Incidence of cancer among anthophyllite asbestos miners in Finland.

A cohort of 736 male and 167 female workers of two anthophyllite mines in Finland was followed up through the Finnish Cancer Registry for cancer in 1953-91. Compared with the total cancer incidence of the east Finnish population, the men had a raised risk of total cancer (standardised incidence ratio (SIR) 1.7; 95% confidence interval (95% CI) 1.4-1.9), mainly attributable to an excess in lung cancer (SIR 2.8; 95% CI 2.2-3.6). The risk of lung cancer was somewhat higher among workers classified as heavily exposed (SIR 3.2; 95% CI 2.4-4.1) than among those moderately exposed (SIR 2.3; 95% CI 1.5-3.6) and the risk increased with increasing smoking and with increasing time of work with exposure. There were four cases of mesothelioma v 0.1 expected, all in men who smoked and had had a long and heavy asbestos exposure. Among women, a non-significant excess in total cancer (SIR 1.5; 95% CI 0.9-2.4) was found in the subgroup with heavy exposure to asbestos. Anthophyllite asbestos seems to have high potency in the carcinogenesis of lung cancer and low potency in carcinogenesis of mesothelioma in comparison with the other types of asbestos.     

Incidence of cancer among the participants of the Finnish Asbestos Screening Campaign

OBJECTIVES: Cancer risk has been estimated for asbestos production workers or other heavily exposed asbestos workers in numerous studies. The bulk of the asbestos epidemic results come, however, from past intermittent exposures during asbestos product use. This study concentrated on estimating the risk of cancer in such a population. METHODS: Altogether 23285 men and 930 women invited to a nationwide screening campaign for benign asbestos-related diseases in 1990-1992 were followed for cancer through the Finnish Cancer Register up to 1998. Standardized incidence ratios (SIR) were calculated in comparison with the total Finnish population. RESULTS: Altogether 1392 cases of cancer were found among the men. The risk was slightly, but significantly elevated for lung cancer [SIR 1.14, 95% confidence interval (95% CI) 1.01-1.26), mesothelioma (SIR 2.77, 95% CI 1.66-4.31), and prostate cancer (SIR 1.21, 95% CI 1.09-1.34). The risk of lung cancer was slightly higher among the invited nonparticipants (SIR 1.48, 95% CI 1.20-1.79) than among the participants (SIR 1.02, 95% CI 0.88-1.17). About 98% of the lung cancers occurred in current or ex-smokers. CONCLUSIONS: In a population of long-term construction workers, the risk of lung cancer and mesothelioma was increased, but considerably lower than among insulators, asbestos sprayers, or patients with asbestosis. As it was not possible to follow most of the invited nonparticipants in the original screening study, selection bias by smoking or other life-style factors possibly correlated to the individual's decision to participate in the health screening cannot be excluded.     

Different measures of asbestos exposure in estimating risk of lung cancer and mesothelioma among construction workers

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.     

Lung cancer and mesothelioma in the pleura and peritoneum among Swedish insulation workers

OBJECTIVES: To estimate the risk of cancer and death in Swedish insulation workers some years after their exposure to asbestos had stopped. One hypothesis was that the risk of lung cancer would tend to decrease some years after the exposure had ended. METHODS: In a cohort study the cancer morbidity and cause of death was investigated in 248 insulation workers and compared with the corresponding morbidity and mortality in the general population. Due to stringent regulations, exposure to asbestos of all types had almost ended in Sweden in the mid- 1970s. Through a questionnaire, surviving insulation workers were asked about their exposure to asbestos and their smoking habits. RESULTS: Between 1970 and 1994 there were 86 deaths compared with the 46.0 expected (standardised incidence ratio (SIR) 1.9; 95% confidence interval (95% CI) 1.5 to 2.3), the increase was mainly due to an increased cancer mortality. The morbidity was increased for lung cancer (11 cases v 2.5 expected (SIR 4.4; 95% CI 2.2 to 7.9)), peritoneal mesothelioma (seven cases; no expected incidence could be calculated as the occurrence is too rare in the general population), cancer in pancreas (five cases v 0.7 expected (SIR 7.1; 95% CI 2.3 to 16.7)). No cases of pleural mesothelioma were found. The risk of lung cancer did not tend to approach that of the general population after the exposure to asbestos decreased. CONCLUSIONS: In the 1980s and the early 1990s, Swedish insulation workers still have a highly increased risk of diseases related to asbestos. The attributable risk for death and cancer was about 50%. The study also confirms the previous finding that mesothelioma in insulation workers seems to be situated in the peritoneum more often than in the pleura.     

Cancer incidence among workers in the asbestos-cement producing industry in Norway

OBJECTIVES: The incidence of cancer among employees of a Norwegian asbestos-cement factory was studied in relation to duration of exposure and time since first exposure. The factory was active in 1942-1968. Most of the asbestos in use was chrysotile, but for technical reasons 8% amphiboles was added. METHODS: For the identification of cancer cases, a cohort of 541 male workers was linked to the Cancer Registry of Norway. The analysis was based on the comparison between the observed and expected number of cancer cases. Standardized incidence ratios (SIR) and 95% confidence intervals (95% CI) were estimated. Period of first employment, duration of employment, and time since first employment were used as indicators of exposure. Poisson regression analysis was used for the internal comparisons. RESULTS: The standardized incidence ratio was 52.5 (95% CI 31.1-83.0) for pleural mesothelioma, on the basis of 18 cases. The highest standardized incidence ratio was found for workers first employed in the earliest production period (SIR 99.0, 95% CI 51.3-173). No peritoneal mesothelioma was found. The standardized incidence ratio for lung cancer was 3.1 (95% CI 2.14.3), but no dose-response effect was observed. The ratio of mesothelioma to lung cancer cases was 1:2. CONCLUSIONS: This study showed a high incidence of mesothelioma and a high ratio of mesothelioma to lung cancer among asbestos-cement workers. The high incidence of mesothelioma was probably due to the fact that a relatively high proportion of amphiboles was used in the production process.     

Mortality from lung cancer and population risk attributable to asbestos in an asbestos cement manufacturing town in Italy

OBJECTIVE: To estimate mortality from lung cancer and the risk attributable to asbestos separately for asbestos cement workers and for the general (non-occupationally exposed) population in the town of Casale Monferrato, where the largest Italian asbestos cement factory had been in operation in 1907-86. According to cancer registry data, in the same town the incidence of malignant mesothelioma in the general population is about 10 times higher than in comparable Italian provinces. METHOD: Decedents from lung cancer in 1989-95 were nominally identified in the list of decedents kept at the Local Health Authority of Casale Monferrato. Workers in the asbestos cement factory have been identified with a search in the nominal list of workers and the same was done for the wives of asbestos cement workers. These lists have already been used in cohort studies. Sensitivity and specificity of the linkage procedure with occupational activity in asbestos cement production have been evaluated in a previous study. Population at risk was estimated on the basis of official figures and on the results of the cohort study of asbestos cement workers. RESULTS: 227 deaths from lung cancer were included (184 men and 43 women). Among the asbestos cement workers mortalities were 234.0 x 100,000 person-years among men and 35.5 among women. Corresponding figures in the general (non- occupationally exposed) population in Casale Monferrato were 80.6 and 18.7. The rates in the general population were not higher than in the rest of the region. Attributable risk (AR) among the asbestos cement workers (and wives) is 67.5% (95% confidence interval (95% CI) 56.8 to 78.2) for men and 51.3% (95% CI 14.9 to 87.8) among women. Population AR to occupational or paraoccupational exposure in the asbestos cement production is 18.3% (95% CI 11.1 to 25.6) among men and 10.1% (95% CI 0 to 24.6) among women. CONCLUSION: This work did not show an increase in mortality from lung cancer for the population not exposed occupationally, but a large excess was found among men and women occupationally exposed in asbestos cement production. The total burden of lung cancer due to occupational exposure to asbestos may be underestimated, as only occupational exposure in asbestos cement production was taken into consideration. Nevertheless even a single factory can be responsible for a considerable proportion of deaths from lung cancer in a population.

 

     

Cancer incidence and mortality among Finnish asbestos sprayers and in asbestosis and silicosis patients

Cohorts of Finnish asbestos sprayers and of asbestosis and silicosis patients were followed for cancer with the aid of the Finnish Cancer Registry in the period 1967–1994. Compared with the cancer incidence of the total Finnish population, asbestos sprayers had an increased risk for total cancer (standardized incidence ratio [SIR] 6.7, 95% confidence interval [95% CI] 4.2–10); lung cancer (SIR 17, 95% CI 8.2–31); and mesothelioma (SIR 263, 95% CI 85–614). The SIR of the asbestosis patients was 3.7 (95% CI 2.8–5.0) for all sites, 10 (95% CI 6.9–14) for lung cancer, and 65 (95% CI 13–188) for mesothelioma. The silicosis patients also had significantly high SIR values for all sites (1.5, 95% CI 1.0–2.1) and lung cancer (2.7, 95% CI 1.5–4.5). The values for the SIR and the standardized mortality ratio for all sites and lung cancer were very similar, and therefore it seems that both are reliable indicators of the occurrence of occupational cancer. It was concluded that pneumoconioses patients and asbestos-exposed workers have a markedly elevated risk for cancer. Asbestos-induced occupational cancers are not only diseases of the elderly, since the relative risk is high also for middle-aged people. Am. J. Ind. Med. 31:693–698, 1997. © 1997 Wiley-Liss, Inc.     

Cancer incidence among Swedish pulp and paper mill workers: a cohort study of sulphate and sulphite mills

Purpose

Associations between various malignancies and work in the pulp and paper industry have been reported but mostly in analyses of mortality rather than incidence. We aimed to study cancer incidence by main mill pulping process, department and gender in a Swedish cohort of pulp and paper mill workers.

Methods

The cohort (18,113 males and 2,292 females, enrolled from 1939 to 1999 with >1 year of employment) was followed up for cancer incidence from 1958 to 2001. Information on the workers’ department and employment was obtained from the mills’ personnel files, and standardized incidence ratios (SIRs) were calculated using the Swedish population as reference.

Results

Overall cancer incidence, in total 2,488 cases, was not increased by work in any department. However, risks of pleural mesothelioma were increased among males employed in sulphate pulping (SIR, 8.38; 95 % CI, 3.37–17) and maintenance (SIR, 6.35; 95 % CI, 3.47–11), with no corresponding increase of lung cancer. Testicular cancer risks were increased among males employed in sulphate pulping (SIR, 4.14; 95 % CI, 1.99–7.61) and sulphite pulping (SIR, 2.59; 95 % CI, 0.95–5.64). Female paper production workers showed increased risk of skin tumours other than malignant melanoma (SIR, 2.92; 95 % CI, 1.18–6.02).

Conclusions

Incidence of pleural mesothelioma was increased in the cohort, showing that asbestos exposure still has severe health consequences, and highlighting the exigency of strict asbestos regulations and elimination. Testicular cancer was increased among pulping department workers. Shift work and endocrine disruptors could be of interest in this context.     

Malignant mesothelioma: attributable risk of asbestos exposure.

OBJECTIVES--To evaluate a case-control study of malignant mesothelioma through patterns of exposure to asbestos based upon information from telephone interviews with next of kin. METHODS--Potential cases, identified from medical files and death certificates, included all people diagnosed with malignant mesothelioma and registered during 1975-1980 by the Los Angeles County Cancer Surveillance Program, the New York State Cancer Registry (excluding New York City), and 39 large Veterans Administration hospitals. Cases whose diagnosis was confirmed in a special pathology review as definite or probable mesothelioma (n = 208) were included in the analysis. Controls (n = 533) had died of other causes, excluding cancer, respiratory disease, suicide, or violence. Direct exposure to asbestos was determined from responses to three types of questions: specific queries as to any exposure to asbestos; occupational or non-vocational participation in any of nine specific activities thought to entail exposure to asbestos; and analysis of life-time work histories. Indirect exposures were assessed through residential histories and reported contact with family members exposed to asbestos. RESULTS--Among men with pleural mesothelioma the attributable risk (AR) for exposure to asbestos was 88% (95% confidence interval (95% CI) 76-95%). For men, the AR of peritoneal cancer was 58% (95% CI 20-89%). For women (both sites combined), the AR was 23% (95% CI 3-72%). The large differences in AR by sex are compatible with the explanations: a lower background incidence rate in women, lower exposure to asbestos, and greater misclassification among women. CONCLUSIONS--Most of the pleural and peritoneal mesotheliomas in the men studied were attributable to exposure to asbestos. The situation in women was less definitive.     

Cancer mortality and incidence of mesothelioma in a cohort of wives of asbestos workers in Casale Monferrato, Italy

BACKGROUND: Family members of asbestos workers are at increased risk of malignant mesothelioma (MM). Although the hazard is established, the magnitude of the risk is uncertain, and it is unclear whether risk is also increased for other cancers. Few cohort studies have been reported. OBJECTIVE: The "Eternit" factory of Casale Monferrato (Italy), active from 1907 to 1986, was among the most important Italian plants producing asbestos-cement (AC) goods. In this article we present updated results on mortality and MM incidence in the wives of workers at the factory. METHODS: We studied a cohort of 1,780 women, each married to an AC worker during his employment at the factory but not personally occupationally exposed to asbestos. Cohort membership was defined starting from the marital status of each worker, which was ascertained in 1988 from the Registrar's Office in the town where workers lived. At the end of follow-up (April 2003), 67% of women were alive, 32.3% dead, and 0.7% lost to follow-up. Duration of exposure was computed from the husband's period of employment. Latency was the interval from first exposure to the end of follow-up. RESULTS: The standardized mortality ratio (SMR) for pleural cancer [21 observed vs. 1.2 expected; SMR = 18.00; 95% confidence interval (CI), 11.14-27.52] was significantly increased. Mortality for lung cancer was not increased (12 observed vs. 10.3 expected; SMR = 1.17; 95% CI, 0.60-2.04). Eleven incident cases of pleural MM were observed (standardized incidence ratio = 25.19; 95% CI, 12.57-45.07). CONCLUSIONS: Household exposure, as experienced by these AC workers' wives, increases risk for pleural MM but not for lung cancer.     

Cancer incidence among asbestos-exposed chemical industry workers: an extended observation period

A previous study on the incidence of cancer in a cohort of 286 asbestos-exposed electrochemical industry workers observed from 1953 through 1980 has been extended with another 8 years of follow-up. The incidence of cancer was derived from the Cancer Registry of Norway, and the expected figures were calculated by a life table method. During the extended follow-up period from 1981 through 1988, among the cohort members there were 12 new cancer cases versus 14.2 expected (SIR 85, 95% CI 44-158). In a lightly exposed sub-cohort, the extended follow-up revealed 4 cases of lung cancer or pleural mesothelioma (ICD, 7th revision 162-163) versus 1.6 cases expected (SIR 256, 95% CI71-654). In a heavily exposed sub-cohort, the corresponding figures were 3 and 0.5 (SIR 588, 95% CI 118-1,725).     

Cancer in ex‐asbestos cement workers in Israel, 1953–1992

A cohort of 3,057 male workers employed in an asbestos‐cement plant using 90% chrysotile‐10% crocidolite, located in Northern Israel, was followed from 1953–1992 for incidence and mortality from cancer. In the years 1978–1992, the cohort had an elevated risk for all malignant neoplasms combined (n > 153, SIR > 117, ns), lung cancer (n > 28, SIR > 135, ns), mesothelioma (n > 21; SIR >5000, p > .0001), unspecified pleural cancer (n > 5; SIR > 278 , P > .0001), and liver cancer (n > 7, SIR 290, ns). Risks for colo‐rectal (n > 19; SIR > 79, ns), bladder (n = 12, SIR 69) and renal cancers (n > 5, SIR 104) were less than expected. Risk for mesothelioma showed a sharp risk gradient with duration of exposure, increasing from 1 per 625 for those employed less than 2 years to 1 per 4.5 workers employed over 30 years. The ratio of mesothelioma to excess lung cancer cases was 2.9 to 1, or 3.6 to 1, if pleural cases of unspecified origin were included; the pleura to peritoneum ratio of verified mesothelioma cases was 20 to 1. This atypically high ratio of mesothelioma to excess lung cancer cases is suggested to be the combined result of high past asbestos exposures in the workers and their low prior risk for lung cancer, and possibly, relatively early smoking cessation in relation to asbestos exposure. Am. J. Ind. Med. 35:1–8, 1999. © 1999 Wiley‐Liss, Inc.     

Risk of lung cancer according to mild steel and stainless steel welding

OBJECTIVES: Whether the elevated risk of lung cancer observed among welders is caused by welding emissions or by confounding from smoking or asbestos exposure is still not resolved. This question was addressed in a cohort with a long follow-up and quantified estimates of individual exposure to welding fume particulates. METHODS: Male metal workers employed at least 1 year at one or more Danish stainless or mild steel industrial companies from 1964 through 1984 were enrolled in a cohort. Data on occupational and smoking history were obtained by questionnaire in 1986. Welders in the cohort who started welding in 1960 or later (N=4539) were followed from April 1968 until December 2003, when information on cancer diagnosis was obtained from the Danish Cancer Registry. During the follow-up, 75 cases of primary lung cancer were identified. Lifetime accumulated exposure to welding fume particulates was estimated by combining questionnaire information and more than 1000 welding-process-specific measurements of fume particulates in the Danish welding industry. RESULTS: The standardized incidence ratio (SIR) for lung cancer was increased among the welders [SIR 1.35, 95% confidence interval (95% CI) 1.06-1.70)]. Among the stainless steel welders, the risk increased significantly with increasing accumulative welding particulate exposure, while no exposure-response relation was found for mild steel welders, even after adjustment for tobacco smoking and asbestos exposure. CONCLUSIONS: The study corroborates earlier findings that welders have an increased risk of lung cancer. While exposure-response relations indicate carcinogenic effects related to stainless steel welding, it is still unresolved whether the mild steel welding process carries a carcinogenic risk.     

Mesothelioma and lung cancer among motor vehicle mechanics: a meta-analysis

We conducted a systematic review and analysis of the epidemiological literature that examines the risk of lung cancer and mesothelioma among motor vehicle mechanics who may have been engaged in brake repair and, thus, were potentially exposed to asbestos. All relevant studies were classified into three tiers according to their quality. Tier III (lowest quality) studies were cited for completeness, but were not included in the meta-analysis. Meta relative risks (meta-RRs) were calculated for mesothelioma and lung cancer using both fixed and random effects models for Tiers I and II, separately, followed by stratified analyses based on study design or exposure characterization (garage workers versus brake workers) and, for lung cancer studies, based on adequate adjustment for smoking. The meta-analysis for Tier I (higher quality) and Tier II (lower quality) studies of mesothelioma yielded RR estimates of 0.92 (95% CI 0.55-1.56) and 0.81 (95% CI 0.52-1.28), respectively. Further stratification according to exposure characterization did not affect the results. The meta-analysis for lung cancer produced RR estimates of 1.07 (95% CI 0.88-1.31) for Tier I and 1.17 (95% CI 1.01-1.36) for Tier II. When the lung cancer analysis was limited to studies that used adequate control for smoking, the resulting RR estimate was 1.09 (95% CI 0.92-1.28). Based on these findings, we conclude that employment as a motor vehicle mechanic does not increase the risk of developing mesothelioma. Although some studies showed a small increase in risk of lung cancer among motor vehicle mechanics, the data on balance do not support a conclusion that lung cancer risk in this occupational group is related to asbestos exposure.     

Epidemiological investigation on the health status of employees in two factories manufacturing and repairing railway rolling stock: a historical perspective study of mortality

BACKGROUND: Epidemiological studies of cancer risk due to occupational exposure to asbestos in production and repair of railway rolling stock has so far given consistent results for mesothelioma, but conflicting evidence for lung cancer. OBJECTIVES: The main purpose of this study was to investigate risk for mesothelioma and lung cancer in relation to estimated patterns of exposure in the occupational environment of railway rolling stock manufacture and repair. METHODS: A historical prospective study approach was adopted. The mortality experience of the study population was compared to that of the population of the Veneto Region. Two historical cohorts of workers employed in two plants manufacturing and repairing railway coaches were followed up for mortality. A total of 1,621 workers were enrolled in the study from the first factory, and 1,190 from the second. RESULTS: An elevation of both pleural mesothelioma and lung cancer was reported in the two factories with SMRs of 21.52 (CI 95%=1.64-32.29) and 6.46 (CI 95%=1.33-18.88), and 1.26 (CI 95%=1.01-1.54) and 1.18 (CI 95%=0.81-1.66) respectively. The two excesses however showed different patterns in relation to historical exposure estimates, which appear to correlate with mesotheliomas but not with lung cancer. An elevation of mortality for non-neoplastic respiratory diseases was associated with employment during periods when it was estimated that exposure was at higher levels in one of the two firms. CONCLUSIONS: The results confirm the high carcinogenic risk deriving from asbestos exposure, although inconsistencies were found between target organs in relation to exposure estimates, and the existence of time periods in production in which cancer risk was different.     

Cancer mortality in a surveillance cohort of German males formerly exposed to asbestos

The objective of this analysis was the estimation of the cancer risks of asbestos and asbestosis in a surveillance cohort of high-exposed German workers. A group of 576 asbestos workers was selected for high-resolution computer tomography of the chest in 1993-1997. A mortality follow-up was conducted through 2007. Standardised mortality ratios (SMRs) were calculated and Poisson regression was performed to assess mesothelioma risks. A high risk was observed for pleural mesothelioma (SMR 28.10, 95% CI 15.73-46.36) that decreased after cessation of exposure (RR 0.1; 95% CI 0.0–0.6 for ≥30 vs. <30 years after last exposure). Asbestosis was a significant risk factor for mesothelioma (RR 6.0, 95% CI 2.4-14.7). Mesothelioma mortality was still in excess in former asbestos workers although decreasing after cessation of exposure. Fibrosis was associated with subsequent malignancy.     

Mortality and cancer incidence in Swedish battery workers exposed to cadmium and nickel

OBJECTIVE: To follow up cancer incidence and mortality in a group of Swedish battery workers exposed to nickel hydroxide and cadmium oxide. METHODS: 869 workers, employed at least one year between the years 1940 and 1980 were followed up until 1992. Vital status and causes of death were obtained from the Swedish cause of death registry. Cancer morbidity was retrieved from the Swedish cancer registry. Regional reference rates were used to compute the expected numbers of deaths and cancers. RESULTS: Up to 31 December, 1992, a total of 315 deaths (292 in men and 23 in women) had occurred in the cohort. For men, the overall standardised mortality ratio (SMR) was 106 (95% confidence interval (95% CI) 93.7 to 118) and for women 83.8 (95% CI 53.1 to 126). The SMRs for total cancer mortality were 125 (95% CI 98.2 to 157) for men and 69.5 (95% CI 25.5 to 151) for women. The SMR for lung cancer in men was 176 (95% CI 101 to 287). No lung cancers were found among female workers. Up to 31 December, 1991, a total of 118 cancers had occurred in the cohort. A significantly increased standardised incidence ratio (SIR) was found for cancer of the nose and nasal sinuses in men, three cases v 0.36 expected, yielding an SIR of 832 (95% CI 172 to 2430). Applying a 10 year latency period in cohort members exposed to > or = 1000 micrograms cadmium/m3, the SIR was 1107 (95% CI 134 to 4000). Similarly, for cohort members exposed to 2000 micrograms nickel/m3, the SIR was 1080 (95% CI 131 to 3900). CONCLUSION: There was an increased overall risk for lung cancer, but no exposure-response relation between cumulative exposure to cadmium or nickel and risk of lung cancer. There was a highly significant increased risk of cancer of the nose and nasal sinuses, which may be caused by exposure to nickel or cadmium or a combination of both exposures.

 

     

Cancer incidence and asbestos in drinking water, Town of Woodstock, New York, 1980-1998

Late in 1985, asbestos contamination was discovered in the public water supply of the Town of Woodstock, Ulster County, New York. Contamination resulted from asbestos-cement pipes installed in the town water system in the mid to late 1950s and the corrosiveness of the local water. The New York State (NYS) Department of Health established the Woodstock Asbestos Exposure Registry (WAER) in 1986 to monitor rates of cancer among individuals who lived on the water supply between 1960 and 1985. Demographic, health, and residential information were collected on 2936 registrants. The follow-up period for observation of cancer was 1980-1998, consistent with the expected lag of 20-30+ years for development of asbestos-related cancers. The NYS Cancer Registry was used to ascertain cancer diagnoses. Standardized incidence ratios (SIRs) for gastrointestinal, respiratory, and total cancers were all approximately 1.00 or less and all 95% confidence intervals (CIs) included 1.00. For individual types of the gastrointestinal cancers, only the SIR for pancreatic cancer was marginally statistically significant at 2.19 (95% CI=1.00-4.16), based on a total of nine observed cases. The excess in pancreatic cancer occurred primarily among men (SIR=3.08; 95% CI=1.13-6.70) and was only slightly elevated among women (SIR=1.39; 95% CI=0.29-4.06). This association may be related to factors other than asbestos exposure such as occupation and lifestyle or to chance. No cases of mesothelioma were observed among WAER participants. There was no increase in incidence by latency or duration of residence on the water supply, but the ability to detect these trends is limited by small numbers and unknown dates of initial exposure. The general pattern of results did not demonstrate a likely link between exposure to asbestos in drinking water and cancer occurrence among participants in the WAER.     

Cancer incidence and mortality in a Swedish rubber tire manufacturing plant

BACKGROUND: A classification of 12 work categories was used to evaluate the cancer incidence and mortality among a cohort of Swedish rubber tire workers. METHODS: Cancer incidence and mortality in the cohort was compared with expected values from national rates. Standardized incidence and mortality ratios were calculated for the total cohort, for sub-cohorts and with the inclusion of a latency requirement. RESULTS: Among men, increased incidence and mortality risks were found for cancer in the larynx; SIR=2.10; 95% confidence intervals (95% CI): 1.05-3.76, SMR=2.08; 95% CI: 0.42-6.09. Increased risks were also seen for cancer in the trachea, bronchus, and lung; SIR=1.62; 95% CI: 1.28-2.02, SMR=1.54; 95% CI: 1.21-1.94, the incidence risk was highest among those with the longest exposure duration and among workers in compounding/mixing, milling, and maintenance. Decreased incidence risks were seen for cancer of the prostate (SIR=0.74; 95% CI: 059-0.92) and skin (SIR=0.57; 95% CI: 0.36-0.84). CONCLUSIONS: The finding of an excess of tumors in the respiratory system is in agreement with earlier findings in other studies on rubber tire workers. The results on other cancer types are compared to earlier findings and related to work processes and chemical exposures of possible causal importance.     

Cancer in the Norwegian printing industry

OBJECTIVES: The aim of this study was to investigate cancer risk among Norwegian workers in the printing industry, particularly lung and bladder cancer. METHODS: Cancer incidence was investigated from 1953 through 1998 in a cohort of 10 549 male members of a trade union in the printing industry in Oslo and nearby areas. Rates from the region, were used to calculate standardized incidence ratios (SIR) separately for the skilled and unskilled workers. Smoking data from a sample of the cohort were utilized for evaluating the risk estimates of smoking-related cancers. Specific exposure data were not available. RESULTS: Among the skilled workers, significantly elevated risks of cancer of the urinary bladder [standardized incidence ratio (SIR) 1.47, 95% confidence interval (95% CI) 1.19-1.79], liver (SIR 1.92, 95% CI 1.15-2.99), pancreas (SIR 1.46, 95% CI 1.07-1.94) and colon (SIR 1.27, 95% CI 1.05-1.55) were observed, whereas an increased risk of lung cancer in this group was confined to those born before 1910. Among the unskilled workers, there were significantly increased risks of cancer of the mouth, esophagus, stomach, larynx, lung, and all sites. CONCLUSIONS: The study showed that workers in the printing industry were at increased risk of several types of cancer. In particular the increased risk of bladder cancer among the skilled workers is suggestive of an occupational cause. However, no specific agent could be identified as an occupational carcinogen. The results did not support the hypothesis of a generally increased risk of lung cancer. The risk pattern for unskilled workers may reflect confounding by nonoccupational factors.