RE: Mesothelioma and lung tumors attributable to asbestos among petroleum workers. Am. J. Ind. Med. 2000. 37:275-282

Our plain-English summary of RE: Mesothelioma and lung tumors attributable to asbestos among petroleum workers. Am. J. Ind. Med. 2000. 37:275-282, by S.P. Tsai, L.C. Waddell, J.C. Ransdell (American Journal of Industrial Medicine, 2001).

The study

• Authors: S.P. Tsai, L.C. Waddell, J.C. Ransdell
• Journal: American Journal of Industrial Medicine
• Published: 2001;39(5):515-21; author reply 517-21
• Type of article: Comment, Letter
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor responding to a 2000 article by Gennaro and colleagues. That article had attributed 96 to 100% of mesotheliomas and 42 to 49% of lung cancers among petroleum-industry maintenance workers to asbestos. The letter writers argued that Gennaro's comparison group of white-collar workers was not the best choice. They said other blue-collar workers, or the least-exposed maintenance workers, would be better. They then presented additional analyses from their own 1996 study of maintenance workers at a Texas refinery and petrochemical plant. Among 2,504 maintenance employees who worked at least 1 year in jobs with potential asbestos exposure, the lung cancer standardized mortality ratio was 0.81 (68 deaths, 95% CI 0.63 to 1.03). Employees with 20 or more years in maintenance were compared with employees who worked 20 or more years in non-maintenance jobs. Their lung cancer rate ratio was 1.09 (95% CI 0.79 to 1.50), not significantly different from 1.0, which gave an attributable risk of 8%. Lung cancer ratios did not rise with longer employment. The authors concluded that their data did not support an increased lung cancer risk. The letter gave no mesothelioma results for their own workers.

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

What the study did and found

• Design: Letter to the editor criticizing the comparison group used by Gennaro et al. (2000) and presenting additional lung cancer analyses from the letter writers' own 1996 mortality study of refinery maintenance workers
• Who was studied: Maintenance employees of a Texas refinery and petrochemical plant (from Tsai et al. 1996): 2,504 who worked 1 year or longer in jobs with potential asbestos exposure. A subgroup worked 20 or more years. The internal comparison group was employees who worked 20 or more years in non-maintenance jobs.
• Exposure: Potential asbestos exposure in maintenance jobs, measured as length of employment as a maintenance worker. No fiber type or dose is given.
• Main results:
  • Gennaro et al. (2000), the article being criticized, had stated that 96 to 100% of mesotheliomas and 42 to 49% of lung cancers among petroleum-industry maintenance workers were attributable to asbestos. This is that article's claim, not a finding of this letter.
  • The authors argued that other blue-collar workers, or the maintenance workers with the lowest exposure or shortest employment, would have been a better comparison group than white-collar workers.
  • Among the 2,504 maintenance employees who worked 1 year or longer, the lung cancer standardized mortality ratio (SMR) was 0.81 (68 observed deaths, 95% CI 0.63 to 1.03).
  • Among maintenance employees who worked 20 or more years, the lung cancer SMR was 0.83 (19 observed deaths, 95% CI 0.50 to 1.29).
  • Maintenance employees with 20 or more years were compared with employees who worked 20 or more years in non-maintenance jobs. The standardized lung cancer rate ratio was 1.09 (95% CI 0.79 to 1.50), which the authors reported as not significantly different from 1.0.
  • Applying Gennaro's approach to this internal comparison gave an attributable risk for lung cancer among maintenance workers of 8%.
  • Lung cancer SMRs were 0.88, 0.77 and 0.83 for those employed as maintenance workers 1 to 4 years, 5 to 19 years and 20 or more years.
• The authors' conclusion: The authors concluded that their data did not support Gennaro et al.'s assertion that petroleum-industry maintenance workers potentially exposed to asbestos have an increased risk of lung cancer. They found no indication of an association between lung cancer and length of employment as maintenance workers.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Mesothelioma and lung tumors attributable to asbestos among petroleum workers — V. Gennaro, M.M. Finkelstein, et al. (2000)
• RE: Mesothelioma and lung tumors attributable to asbestos among petroleum workers. Am. J. Ind. Med. 2000. 37:275-282 — E.R. Ludwig, L. Madeksho, et al. (2001)
• Mortality and cancer morbidity in a cohort of Canadian petroleum workers — R.J. Lewis, A.R. Schnatter, et al. (2003)
• An updated study of mortality among workers at a petroleum manufacturing plant — Y. Honda, E. Delzell, et al. (1995)
• An updated mortality study of workers at a petroleum refinery in Beaumont, Texas — G.K. Raabe, K.W. Collingwood, et al. (1998)
• Kidney cancer and hydrocarbon exposures among petroleum refinery workers — C. Poole, N.A. Dreyer, et al. (1993)

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