. P. Boffetta, P. Autier, M. Boniol, et al. 2010;52(4):399-406. PubMed · Publisher

  Abstract

  Objective: To perform a quantitative estimate of the proportion of cancers attributable to occupational exposures in France in 2000.

  Methods: Exposure data for established carcinogens were obtained from a 1994 survey and other sources. Relative risks for 23 exposure-cancer combinations were derived from meta-analyses and pooled analyses.

  Results: A total of 4335 cases of cancer among men (2.7% of all cancers) and 403 cases among women (0.3% of all cancers) were attributed to occupational exposures. Asbestos, polycyclic aromatic hydrocarbons, and chromium VI were the main occupational carcinogens in men, and asbestos and involuntary smoking were the main carcinogens in women. Corresponding proportions for cancer deaths were 4.0% and 0.6% in men and women, respectively. Lung cancer represented 75% of deaths attributable to occupational exposures.

  Conclusion: Our estimates are comparable with those obtained for other countries in studies based on similar methodology.

• Asbestos is still with us: repeat call for a universal ban. C. Ramazzini. 2010;52(5):469-72. Editorial PubMed · Publisher

  Summary

  In this editorial, the Collegium Ramazzini, an international academic society in occupational and environmental medicine, repeated its call for a worldwide ban on the mining, manufacture and use of all forms of asbestos. The editorial reviewed published evidence and estimates rather than presenting new data. It stated that all forms of asbestos cause asbestosis, mesothelioma, and lung, laryngeal and ovarian cancers, and that there is no evidence of a threshold below which there is no risk of mesothelioma. It cited estimates that about 125 million people worldwide are exposed to asbestos at work and that 100,000 to 140,000 workers die of asbestos-related cancer each year. It described environmental exposure from asbestos in building materials, especially asbestos-cement products, which account for more than 90% of current use, mostly in developing countries. It rejected industry claims that chrysotile, which makes up 95% of all asbestos ever used, can be handled safely, and described "controlled use" as a fallacy. It reported that world production remained above 2 million tons a year and that asbestos was banned in 52 countries. It also reported that efforts to list chrysotile under the Rotterdam Convention had failed, with opposition at the 2008 conference led by Canada, Russia and India. It noted that safer substitutes exist and that the pandemic may take as many as 10 million lives. The Collegium concluded that an international ban on all forms of asbestos is urgently needed.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Italian National Register of Occupational Cancers: data system and findings. A. Scarselli, S. Massari, A. Binazzi, et al. 2010;52(3):346-53. PubMed · Publisher

  Abstract

  Objective: To analyze data stored in the National Register of Occupational Cancers, set up by law at the Italian Institute for Occupational Safety and Prevention.

  Methods: Statistical analyses were performed on economic activity, cancer site, and carcinogenic agent. Mesothelioma cases were excluded because they were exhaustively recorded and managed in a proper register.

  Results: The number of cancers diagnosed between 1995 and 2008 was 936 (92% men). Lung cancer was the most frequently reported neoplasm (58% of cases). The metal industry had the highest reporting percentage (15%), and silica was the most common causative agent (20%).

  Conclusions: Despite some limits and incompleteness pertaining to data flow, the results of this study are in accordance with epidemiological findings on occupational cancer risks. The collection of information on occupational cancers is of primary importance to plan targeted prevention programs.

• Vermiculite worker mortality: estimated effects of occupational exposure to Libby amphibole. T.C. Larson, V.C. Antao, F.J. Bove. 2010;52(5):555-60. PubMed · Publisher

  Abstract

  Objective: To examine the relationship between cumulative fiber exposure (CFE) and mortality in a retrospective cohort study of vermiculite workers exposed to Libby amphibole (n = 1862).

  Methods: Extended Cox regression was used to estimate the hazards associated with CFE as a time-dependent covariate of multiple-cause mortality.

  Results: The Cox models for mesothelioma, asbestosis, lung cancer, and non-malignant respiratory disease were significant with rate ratios that increased monotonically with CFE. The model for deaths due to cardiovascular disease was also significant (rate ratio for CFE > or =44.0 f/cc-y vs <1.4 f/cc-y was 1.5; 95% confidence interval = 1.1 to 2.0).

  Conclusions: By using a within-cohort comparison, the results demonstrate a clear exposure-response relationship between CFE and mortality from asbestos-related causes. The finding of an association between CFE and cardiovascular mortality suggests persons exposed to Libby amphibole should be monitored for this outcome.

2000s

• Occupational exposure to rock wool and glass wool and risk of cancers of the lung and the head and neck: a systematic review and meta-analysis. L. Lipworth, C. La Vecchia, C. Bosetti, et al. 2009;51(9):1075-87. Meta-analysis · Systematic review PubMed · Publisher

  Abstract

  Objective: To conduct a review and meta-analysis of risks of cancers of the lung and head and neck (HN) from exposure to rock wool (RW) and glass wool (GW).

  Methods: We performed a systematic review and meta-analysis of risk estimates of lung and HN cancer in epidemiologic studies of workers exposed to man-made vitreous fibers (MMVF), specifically RW and GW.

  Results: Sixteen estimates of lung cancer risk yielded a summary relative risk (RR) of 1.21 (95% CI = 1.11 to 1.32, based on 1662 exposed cases). Corresponding RRs were 1.26 (95% CI = 1.10 to 1.44) in studies of production workers (with similar risk for RW and GW workers), 1.06 (95% CI = 0.77 to 1.48) in studies of end users, and 1.18 (95% CI = 0.98 to 1.42) in community-based studies. The summary RR for HN cancer was 1.36 (95% CI = 1.13 to 1.63, 414 exposed cases). With a few exceptions, all studies that assessed the risk of lung or HN cancer according to various indices of MMVF exposure failed to detect a dose-risk relation. There was limited evidence of a confounding effect of tobacco smoking. No clear excess of pleural mesothelioma has been reported in MMVF-exposed workers.

  Conclusions: Despite a small elevation in RR for lung cancer among MMVF production workers, the lack of excess risk among end users, the absence of any dose-risk relation, the likelihood of detection bias, and the potential for residual confounding by smoking and asbestos exposure argue against a carcinogenic effect of MMVF, RW, or GW at this time. Similar conclusions apply to HN cancer risk among workers exposed to MMVF.

• Risk of mesothelioma and occupational exposure to asbestos and man-made vitreous fibers: evidence from two case-control studies in Montreal, Canada. J. Pintos, M.E. Parent, B.W. Case, et al. 2009;51(10):1177-84. PubMed · Publisher

  Abstract

  Objective: To examine the effects of exposure to occupational asbestos and man-made vitreous fibers (MMVF) across a wide range of occupations on risk of mesothelioma.

  Methodology: Two population-based case-control studies (1979-1986 and 1996-2001) provided 35 histologically confirmed mesothelioma cases and 1965 controls. A detailed job history was obtained to evaluate occupational exposure to many agents, including asbestos and MMVF.

  Results: The mesothelioma odds ratio for exposure to any asbestos type was 3.7 (95% confidence interval = 1.7 to 7.8). The subset exposed to amphibole fibers experienced an odds ratio = 7.0 (95% confidence interval = 2.7 to 18.5). Effects of MMVF could not be disentangled from those of asbestos.

  Discussion: In workers with exposure levels lower than in most historical cohort studies and across a wide range of industries, a strong association was found between asbestos, especially when it was amphibole, and mesothelioma.

• Canada, chrysotile and cancer: Health Canada's Asbestos International Expert Panel report. L.T. Stayner. 2008;50(12):1327-8. Editorial PubMed · Publisher

• Occupational exposure to asbestos and man-made vitreous fibers, and risk of lung cancer: evidence from two case-control studies in Montreal, Canada. J. Pintos, M.E. Parent, M.C. Rousseau, et al. 2008;50(11):1273-81. PubMed · Publisher

  Abstract

  Objective: To examine the effects of occupational asbestos and man-made vitreous fibers (MMVF) on the risk of lung cancer in two population-based case-control studies entailing exposure at lower levels than in historic cohort studies.

  Methodology: Study I (1979 to 1986) comprised 857 cases and 1066 population and cancer controls. Study II (1996 to 2001) comprised 858 cases and 1295 population controls. A detailed job history was obtained to evaluate lifetime occupational exposure to 294 agents, including asbestos and MMVF.

  Results: We found increased risks for substantial exposure to asbestos (odds ratio = 1.78; 95% confidence interval: 0.94 to 3.36). The corresponding odds ratio for substantial exposure to MMVF was 1.10 (95% confidence interval: 0.37 to 3.22).

  Discussion: Low and moderate levels of exposure to asbestos, as encountered in this population, were associated with some excess risk of lung cancer. Results for MMVF were inconclusive.

• The influence of genetic polymorphisms of GSTP1 on the development of asbestosis. A. Franko, V. Dolzan, N. Arnerić, et al. 2008;50(1):7-12. PubMed · Publisher

  Abstract

  Objective: Genetic factors play an important role in the development of asbestosis. The aim of this study was to investigate whether genetic polymorphisms of glutathione S-transferase (GST) P1 represent a risk factor for this disease.

  Methods: The study population included 262 workers with asbestosis and 265 matched controls. Information on cumulative asbestos exposure was available. A real-time PCR based on the 5' nuclease assay was designed for the analysis of GSTP1 Ile105Val and Ala114Val polymorphisms.

  Results: Asbestosis was associated with GSTP1 genotype coding for an enzyme with high conjugation capacity versus genotypes resulting in intermediate and low enzyme activity (odds ratio = 1.49, confidence interval = 1.06-2.10).

  Conclusions: The key finding of the study was that GSTP1 genotype coding for an enzyme with high conjugation capacity significantly increases the risk of developing asbestosis.

• A 56-year mortality follow-up of Texas petroleum refinery and chemical employees, 1948-2003. S.P. Tsai, F.S. Ahmed, J.K. Wendt, et al. 2007;49(5):557-67. PubMed · Publisher

  Abstract

  Objective: To further investigate the mortality risk of employees who worked in the petroleum refinery industry, we updated an earlier investigation by extending the mortality follow-up by an additional 14 years through 2003.

  Methods: The cohort consisted of 10,621 employees with an average follow-up of 34 years. We used the standardized mortality ratio (SMR) adjusted for age, race, and calendar years as a measure of risk.

  Results: Overall mortality (SMR=0.77, 95% confidence interval [CI], 0.74-0.79), all cancer mortality (SMR=0.87, 95% CI=0.82-0.93), and most cause-specific mortalities for the total study population were lower than or similar to that of the population of Harris County, Texas. This study did not show a significant increase in leukemia in the total population or in any of the subgroups. The only statistically significant excess of mortality found in this study was an increase in mesothelioma among maintenance employees; the SMR was 4.78 (95% CI=2.54-8.17) among employees who worked for a minimum of one year and was 7.51 (95% CI=3.75-13.45) among those with 10 or more years of employment and 20 or more years of latency.

  Conclusions: After more than half a century of follow-up, employees at this facility continue to show more favorable mortality outcomes than the general local population. Overall, no statistically significant increase of leukemia or of any of the specific cell types was found. The increased mesothelioma is likely related to past exposure to asbestos.

• Changes in B-readings over time in the United States Navy Asbestos Medical Surveillance Program. J.G. Muller, W.G. Rudolph, J.M. Lieske, et al. 2007;49(2):194-203. PubMed · Publisher

  Abstract

  Objective: To study the impact of variability among B-readers on clinical occupational medicine.

  Methods: A total of 419,770 B-reading reports from February 1980 to May 2004 in the US Navy Asbestos Medical Surveillance Program were analyzed for changes in category from the previous B-reading on each individual worker.

  Results: Over 7% of films were categorized as worse (ie, read as going from negative to positive), and over 6% were categorized as better. When profusion categories were reported as different from the previous reading (over 6% of the time), they were more frequently read as 2 or more minor categories worse or better.

  Conclusions: Changes from previous B-readings are common, and may have clinical and other implications, which are discussed. B-readings should not be used as the sole basis for determining the presence or absence of pneumoconiosis.

• Chronic bronchitis among nonsmoking farm women in the agricultural health study. M. Valcin, P.K. Henneberger, G.J. Kullman, et al. 2007;49(5):574-83. PubMed · Publisher · Free full text

  Abstract

  Objective: The purpose of this study was to examine agricultural risk factors for chronic bronchitis among nonsmoking farm women.

  Methods: We used self-reported enrollment data from the 21,541 nonsmoking women in the Agricultural Health Study to evaluate occupational risk factors for prevalent chronic bronchitis among farm women. Odds ratios (ORs) for chronic bronchitis for occupational exposures were adjusted for age, state, and related agricultural exposures.

  Results: Applying manure and driving combines were independently associated with chronic bronchitis. Off-farm job exposures associated with chronic bronchitis were organic dusts, asbestos, gasoline, and solvents. Five pesticides were associated with chronic bronchitis after multivariate adjustment and sensitivity analyses: dichlorvos (OR=1.63, 95% CI=1.01, 2.61), DDT (OR=1.67, 95% CI=1.13, 2.47), cyanazine (OR=1.88, 95% CI=1.00, 3.54), paraquat (OR=1.91, 95% CI=1.02, 3.55), and methyl bromide (OR=1.82, 95% CI=1.02, 3.24).

  Conclusion: Pesticides as well as grain and dust exposures were associated with chronic bronchitis among nonsmoking farm women.

• Glutathione S-transferases GSTM1 and GSTT1 polymorphisms and asbestosis. A. Franko, M. Dodic-Fikfak, N. Arnerić, et al. 2007;49(6):667-71. PubMed · Publisher

  Abstract

  Objective: In a nested case-control study, the authors investigated whether the deletion polymorphism of glutathione S-transferases GSTM1 and GSTT1 represents a risk factor for the development of asbestosis.

  Methods: In total, 262 cases with asbestosis and 265 controls, selected from a cohort of 2080 workers occupationally exposed to asbestos, were genotyped for GSTM1 and GSTT1-null alleles. Cumulative exposure for each subject was available.

  Results: Asbestosis was associated with cumulative exposure (odds ratio [OR]=3.21, confidence interval [CI] 2.43-4.23) and GSTT1-null genotype (OR=0.61, CI 0.40-0.94), but not with GSTM1-null genotype (OR=1.01, CI 0.71-1.43). The risk of GSTM1-null and GSTT1-null genotype for asbestosis did not change after adjustment by cumulative exposure, smoking, gender, and age.

  Conclusions: An important finding of this study is that GSTT1 gene deletion might have a protective effect on the development of asbestosis.

• Malignant mesothelioma in telephone workers. C. Bianchi, T. Bianchi. 2007;49(4):359. Comment · Letter PubMed · Publisher

• Mortality and cancer incidence among tire manufacturing workers hired in or after 1962. C. Beall, M. Corn, H. Cheng, et al. 2007;49(6):680-90. PubMed · Publisher

  Abstract

  Objective: This study evaluated mortality during 1962 through 2003 and cancer incidence during 1995 through 2003 at a tire manufacturing plant.

  Methods: The mortality study included 3425 men and women, employed for at least one year. Of these, 3069 were eligible for the cancer incidence study.

  Results: Employees experienced 390 deaths compared with 608 expected (standardized mortality ratio (SMR)=64; 95% confidence interval (CI)=58-71). Total cancer mortality (123 observed, SMR=75, CI=62-89) and lung cancer mortality (47 observed, SMR=72, CI=53-96) were lower than expected. Hourly white men had small increases in stomach cancer, bladder cancer, and leukemia deaths. During 1995 through 2003, 169 incident cancers were observed compared with 197 expected (SIR=86, 95% CI=74-100). Three mesothelioma cases occurred among hourly white men (SIR=653, CI=135-1907); all were exposed potentially to asbestos before starting at the rubber plant.

  Conclusions: Small numbers and limited information on jobs, occupational agents, and lifestyle preclude attribution of observed increases to workplace exposures.

• Lung cancer mortality and carbon black exposure: a nested case-control study at a German carbon black production plant. S.F. Büchte, P. Morfeld, J. Wellmann, et al. 2006;48(12):1242-52. PubMed · Publisher

  Abstract

  Objective: The objective of this study was to conduct a case-control study of lung cancer nested within a cohort of 1528 German carbon black workers, 1976-1998.

  Methods: The authors conducted risk-set sampling of two controls matched on year of birth and conditional logistic regression modeling of cumulative carbon black exposure, duration of work in different departments, feedstock contact, asbestos exposure, smoking, age at hire, exposures before the carbon black job, and serving as a soldier in World War II or being a prisoner of war. Analyses were performed with both the full cohort and members of an inception cohort subset. Exposures were lagged by 10 years.

  Results: Analysis of 50 lung cancer deaths showed no association to carbon black exposure.

  Conclusions: Carbon black exposure was not linked to lung cancer risk. Suggestions of positive associations with asbestos exposure, feedstock contact, and work in specific departments are inconclusive due to small numbers.

• Lung cancer mortality and occupational exposure to asbestos among telephone linemen: a historical cohort study in France. D. Meguellati-Hakkas, D. Cyr, I. Stücker, et al. 2006;48(11):1166-72. PubMed · Publisher

  Abstract

  Objective: The authors studied the mortality by lung cancer in telephone linemen exposed to asbestos at low levels during installation of telephone cables.

  Methods: Three hundred eight lung cancers deaths were identified in the cohort. Exposure to asbestos and to other occupational carcinogens was assessed using a job-exposure matrix.

  Results: The relative risk for lung cancer death associated with an estimated exposure of approximately 2 f/cc-years was 2.1 (95% confidence interval = 1.1-4.0) as compared with workers exposed to less than 0.5 f/cc-years. Mean annual exposure or exposure duration were not clearly related to lung cancer. Adjustment for other occupational lung carcinogens did not change this finding.

  Conclusion: The observed mortality by lung cancer associated with asbestos exposure at low levels is higher than the prediction based on linear downward extrapolations from highly exposed occupational cohorts.

• Occupational risk factors for brain cancer in Canada. S.Y. Pan, A.M. Ugnat, Y. Mao, et al. 2005;47(7):704-17. PubMed · Publisher

  Abstract

  Objective: We sought to examine the impact of occupational exposure on brain cancer risk.

  Methods: Mailed questionnaires were used to collect information on lifetime employment history, occupational exposure to 18 chemicals, and other risk factors for 1009 incident cases of brain cancer and 5039 control subjects in Canada in 1994 to 1997.

  Results: People exposed to asphalt and welding had respective odds ratio (and 95% confidence interval) of 1.29 (1.02-1.62) and 1.26 (0.98-1.45). An increased risk of brain cancer might be associated with exposure to asbestos, benzene, mineral or lubricating oil, isopropyl oil, and wood dust and with following occupations: teaching; protective service; metal processing and related jobs, and metal shaping and forming; knitting in textile processing; construction trades; and transport equipment operating.

  Conclusions: Our study suggests a possible role for occupational exposure in the etiology of brain cancer.

• Plasma concentrations of retinol, carotene, and vitamin E and mortality in subjects with asbestosis in a cohort exposed to crocidolite in Wittenoom, Western Australia. H.S. Alfonso, L. Fritschi, N.H. de Klerk, et al. 2005;47(6):573-9. PubMed · Publisher

  Abstract

  Objective: We sought to examine the relationships between plasma concentrations of retinol, carotene, and vitamin E and mortality associated with asbestosis in people previously exposed to crocidolite.

  Methods: Cox regression modeling was applied to examine these relationships at the first measurement of each vitamin, at the measurement at each visit, and with the rate of change of each vitamin during the follow-up.

  Results: There were 76 deaths of people with asbestosis during the follow-up period and 1885 subjects censored. Mortality in subjects with asbestosis was inversely related to plasma levels of retinol and Vitamin E concentrations and to their rate of increase during the follow-up. Carotene concentrations at first visit were associated with lower mortality but not during the follow up period.

  Conclusions: Chronically low levels of these vitamins are associated with an increased risk of dying with asbestosis.

• Risk assessment for asbestos-related cancer from the 9/11 attack on the World Trade Center. R.P. Nolan, M. Ross, G.L. Nord, et al. 2005;47(8):817-25. PubMed · Publisher

  Abstract

  Objective: We sought to estimate the lifetime risk of asbestos-related cancer for residents of Lower Manhattan attributable to asbestos released into the air by the 9/11 attack on New York City's World Trade Center (WTC).

  Methods: Exposure was estimated from available data and reasoned projections based on these data. Cancer risk was assessed using an asbestos risk model that differentiates asbestos fiber-types and the US Environmental Protection Agency's model that does not differentiate fiber-types and combines mesothelioma and lung cancer risks.

  Results: The upper limit for the expected number of asbestos-related cancers is less than one case over the lifetime of the population for the risk model that is specific for fiber-types and 12 asbestos-related cancers with the US Environmental Protection Agency's model.

  Conclusions: The cancer risk associated with asbestos exposures for residents of Lower Manhattan resulting from the collapse of the WTC is negligible.

• The art of perpetuating a public health hazard. M. Greenberg. 2005;47(2):137-44. Review PubMed · Publisher

  Abstract

  Objectives: Canadian chrysotile (white asbestos) could be a paradigm for those agents that are successfully exploited commercially long after they have been found to be lethal. Mining started in the late 1870s, and reports of disability and death followed in Britain (1898), in France (1906), and Italy (1908), but it was not until 1955 that Canada acknowledged asbestosis in its asbestos miners and millers. Even when shortly after asbestos was shown to be carcinogenic, Canadian Public Relations experts assisted by their scientists exculpated chrysotile by deeming other agents to have been causal.

  Results: The PR techniques that have been successfully used in the defense of chrysotile are reviewed, to forewarn scientists involved in formulating public health policy for similar agents, as to the tricks that will be played on them.

• Asbestos exposure, manganese superoxide dismutase (MnSOD) genotype, and lung cancer risk. L.I. Wang, D. Neuberg, D.C. Christiani. 2004;46(6):556-64. PubMed · Publisher

  Abstract

  To assess whether differences in genetic susceptibility to oxidative stress modify asbestos-related lung cancer risk (caused by lung inflammation, free radical production), we examined possible interactions between manganese superoxide dismutase (MnSOD) genotypes and asbestos in a hospital-based case-control study of 811 white lung cancer cases and 957 friend/spouse controls. Cumulative lifetime asbestos exposure score (AES) was calculated from self-reported duration and intensity of occupational and nonoccupational exposures. A total of 13.5% of cases and 10% of controls had "high" AES (determined by a priori cut point). The homozygous variant MnSOD genotype was associated with increased lung cancer risk among individuals with zero or "low" AES (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.52-3.01) and no association (OR = 1.00; 95% CI = 0.36-2.73) among the "high" AES group. We observed no statistically significant interaction between MnSOD genotype and asbestos exposure for lung cancer risk.

• Cancer incidence among members of the Norwegian trade union of insulation workers. B. Ulvestad, K. Kjaerheim, J.I. Martinsen, et al. 2004;46(1):84-9. PubMed · Publisher

  Abstract

  Insulation work has been described as an occupation with high exposure to asbestos. A cohort of members of the Norwegian Trade Union of Insulation Workers (n = 1116), hired between 1930 and 1975, was established. During 2002, the cohort was linked to the Cancer Registry of Norway. The standardized incidence ratio (SIR) of pleural mesothelioma was 12.9 (95% confidence interval [CI] = 6.0-24.6). Two cases with peritoneal mesotheliomas were found (SIR, 14.8; 95% CI = 1.8-53.4). The SIR of lung cancer was 3.0 (95% CI = 2.3-3.8). Four cases of lung cancer were observed among cork workers without any exposure to asbestos, but to cork dust and tar smoke (SIR, 5.3; 95% CI = 1.5-13.6). Our study showed a high risk of mesothelioma and an elevated risk of lung cancer among members of the Trade Union of Insulation Workers.

• Differences in mortality by radiation monitoring status in an expanded cohort of Portsmouth Naval Shipyard workers. S.R. Silver, R.D. Daniels, T.D. Taulbee, et al. 2004;46(7):677-90. PubMed · Publisher

  Abstract

  Studies of leukemia and lung cancer mortality at the Portsmouth Naval Shipyard (PNS) have yielded conflicting results. In an expanded cohort of PNS workers employed between 1952 and 1992 and followed through 1996, the all-cause standardized mortality ratio (SMR) was 0.95 (95% confidence interval, 0.93-0.96). Employment duration SMRs were elevated with confidence intervals excluding 1.00 for lung cancer, esophageal cancer, and all cancers combined. Leukemia mortality was as expected overall, but standardized rate ratio analyses showed a significant positive linear trend with increasing external radiation dose. The role of solvent exposures could not be evaluated. Findings differed by radiation monitoring subcohort, with excess asbestosis deaths limited to radiation workers and several smoking-related causes of death higher among nonmonitored workers. At PNS, asbestos exposure and possibly smoking could be nonrandomly distributed with respect to radiation exposure, suggesting potential for confounding in internal analyses of an occupational cohort.

• Disease and illness in U.S. mining, 1983-2001. D.F. Scott, R.L. Grayson, E.A. Metz. 2004;46(12):1272-7. PubMed

  Abstract

  Objectives: We describe inconsistencies in disease and illness reporting in U.S. mining, identify under-reporting of disease and illness in U.S. mining, and summarize selected disease and illness in U.S. mining from 1983 through 2001.

  Methods: We summarized information on mining-related disease and illness data for the years 1983-2001 from the Mining Safety and Health Administration database (MSHA).

  Results: Discrepancies exist in types of information collected by the Centers for Disease and Control, the National Institute for Occupational Safety and Health, and the Mining Safety and Health Administration database. Several factors, including a worker's fear of losing his or her job, health insurance, or other job-related benefits contribute to under-reporting of disease and illness information in the US mining industry.

  Conclusions: Since 1997, both number of workers employed in mining and disease and illness rates have decreased; however, the highest disease and illness rates in mining continue to be coal worker's pneumoconiosis and hearing loss.

• Smoking trend in a high-risk group: asbestos abatement workers. J.H. Lange, G. Priolo, G. Mastrangelo. 2004;46(12):1195. Letter · Comment PubMed

• A pilot study of telephone-based smoking cessation intervention in asbestos workers. O.Y. Osinubi, J. Moline, E. Rovner, et al. 2003;45(5):569-74. Randomized trial PubMed · Publisher

  Abstract

  Smoking markedly increases the risk of asbestos-related lung cancer. We conducted a randomized pilot trial of a telephone-based smoking cessation intervention in asbestos workers. Fifty-nine smokers were assigned to either a control or telephone-based smoking cessation treatment group and were followed-up at 6 months. Intent-to-treat analysis revealed a 16.7% quit rate at 6 months for the intervention group compared to 6.9% for the control group (P = 0.25). Treatment-received quit-rates were 33% for the intervention group and 6.9% for the control group (P = 0.05). The intervention group was twice as likely to use smoking cessation medicines and progressed further along the stage of change continuum compared with the control group. Incorporating telephone-based smoking cessation treatment into medical screening activities for asbestos workers is feasible and the intervention is effective in increasing quit rates at 6 months.

• Estimating the induction period of pleural mesothelioma from aggregate data on asbestos consumption. M. Nurminen, A. Karjalainen, K. Takahashi. 2003;45(10):1107-15. PubMed · Publisher

  Abstract

  This study aimed to estimate the induction period from causal action of asbestos exposure to the manifestation of mesothelioma. We included the 9 countries for which we could find published aggregate data on the use of raw asbestos for a relevant time period. We extracted the annual numbers of cases of pleural cancer among men from the World Health Organization mortality database for those years using the International Classification of Diseases, 9th revision, classification. For the Scandinavian countries, we used published national cancer incidence data. In autoregressive Poisson regression modeling, we invoked different time lags of the mean annual use of asbestos to specify which time span produced the best correlation between the 2 time series. The ecologic analysis suggested that the most probable estimate for the mean induction period (use versus morbidity at society level) is approximately 25 years.

• Time trends and occupational risk factors for peritoneal mesothelioma in Sweden. K. Hemminki, X. Li. 2003;45(4):451-5. PubMed · Publisher

  Abstract

  Epidemiologic data on peritoneal mesothelioma are scarce but exposure to asbestos is an identified risk factor. To characterize the disease, time trends, age-incidence relationships, and occupational risk factors for peritoneal mesothelioma were studied based on the Swedish Family-Database covering years 1961 to 1998. Peritoneal mesothelioma is a rare disease and only 96 male and 113 female cases were recorded during the 38-year period. Age-standardized incidence of the disease has increased for men until 1985 and leveled off thereafter. The incidence in women has been equally high but it has continued to increase toward the end of the follow-up period. The incidence was maximal at an age around 80 years for both genders. No female occupational or socioeconomic group was at risk. For men, 29% of the cases had typical asbestos related jobs with a SIR of 1.70. Bricklayers and plumbers had the highest risk of 7.22 and 5.12, respectively. Within limits of the sample size, no evidence was noted for risk from environmental exposures to asbestos because the risk of farmers and that of urban residents were not different.

• Time trends and occupational risk factors for pleural mesothelioma in Sweden. K. Hemminki, X. Li. 2003;45(4):456-61. PubMed · Publisher

  Abstract

  Epidemiologic data on pleural mesothelioma are scarce on regional and occupational time trends, which would monitor the effects of changes in exposure to asbestos. We aim to characterize time trends, regional, socioeconomic, and occupational risk factors for pleural mesothelioma in Sweden in the years from 1961 to 1998. The Swedish Family-Cancer Database was used to identify patients with pleural mesothelioma. Age-standardized incidence rates and standardized incidence ratio (SIR) were calculated for the population in the Database. A total of 1298 male and 233 female pleural mesotheliomas were retrieved. Age-standardized incidence of the disease was highest, and the trend increased in residents of large industrial and shipbuilding cities. In the last follow-up period, the male rate exceeded the female rate about 10-fold. Among male socioeconomic groups, manual workers showed the highest and ever-increasing SIR. No female socioeconomic group was at risk. For men, plumbers and seamen had the highest risk of 4.56 and 2.83, respectively, but the risks appeared to be decreasing for plumbers, whereas no clear trend was noted for seamen, probably because of indirect expose in ships. Farmers showed an SIR of 0.28, indicating that the population at large was at four times higher risk than farmers. The SIRs of many academic/college-educated groups were two to six times higher than those of farmers, suggesting indirect exposure to asbestos in these groups.

• Different measures of asbestos exposure in estimating risk of lung cancer and mesothelioma among construction workers. K. Koskinen, E. Pukkala, R. Martikainen, et al. 2002;44(12):1190-6. PubMed · Publisher

  Abstract

  To analyze occupation, expert-evaluated cumulative exposure, and radiographic abnormalities as indicators of asbestos-related cancer risk we followed 16,696 male construction workers for cancer in 1990-2000. We calculated standardized incidence ratios (SIR) in comparison to the Finnish population and relative risks (RR) in a multivariate analysis in comparison to the internal low-exposure category of each indicator. Overall, the risk was increased for mesothelioma (SIR 2.0, 95% CI = 1.0-3.3), but not for lung cancer (SIR 1.1, 95% CI = 0.9-1.2). Radiographic lung fibrosis indicated a 2-fold and a high value of the exposure index a 3-fold RR of lung cancer, while there was no risk among those with pleural plaques. The risk of lung cancer was the highest in insulators (RR 3.7, 95% CI = 1.4-9.9). Occupation, expert-evaluated cumulative exposure, and lung fibrosis are useful indicators of lung cancer risk among construction workers.

• Exposure to asbestos and lung and pleural cancer mortality among pulp and paper industry workers. R. Carel, P. Boffetta, T. Kauppinen, et al. 2002;44(6):579-84. PubMed · Publisher

  Abstract

  We studied the mortality from lung and pleural cancers in a cohort of 62,937 male workers employed for at least 1 year in the pulp and paper industry in 13 countries during 1945 to 1996. Mill departments were classified according to probability and level of exposure to asbestos on the basis of available dust measurements and mill-specific information on exposure circumstances. Thirty-six percent of workers were classified as ever exposed to asbestos. Standardized mortality ratios of lung cancer were 0.99 (95% confidence interval [CI], 0.90 to 1.08) among unexposed and 1.00 (95% CI, 0.90 to 1.11) among ever exposed workers. The number of pleural cancer deaths among unexposed workers was 10; that among exposed workers was 14, most of which occurred among maintenance workers. In internal analyses, a trend in mortality from either neoplasm was suggested for estimated cumulative exposure to asbestos, weighted for the individual probability of exposure within the department and for duration of exposure (relative risk for lung cancer for 0.78+ f/cc-years, as compared with < or = 0.01 f/cc-years: 1.44; 95% CI, 0.85 to 2.45; corresponding relative risk for pleural cancer: 2.43; 95% CI, 0.43 to 13.63). Despite a possible nondifferential misclassification of exposure and outcome, this study suggests that the carcinogenic effect of asbestos can be detected among workers employed in industries such as the pulp and paper industry, in which it is not considered to be a major hazard.

• Occupational risk factors for renal cell cancer: a case--control study in northern Italy. S. Mattioli, D. Truffelli, A. Baldasseroni, et al. 2002;44(11):1028-36. PubMed · Publisher

  Abstract

  Relatively little is known about occupational and other risk factors for renal-cell carcinoma (RCC). Associations between RCC and occupations, exposures and other factors were investigated in a hospital-based case-control study in Bologna (central-northern Italy). Between 1986 and 1994, 324 histologically confirmed RCC cases were diagnosed at Policlinico S. Orsola-Malpighi in patients from the Province of Bologna. Corresponding control subjects admitted to the same hospital with any diagnosis except RCC were matched for sex, age, and residency. We studied the 249 cases and 238 controls for whom detailed information on occupational history, diet, smoking habits, alcohol and drug intake was obtained. At conditional logistic regression, among males (167 matched pairs), significant matched odds ratios (OR) were found, after adjusting for cigarette smoking and alcohol intake, for high body-mass index BMI (third quartile: OR, 4.91; confidence interval [95% CI], 1.56-15.5; last quartile: OR, 4.42; 95% CI, 1.48-13.18), railway workers (OR, 10.14; 95% CI, 1.46-70.17) and asbestos exposure (OR, 7.11; 95% CI, 1.46-34.51); nearly significant OR were found for managers (OR, 3.59; 95% CI, 0.82-15.59) and metal workers (OR, 2.21; 95% CI, 0.99-5.37). Among females (52 pairs), significant OR were found for BMI > 25.4 (OR, 8.46; 95% CI, 1.02-68.0). Railway workers (on or near to trains) may have increased risk of developing RCC, possibly due to asbestos exposure. Studies are required on possible risks encountered by railway (and metal) workers and by managers.

• Asbestos exposure assessment by mineralogical analysis of bronchoalveolar lavage fluid. P. Sartorelli, G. Scancarello, R. Romeo, et al. 2001;43(10):872-81. PubMed · Publisher

  Abstract

  Mineralogical analysis of bronchoalveolar lavage fluid (BALF) by electron microscopy can represent the most suitable method for assessing asbestos exposure. However, it has been claimed that no standardized or systematic approach to the subject of mineralogical analysis exists. This study aimed to evaluate BALF mineralogical analysis by transmission electron microscopy as biomarker of asbestos fiber load. BALF was examined in 108 exposed workers and 57 patients who underwent diagnostic fiberoptic bronchoscopy for various clinical purposes. Asbestos bodies in BALF were counted with a phase-contrast microscope. Fibers were counted and analyzed by transmission electron microscopy, which showed a significant difference between the two populations and positive results for all exposed subjects. Only 82.2% of the exposed population tested positive for asbestos bodies. Subjects with long-term exposure had higher concentrations of fibers than did those with more recent exposure, probably because of the higher workplace exposure levels in the past. The results of the study confirm that fiber concentration in BALF can be considered as a reliable biomarker of past asbestos exposure, even many years after the end of exposure.

• Historical cohort study of US man-made vitreous fiber production workers: I. 1992 fiberglass cohort follow-up: initial findings. G.M. Marsh, A.O. Youk, R.A. Stone, et al. 2001;43(9):741-56. PubMed · Publisher

  Abstract

  This 1986 to 1992 update and expansion of an earlier historical cohort study examined the 1946 to 1992 mortality experience of 32,110 workers employed for 1 year or more during 1945 to 1978 at any of 10 US fiberglass (FG) manufacturing plants. Included are (1) a new historical exposure reconstruction for respirable glass fibers and several co-exposures (arsenic, asbestos, asphalt, epoxy, formaldehyde, polycyclic aromatic hydrocarbons, phenolics, silica, styrene, and urea); and (2) a nested, matched case-control study of 631 respiratory system cancer (RSC) deaths in male workers during 1970 to 1992 with interview data on tobacco smoking history. Our findings to date from external comparisons based on standardized mortality ratios (SMRs) in the cohort study provide no evidence of excess mortality risk from all causes combined, all cancers combined, and non-malignant respiratory disease. Also, excluding RSC, we observed no evidence of excess mortality risk from any of the other cause-of-death categories considered. For RSC among the total cohort, we observed a 6% excess (P = 0.05) based on 874 deaths. Among long-term workers (5 or more years of employment) we observed a not statistically significant 3% excess based on 496 deaths. Among the total cohort, we observed increases in RSC SMRs with calendar time and time since first employment, but these were less pronounced among long-term workers. RSC SMRs were not related to duration of employment among the total cohort or long-term workers. In an externally controlled analysis of male workers at risk between 1970 and 1992, we observed no association between RSC SMRs and increasing exposure to respirable FG. Our findings to date from internal comparisons based on rate ratios in the case-control study of RSC were limited to analyses of categorized study variables with and without adjustment for smoking. On the basis of these analyses, the duration of exposure and cumulative exposure to respirable FG at the levels encountered at the study plants did not appear to be associated with an increased risk of RSC. RSC risk also did not seem to increase with time since first employment. There is some evidence of elevated RSC risk associated with non-baseline levels of average intensity of exposure to respirable glass, but when adjusted for smoking this was not statistically significant, and there was no apparent trend with increasing exposure. This same pattern of findings was observed for duration of exposure, cumulative exposure, and average intensity of exposure to formaldehyde. None of the other individual co-exposures encountered in the study plants appeared to be associated with an increased risk of RSC. The primary focus of ongoing analyses is to determine the extent to which our present findings are robust to alternative characterizations of exposure.

• Historical cohort study of US man-made vitreous fiber production workers: II. Mortality from mesothelioma. G.M. Marsh, M.J. Gula, A.O. Youk, et al. 2001;43(9):757-66. Case report PubMed · Publisher

  Abstract

  As part of our ongoing mortality surveillance program for the US man-made vitreous fiber (MMVF) industry, we examined mortality from malignant mesothelioma using data from our 1989 follow-up of 3478 rock/slag wool workers and our 1992 follow-up of 32,110 fiberglass workers. A manual search of death certificates for 1011 rock/slag wool workers and 9060 fiberglass workers revealed only 10 death certificates with any mention of the word "mesothelioma." A subsequent review of medical records and pathology specimens for 3 of the 10 workers deemed two deaths as definitely not due to mesothelioma and one as having a 50% chance of being caused by mesothelioma. Two other deaths, for which only medical records were available, were given less than a 50% chance of being due to mesothelioma. Eight of the 10 decedents had potential occupational asbestos exposure inside or outside the MMVF industry. We also estimated the mortality risk from malignant mesothelioma in the cohort using two cause-of-death categorizations that included both malignant and benign coding rubrics. Using the more comprehensive scheme, we observed overall deficits in deaths among the total cohort and fiberglass workers and an overall excess among rock/slag wool workers. The excess in respiratory system cancer is largely a reflection of elevated lung cancer risks that we attributed mainly to confounding by smoking, to exposures outside the MMVF industry to agents such as asbestos, or to one or more of the several co-exposures present in many of the study plants (including asbestos). The second scheme, which focused on pleural mesothelioma in time periods when specific malignant mesothelioma coding rubrics were available, classified only one cohort death as being caused by malignant mesothelioma, compared with 2.19 expected deaths (local county comparison). We conclude that the overall mortality risk from malignant mesothelioma does not seem to be elevated in the US MMVF cohort.

• Pulmonary function in long-term asbestos workers in China. X.R. Wang, E. Yano, M. Wang, et al. 2001;43(7):623-9. PubMed · Publisher

  Abstract

  The relationship of pulmonary function to exposure to asbestos and radiographic abnormalities has been controversial, especially when smoking is present as a confounder. The aim of the study was to provide further understanding on the radiographic-physiologic associations in nonsmoking and smoking asbestos workers. Radiographic asbestosis, pleural lesion, and pulmonary function were studied in 269 Chinese asbestos workers, with average exposure years of 23 for male workers and 18 for female workers. Their functional data were compared with those of 274 controls without exposure to dust. Although most of the male workers were smokers, none of the female workers smoked. In comparison with controls, asbestos workers had significantly lower lung volume and diffusing capacity, irrespective of gender. Female workers and smoking male workers had lower measurements of forced expiratory volume in 1 second and instantaneous forced expiratory flow at 50% and 25% of forced vital capacity. After adjustment for relevant covariates, asbestos exposure, asbestosis, and pleural abnormalities were associated with decreased parameters of pulmonary function, including lung volume, diffusing capacity, and airway flow. These data indicate that asbestos-related functional defects manifested by lung restriction and mild airway obstruction correlate with exposure to asbestos and with parenchymal and pleural abnormalities, independent of smoking.

• Circulating natural killer cells in retired asbestos cement workers. P. Froom, N. Lahat, E. Kristal-Boneh, et al. 2000;42(1):19-24. PubMed · Publisher

  Abstract

  The effect of past exposure to asbestos on natural killer (NK) cell number and activity is uncertain. We measured NK cell number and activity in 1052 retired asbestos workers without symptomatic lung disease, lung cancer, or mesothelioma and with a long latency period from exposure; results were compared with those for 100 healthy age-matched controls. The exposed workers showed a decreased NK cell activity and increased NK cell number, yielding a 10.8 higher odds ratio for low NK activity per cell compared with controls (95% confidence interval 6.4 to 18.4), which was due to both a decrease in NK cell activity and an increase in NK cell number. Asbestos exposure of 10 years or more increased the risk of low NK activity per cell. We conclude that exposure to asbestos is associated with diminished effectiveness of NK cells and a concomitant increase in the number of NK circulating cells.

• Incidence of cancer among welders and other shipyard workers with information on previous work history. T.E. Danielsen, S. Langård, A. Andersen. 2000;42(1):101-9. PubMed · Publisher

  Abstract

  The incidence of cancer among 4480 shipyard workers, including 861 welders, was investigated for a potential relationship between exposure to welding fumes and lung cancer. A subcohort of 3150 workers with information on previous work history was studied separately. This investigation is a historical prospective cohort study. Environmental air samples were collected in 1973, 1977, and 1989. Information on smoking habits was surveyed in 1976 and 1984. The employment work histories were collected from the personnel register. There were 411 observed cancers of all sites versus 387.5 expected, and 45 cases of lung cancer versus 51.3 expected. Nine cases of lung cancer were found among the welders versus 7.1 expected. Among 310 former seamen with welding experience, there was 1 case of lung cancer versus 2.1 expected. These shipyard workers showed no excess risk of lung cancer. Tobacco smoking and asbestos exposure are potential confounders in the study. There was no clear relationship between exposure to welding fumes and lung cancer, but welders with the longest experience had a relative risk of 1.9 for lung cancer. The differences in lung cancer incidence among the different shipyard workers could not be attributed to differences in recruitment patterns or previous work history.

• Occupational exposures and lung cancer in Buenos Aires, Argentina. E.L. Matos, M. Vilensky, D. Mirabelli, et al. 2000;42(6):653-9. PubMed · Publisher

  Abstract

  The main objective of this study was to analyze the risks associated with occupational exposures in an industrializing country where lung cancer is the primary neoplastic cause of death in men. A full occupational history was collected through interviewing 199 men with lung cancer and 393 control subjects. Exposure to arsenic, asbestos, chromium, dust, nickel, and polynuclear aromatic hydrocarbons was assessed by means of a job-exposure matrix. Elevated odds ratios were observed for employment in the alcoholic beverages industry (5.2; 95% confidence interval [CI], 1.1 to 23.1), sawmills and wood mills (4.8; 95% CI, 1.2 to 19.0), water transport (3.3; 95% CI, 1.1 to 12.1), and chemicals/plastics manufacturers (1.9; 95% CI, 1.1 to 3.3). A small, non-significant increased risk was observed after long-term exposure to arsenic and chromium, with a dose-response for chromium. Although some of the present results may result from chance, most are consistent with those of previous investigations in other countries.

• Respiratory symptoms and functional status in workers exposed to silica, asbestos, and coal mine dusts. X.R. Wang, D.C. Christiani. 2000;42(11):1076-84. PubMed · Publisher

  Abstract

  This study aims to provide further understanding of physiologic and symptomatic changes and radiographic abnormalities due to exposure to silica, asbestos, and coal dusts. Questionnaires and pulmonary function tests were given to 220 silica, 277 asbestos, and 511 coal workers from three different industries in China. Posteroanterior chest radiographs were classified as stages 0, I, II, and III according to degree of parenchymal fibrosis. Significantly poorer pulmonary function and a higher prevalence of dyspnea and chronic cough were observed in workers with pneumoconiosis than those without, irrespective of dust type. Workers with stages II and III silicosis had worse pulmonary function and more common symptoms relative to workers with equivalent coal workers' pneumoconiosis or asbestosis. After adjusting for relevant confounders, reductions in the spirometric parameters and single breath diffusing capacity for carbon monoxide (DLCO) and the occurrence of respiratory symptoms were associated with increasing stage of silicosis, whereas lower DLCO and the occurrence of symptoms were associated with increasing stage of asbestosis and coal workers' pneumoconiosis. The study suggests that despite the differences in degree and pattern due to exposure to different fibrogenic dusts, respiratory impairments of all of the workers are associated with the presence and progression of parenchymal fibrosis and smoking.

1990s

• A case-control study of lung cancer among refinery workers. K. Rosamilia, O. Wong, G.K. Raabe. 1999;41(12):1091-103. PubMed · Publisher

  Abstract

  This case-control study examined the relationship between lung cancer and the work histories of male employees at a large Texas refinery. The study included 112 lung cancer deaths observed between 1946 and 1987 and 490 matched controls. Employment histories were obtained from personnel records, and smoking information was available from medical records. Both stratification methods and conditional logistic regression were used in data analyses. Overall employment in four general job categories (administrative, engineering/laboratory, process, maintenance/mechanical) was not associated with lung cancer mortality. Results by hire period (< 1940, 1940+) showed that workers hired into process jobs before 1940 had a nonsignificantly elevated odds ratio (OR) of 1.71 (95% confidence interval [CI] = 0.85-3.45) compared with nonprocess workers hired before 1940. Among process workers hired before 1940, there was a significant trend toward increasing OR with increasing duration of employment in process jobs, and the association with lung cancer was strongest among smokers in the highest duration category of 30+ years (OR = 2.98, 95% CI = 1.07-8.31). Latency analyses of process workers hired before 1940 indicated that their lung cancer risk had peaked between 30 and 50 years since first employment. Definitive statements about causal factors are limited because results among process workers were based on small numbers of subjects in some exposure categories, and there was no information on specific workplace exposures. The OR for maintenance/mechanical jobs after adjustment for smoking was 1.00 (95% CI = 0.55-1.82). Furthermore, there was no pattern in relation to duration of employment in maintenance/mechanical jobs. The results from this study do not support the hypothesis that work in maintenance/mechanical jobs increases lung cancer risk. On the basis of analyses in this study, it is unlikely that asbestos exposure contributed to excess lung cancer mortality. Additional analyses were conducted for specific maintenance jobs with potential exposure to asbestos and by duration in jobs with occasional or routine asbestos exposure. No significant increase in lung cancer was found in any subgroup. Furthermore, there was no significant trend toward lung cancer risk in relation to duration of employment in jobs with asbestos exposure.

• Call for an international ban on asbestos. C. Ramazzini. 1999;41(10):830-2. Editorial PubMed · Publisher

  Abstract

  To eliminate the burden of disease and death that is caused worldwide by exposure to asbestos, the Collegium Ramazzini calls for an immediate ban on all mining and use of asbestos. To be effective, the ban must be international in scope and must be enforced in every country in the world.

• Cancer mortality among arc welders exposed to fumes containing chromium and nickel. Results of a third follow-up: 1989-1995. N. Becker. 1999;41(4):294-303. PubMed · Publisher

  Abstract

  For the historical follow-up study among arc welders exposed to chromium and nickel, which was started in 1980 in Germany, a third follow-up extending the observation period to the years 1989 through 1995 has been carried out. By 1995, of the 1213 welders and 1688 turners (control group) who were originally included in the study, 274 welders and 448 turners had died. Death certificates could be obtained for approximately 96% of the deceased. Results of the evaluation presented in this article showed that cancer mortality remains significantly increased, compared with the general population and the control group, by approximately 35%. There was an elevation of approximately 50% or 60% in mortality from cancers of the respiratory tract, which is also statistically significant. However, this increase is predominantly due to a large excess in mortality from mesothelioma, which is known to be caused chiefly by asbestos exposure. Lung cancer mortality is nonsignificantly increased by approximately 20% to 30%. An indirect assessment of asbestos-related lung cancers and total cancer indicates that the observed increase of mortality might be mainly due to asbestos exposure. Beyond that, no indication of an elevated cancer risk specifically associated with the exposure to welding fumes containing chromium and nickel could be determined.

• Structure and function of occupational health services within selected Department of Energy sites. M.K. Salazar, T.K. Takaro, K. Ertell, et al. 1999;41(12):1072-8. PubMed · Publisher

  Abstract

  The mission of the United States Department of Energy sites has recently changed from nuclear weapons production to site remediation. Considering the mass of radiological and chemical contaminants at these sites, ensuring the health and safety of workers is a major challenge. This study used the findings from a written survey to describe occupational health services at 10 Department of Energy sites. The study aims were to describe and compare: (1) the primary hazards associated with the site activities; (2) the occupational safety and health structure, including service providers; and (3) the occupational health and safety functions, including surveillance, training, and service provision. Although explosions and radiological agents were identified as the hazards with the greatest associated risks, workers at these sites were most likely to be exposed to physical hazards, ergonomic hazards, and/or chemicals, including asbestos. Physicians accounted for 2.4% of service providers, nurses for 5.5%, industrial hygienists for 12.2%, safety personnel for 11.8%, and health physicists for 64.9%. It was concluded that there is an imbalance between the most important hazards and the types of health and safety personnel at these sites.

• Effects of the intensity and timing of asbestos exposure on lung cancer risk at two mining areas in Quebec. P.M. Vacek. 1998;40(9):821-8. PubMed · Publisher

  Abstract

  Mortality data from 9609 workers at two asbestos mining areas in Quebec were analyzed to assess the effects of the intensity and timing of exposure on lung cancer risk. Summary exposure measures based on differing assumption were computed for lung cancer cases and matched controls and were fitted to the data using conditional logistic regression. A non-linear relationship between intensity and risk fit both mining areas, but risk was greater at one area than the other. At the mine with lower risk, exposure occurring more than 30 years prior to death had little effect, while at the other mine risk did not vary with time since exposure and men starting employment before 1924 were at elevated risk. The results point to differences in dust composition at the two areas and illustrate the difficulties in estimating risk.

• In vitro toxicity of respirable-size particles of diatomaceous earth and crystalline silica compared with asbestos and titanium dioxide. G.A. Hart, T.W. Hesterberg. 1998;40(1):29-42. PubMed · Publisher

  Abstract

  The relationship between particle characteristics and in vitro toxicity was investigated using Chinese hamster ovary cells. Test dusts included respirable natural (Nat) and flux-calcined (FC) diatomaceous earth (DE), quartz, cristobalite, TiO2, and chrysotile and crocidolite asbestos. All dusts elicited a qualitatively similar, concentration-dependent response: particle uptake, induction of micro- and polynuclei, and reduction in cell proliferation. However, similar mass concentrations of the dusts yielded a 35-fold range of toxicity: chrysotile > crocidolite > Nat DE > FC DE > quartz > Cristobalite > TiO2. In vitro toxicity did not correlate with crystalline silica content, surface area, composition, volume, particles/cm2, or fibrous geometry. Toxicity was closely associated with the number of particles/cm2 culture surface that had at least one dimension > 7.5 mu. Thus particle size but not shape could be a determinant of in vitro toxicity. Particle size might also impact in vivo pathogenesis.

• Occupational risk factors for cancer of the gastric cardia. Analysis of death certificates from 24 US states. P. Cocco, M.H. Ward, M. Dosemeci. 1998;40(10):855-61. PubMed · Publisher

  Abstract

  We evaluated the risk of gastric cardia cancer by occupation and industry in a case-control study using information from death certificates for 24 US states in 1984-1992. One thousand fifty-six cases of gastric cardia cancer were identified among men aged 20 years or more, including 1,023 whites and 33 blacks. Controls were 5,280 subjects who died of nonmalignant diseases, 5:1 matched to cases by geographic region, race, gender, and 5-year age group. Among white men, occupations with elevated risk included financial managers (odds ratio [OR] = 6.1; 95% confidence interval [CI], 1.3-28.8), janitors and cleaners (OR = 1.7; 95% CI, 1.0-2.9), production inspectors (OR = 3.2; 95% CI, 1.5-6.9), and truck drivers (OR = 1.5; 95% CI, 1.0-2.2). Industries with elevated risk included pulp and paper mills (OR = 2.0; 95% CI, 1.0-37), newspaper publishing and printing (OR = 2.6; 95% CI, 1.0-6.3), industrial and miscellaneous chemicals (OR = 2.0; 95% CI, 1.0-3.9), water supply and irrigation (OR = 5.6; 95% CI, 1.6-19.9). Among black men, risks were nonsignificantly increased for subjects employed in railroads (3 cases, 2 controls) and for carpenters (3 cases, 0 controls). We created job-exposure matrices for asbestos, inorganic dust, metal dust, lead, polycyclic aromatic hydrocarbons, nitrogen oxides, nitrosamines, sulfuric acid, fertilizers, herbicides, other pesticides, and wood dust. Among white men, a consistent pattern of risk increase by level and probability of exposure was observed only for sulfuric acid mists, with a twofold excess (95% CI, 0.6-7.3) associated with high probability of high intensity exposure. A significant 30% increase in risk was observed for those subjects with a high probability of exposure (all levels combined) to lead, and a 60% increase was observed for subjects with high-level exposure to lead (all probabilities combined). However, crosstabulation of gastric cardia cancer risk by probability and level of exposure to lead did not show consistent trends. Asbestos exposure also showed an overall 50% increase but no consistent trends among white men. None of the 12 occupational hazards showed an association with risk for black men.

• Asbestos disease in foundrymen. A.M. Langer, R.P. Nolan. 1997;39(8):699-700. Comment · Letter PubMed · Publisher

• Asbestos disease in foundrymen. M. Wyart-Remy. 1997;39(8):700. Comment · Letter PubMed · Publisher

• Historical cohort mortality study of a continuous filament fiberglass manufacturing plant. I. White men. L. Chiazze, D.K. Watkins, C. Fryar. 1997;39(5):432-41. PubMed · Publisher

  Abstract

  An historical cohort mortality study of a continuous filament fiberglass manufacturing plant was undertaken to determine whether an elevated lung cancer risk would be observed on a cohort basis. A nested case-control study of white male lung cancer deaths was incorporated into the study design. An interview survey to obtain information on sociodemographic factors, including smoking, and an historical environmental reconstruction to identify elements in the plant environment to which workers might be exposed were included in the study design. Respirable glass (Beta) fibers were produced only from 1963 to 1968. The lung cancer odds ratio (OR) among those workers exposed to respirable glass fibers is below unity, as are ORs for exposure to asbestos, refractory ceramic fibers, respirable silica (except for the lowest exposure level), total chrome and arsenic. There is a suggestion of an increase with exposure among smokers only for exposure to formaldehyde, although the OR for the highest level is based on only one case and is not likely to be meaningful. None of these plant exposures suggests an increase in lung cancer risk for this population. Although the lung cancer standardized mortality ratios are slightly elevated, results of the case-control investigation confirm that neither respirable glass fibers nor any of the substances investigated as part of the plant environment are associated with an increase in lung cancer risk for this population.

• Differentiation of the ILO boundary chest roentgenograph (0/1 to 1/0) in asbestosis by high-resolution computed tomography scan, alveolitis, and respiratory impairment. T.J. Harkin, G. McGuinness, R. Goldring, et al. 1996;38(1):46-52. PubMed · Publisher

  Abstract

  High-resolution computed tomography (HRCT) scans have been advocated as providing greater sensitivity in detecting parenchymal opacities in asbestos-exposed individuals, especially in the presence of pleural fibrosis, and having excellent inter- and intraobserver reader interpretation. We compared the 1980 International Labor Organization (ILO) International Classification of the Radiographs of the Pneumoconioses for asbestosis with the high-resolution CT scan using a grid scoring system to better differentiate normal versus abnormal in the ILO boundary 0/1 to 1/0 chest roentgenograph. We studied 37 asbestos-exposed individuals using the ILO classification, HRCT grid scores, respiratory symptom questionnaires, pulmonary function tests, and bronchoalveolar lavage. We used Pearson correlation coefficients to evaluate the linear relationship between outcome variables and each roentgenographic method. The normal HRCT scan proved to be an excellent predictor of "normality," with pulmonary function values close to 100% for forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), total lung capacity (TLC), and carbon monoxide diffusing capacity (DLCO) and no increase in BAL inflammatory cells. Concordant HRCT/ILO abnormalities were associated with reduced FEV1/FVC ratio, reduced diffusing capacity, and alveolitis consistent with a definition of asbestosis. In our study, the ILO classification and HRCT grid scores were both excellent modalities for the assessment of asbestosis and its association with impaired physiology and alveolitis, with their combined use providing statistical associations with alveolitis and reduced diffusing capacity.

• Lung function and respiratory symptoms related to changes in smoking habits in asbestos-exposed subjects. H.P. Waage, L.J. Vatten, E. Opedal, et al. 1996;38(2):178-83. PubMed · Publisher

  Abstract

  The purpose of this study was to examine respiratory symptoms and lung function (forced vital capacity [FVC] and forced expiratory volume in 1 second [FEV1]) as related to changes in smoking habits in subjects previously exposed to asbestos. The study was linked to a smoke-ending program among asbestos-exposed males. Subjects were recruited from a population-based survey, and 231 smokers met for the baseline consultation. The baseline prevalences of cough, chronic cough, and dyspnea among smokers were 68.0%, 44.6%, and 42.4%, respectively. Both smoke-ending (n = 10) and tobacco reduction (n = 52) during the 2-year follow-up resulted in remission of cough and chronic cough, whereas dyspnea was unaffected. When the 2-year measurements of FVC and FEV1 were adjusted for the respective baseline measurements, FEV1 tended to improve in subjects who had quit during the study, relative to the continuing smokers. It was concluded that both smoke-ending and reduction of tobacco consumption resulted in reduction of cough and chronic cough, but not of dyspnea. The study further suggests a possible positive effect of smoking cessation on FEV1, but not merely by reduction of tobacco consumption.

• Mesothelioma: An unwarranted causal model. D.S. Egilman, A.S. Goldin, G.A. Goldin. 1996;38(3):239-40. Comment · Letter PubMed · Publisher

• Radiographic small lung opacities and pleural abnormalities in relation to smoking, urbanization status, and occupational asbestos exposure in Finland. A.J. Zitting, A. Karjalainen, O. Impivaara, et al. 1996;38(6):602-9. PubMed · Publisher

  Abstract

  The role of smoking and an urban living environment in the etiology of radiographic pleural and pulmonary abnormalities was studied in a population sample that was representative of the Finnish adult population. A total of 7095 full-size chest radiographs were classified according to the International Labor Organization's 1980 classification of radiographs of pneumoconioses, with some modifications. The risk of bilateral pleural plaques was significantly higher among urban men (RR, 2.0) and women (RR, 3.8), even when adjusted for age and probability of occupational asbestos exposure and smoking. The risks of small lung opacities and abnormalities of the visceral pleura were not higher in urban areas. Risks of small lung opacities and thickening of the visceral pleura were positively associated with smoking, and the risk of small lung opacities was also higher among smokers than never-smokers in the population fraction with unlikely occupational asbestos exposure.

• Respiratory disease as a result of talc inhalation. G. Scancarello, R. Romeo, E. Sartorelli. 1996;38(6):610-4. Case report PubMed · Publisher

  Abstract

  Three cases of respiratory disease in workers with occupational exposure to talc containing asbestos fibers are reported. Standard chest roentgenographs, high-resolution computed tomography, respiratory function tests, morphologic study of bronchoalveolar lavage fluid (BAL), light microscopic examination, and mineralogical analysis by transmission electron microscopy (TEM) of BAL was performed. All subjects showed bilateral pleural plaques, and in two subjects the study of BAL revealed lymphocytic alveolitis with an increased T4/T8 ratio. Mineralogical analysis of BAL detected asbestos-fiber concentrations of 510, 2039, and 3392 fibers/mL and many asbestos bodies. In one patient, mineralogical analysis of lung tissue was also performed; a concentration of 3,659,000 fibers/g dry tissue was found. Simultaneously, we performed a mineralogical study of 12 commercial talc samples, including those used by the patients during the last phase of their working lives. TEM revealed asbestos fibers in five samples. Two subjects used two of these talc powders. The study presented here confirms the need to perform all relevant clinical tests together with the study of BAL and mineralogical analysis of the materials to which the patients are or were exposed to determine occupational exposure to fibers, including those associated with talc, which are often misidentified.

• An updated study of mortality among workers at a petroleum manufacturing plant. Y. Honda, E. Delzell, P. Cole. 1995;37(2):194-200. PubMed · Publisher

  Abstract

  This study evaluated mortality among 9796 white male workers at a petroleum-manufacturing plant. The main purpose was to examine recent patterns in leukemia mortality, for which an increase had been reported in an earlier investigation. Compared to U.S. white men, the cohort had an excess of leukemia in 1940-1979 (38 observed/23 expected; standardized mortality ratio = 168; 95% confidence interval = 119-230). In the 1980s, there was a deficit of leukemia (8 observed/14 expected; standardized mortality ratio = 55; 95% confidence interval = 24-108). However, this was balanced by an excess of myelofibrosis and myelodysplasia (4 observed, < 1 expected). These results indicate that any occupational leukemogenic exposures at the plant have been reduced to a point at which they are insufficient to cause leukemia. Hourly workers also had an excess of deaths from mesothelioma in the 1980s (8 observed, about 2.5 expected), possibly because of exposure to asbestos in the past.

• Asbestos-related radiographic changes by ILO classification of 10 x 10 cm chest X-rays in a screening of the general population. B. Hilt, G. Hillerdal, P.G. Lund-Larsen, et al. 1995;37(2):189-93. PubMed · Publisher

  Abstract

  A sample of 1388 10 x 10 cm chest X-rays from a previous population screening of males aged 40+ years were reevaluated by use of the ILO classification. There were 1036 films of subjects from an industrialized town, and 352 from a rural community. The observed rates of parenchymal changes (profusion > or = 1/0) at the reevaluation were 1.3% in the urban community and 3.4% in the rural community. The corresponding figures for pleural changes were 5.0% and 0.6%, respectively. Based on additional questionnaire information on asbestos exposure, it was found that the radiographic changes were probably related to past asbestos exposure for 2.3% of the subjects from the urban community and 0.6% from the rural community. In cases of asbestos-related illnesses the mean time since first exposure to asbestos was 35.9 years, whereas the mean duration of the exposures was 11.4 years. The results seem to indicate that the ILO reassessment of the radiographs was more sensitive in detecting pleural changes than the previous clinical screening of both small and large films.

• Man-made vitreous fibers and risk of respiratory system cancer: a review of the epidemiologic evidence. I.M. Lee, C.H. Hennekens, D. Trichopoulos, et al. 1995;37(6):725-38. Review PubMed · Publisher

  Abstract

  Because asbestos has been demonstrated to cause lung cancer, the issue regarding safety of other fibers, including man-made vitreous fibers (MMVF), has been raised. We reviewed the available evidence, in particular the epidemiologic data, on MMVF and the risk of respiratory system cancer. Glass fibers (especially glass wool) have been studied most extensively. Taken together, the data indicate that among those occupationally exposed, glass fibers do not appear to increase risk of respiratory system cancer. Of six studies that specifically examined rock and slag wool workers, three reported excesses in respiratory system cancer among such workers. Two of these three studies, however, did not control for cigarette smoking, a powerful predictor of such cancers. There are no published studies, in humans, of refractory ceramic fibers. Future studies evaluating the potential of MMVF to increase risk of respiratory system cancer will not add to existing knowledge if investigators do not address potential confounding by cigarette smoking and other workplace carcinogens.

• p53 and ras gene mutations in lung cancer: implications for smoking and occupational exposures. K. Husgafvel-Pursiainen, M. Ridanpää, S. Anttila, et al. 1995;37(1):69-76. Review PubMed · Publisher

  Abstract

  This paper reviews mutational activation of ras oncogenes and inactivation of the p53 tumor suppressor gene in human lung cancer. We discuss the frequency, type, and location of mutations in these genes in relation to known etiological factors for lung cancer. The most studied examples of these are exposure to tobacco smoke, and to radon and asbestos fibers at work. We summarize data from our laboratory on K-ras and p53 mutations in fresh tissue samples from patients with resected primary lung carcinoma whose smoking and occupational histories were known. Most of the tumors examined were histologically non-small cell carcinoma (NSCLC), mainly of the squamous cell carcinoma and adenocarcinoma types. We compare the prevalence and nature of mutations in the two histological types of NSCLC.

• The lack of causality between asbestos and colorectal cancer. W. Weiss. 1995;37(12):1364-73. Meta-analysis PubMed · Publisher

  Abstract

  To evaluate a potential causal relationship between asbestos exposure and the risk of colorectal cancer, 30 cohort studies published in English were reviewed and analyzed. The latest report of each cohort up through 1993 was used. The outcome measure was the standardized morbidity (incidence) or mortality ratio (SMR). Summary SMRs were examined by type of cohort registration, type of work, type of asbestos, latency from onset of exposure to period of risk, and incidence only. The overall relative risk was 0.99 for all 30 studies. The evidence does not meet the important criteria for a judgment of causality because the relative risk is not consistently elevated, weak in the two studies with a statistically significant elevation of SMR, and limited data do not support a dose-response relationship.

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