| are already aware, asbestos exposure has been | | | | period of domestic exposure whereas the |
| linked to a number of life threatening diseases. | | | | remaining 224 married an asbestos cement |
| Most exposure related illnesses result from the | | | | worker only after he definitely stopped his |
| inhalation of tiny asbestos particles or fibers. One | | | | activity in the asbestos cement plant; these have, |
| interesting study that examined the rate of | | | | therefore, been considered as unexposed. |
| disease in miners is called, Relation between | | | | The cohort of wives was constructed entirely |
| asbestosis and bronchial cancer in amphibole | | | | through official records in the town offices and is |
| asbestos miners by G K Sluis-Cremer, B N | | | | both exhaustive and unaffected by recall bias. At |
| Bezuidenhout - Br J Ind Med 1989;46:537-540 - | | | | the end of follow up (1988) 1669 women were |
| Epidemiology Research Unit, Medical Bureau of | | | | alive, 270 were dead and 25 (1.2%) were |
| Occupational Disease, Johannesburg, Republic of | | | | untraced. Main mortality analyses were only up to |
| South Africa. Here is an excerpt: Abstract - In | | | | age 79 to reduce the misclassification of causes |
| a necropsy series of 339 amphibole asbestos | | | | of death. Expected mortality was based on local |
| miners heavy smoking, age, and the presence of | | | | rates. Mortality analyses were limited to the period |
| asbestosis were significantly associated with the | | | | 1965-88 due to the availability of local rates: in |
| presence of bronchial cancer. Of the 35 cases of | | | | that period 210 deaths occurred among women |
| bronchial cancer, 24 were associated with | | | | with domestic exposure v 229.1 expected. There |
| asbestosis. Eleven cases of bronchial cancer | | | | were four deaths from pleural tumours (one |
| occurred in men without asbestosis; all were | | | | diagnosed as mesothelioma at necropsis) and six |
| smokers. Standardised proportional mortality rates | | | | from lung cancer v. 0.5 and 4.0 expected |
| indicated no excess of bronchial cancer in 302 | | | | respectively. Two further cases of mesothelioma |
| exposed men without asbestosis whereas these | | | | were diagnosed by histological examination after |
| rates were progressively raised in men with slight | | | | the end of follow up. None of the three wives |
| or moderate/severe asbestosis. Of the four | | | | with histologically diagnosed mesothelioma had |
| exposure variables introduced separately into a | | | | been engaged in industrial activities. Corresponding |
| logistic regression model, "years of exposure" | | | | information for the other three cases could not |
| made a small but significant contribution; | | | | be traced. |
| "residence time" marginally failed to achieve a 5% | | | | A third study is called, Asbestosis: a marker |
| level of significance. Two other exposure variables | | | | for the increased risk of lung cancer among |
| tested including cumulative fibre exposure (fibre | | | | workers exposed to asbestos. By Weiss W. - |
| years) made no significant contribution. In the | | | | Chest. 1999 Feb;115(2):536-49. Here is an excerpt: |
| absence of asbestosis at necropsy a bronchial | | | | Abstract - This review examines the |
| cancer in a man exposed to asbestos is unlikely | | | | hypothesis that excess lung cancer risk in worker |
| to be due to asbestos. | | | | cohorts exposed to asbestos occurs only among |
| Another interesting study is called, A cohort | | | | those with asbestosis. The adequately designed |
| study on mortality among wives of workers in | | | | studies in the literature support this hypothesis. |
| the asbestos cement industry in Casale | | | | The summary relative risk for lung cancer was |
| Monferrato, Italy. By C Magnani, B Terracini, C | | | | 1.00 in seven cohorts with no deaths from |
| Ivaldi, M Botta, P Budel, A Mancini, R Zanetti | | | | asbestosis. In addition, there is a high correlation |
| — Br J Ind Med 1993; 50:779-784 - Here is | | | | between asbestosis rates and lung cancer rates in |
| an excerpt Abstract - The study investigates | | | | 38 cohorts in contrast to a poor correlation |
| mortality from cancer and other diseases in a | | | | between cumulative exposure data and lung |
| cohort of wives of asbestos cement workers in | | | | cancer relative risks in eight cohorts with |
| Casale Monferrato (northwest Italy). After the | | | | adequate data. The evidence indicates that |
| exclusion of women with an occupational record in | | | | asbestosis is a much better predictor of excess |
| the asbestos cement industry, the cohort | | | | lung cancer risk than measures of exposure and |
| comprised 1964 women. Their domestic exposure | | | | serves as a marker for attributable cases. |
| was estimated according to their husbands' | | | | If you found any of these excerpts interesting, |
| periods of employment in the plant: 1740 had a | | | | please read the studies in their entirety. |