Relative burden of lung and pleural cancers from exposure to asbestos: a cross-sectional analysis of occupational mortality in England and Wales.
epidemiology
occupational & industrial medicine
respiratory tract tumours
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
08 04 2020
08 04 2020
Historique:
entrez:
11
4
2020
pubmed:
11
4
2020
medline:
21
4
2021
Statut:
epublish
Résumé
To explore the extent to which asbestos-exposed jobs vary in the ratio of excess mortality from lung cancer to deaths from pleural cancer. Using data on underlying cause of death and last full-time occupation for 3 688 916 deaths among men aged 20-74 years in England and Wales during 1979-2010, we calculated proportional mortality ratios (PMRs), standardised for age and social class, with all occupations combined as reference. For each of 22 asbestos-exposed job groups with significantly elevated PMRs for pleural cancer, we calculated excess mortality from lung cancer (observed minus expected deaths) and its ratio to number of deaths from pleural cancer. To reduce confounding effects of smoking, we adjusted expected deaths from lung cancer in each job group, according to a formula based on its PMR for chronic obstructive pulmonary disease. England and Wales. 3 688 916 men who died aged 20-74 years during 1979-2010. Ratios of excess mortality from lung cancer to deaths from pleural cancer by job group. Adjusted PMRs for lung cancer were elevated in all but 4 of the 22 asbestos-exposed job groups, but the ratio of excess lung cancer to deaths from pleural cancer varied widely between job groups, being significantly greater than the overall ratio in six, and significantly less in seven. Analysis for 2001-2010, when (because of changes in coding) ascertainment of pleural tumours was more reliable, showed similar variation between job groups, and indicated an overall ratio of 0.28. Excess lung cancer in asbestos-exposed jobs is not in a simple proportion to deaths from pleural cancer, and the ratio may vary importantly according to intensity of exposure to different types of asbestos and concomitant smoking habits. The current burden of lung cancer from occupational exposure to asbestos in Britain may not be so high as previously thought.
Identifiants
pubmed: 32273321
pii: bmjopen-2019-036319
doi: 10.1136/bmjopen-2019-036319
pmc: PMC7245407
doi:
Substances chimiques
Asbestos
1332-21-4
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e036319Subventions
Organisme : Medical Research Council
ID : MC_U147585823
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12011/5
Pays : United Kingdom
Organisme : Medical Research Council
ID : MRC_MC_UP_A620_1018
Pays : United Kingdom
Organisme : Medical Research Council
ID : MRC_MC_UU_12011/5
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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