title: Lung cancer in the lower lobe is associated with pulmonary asbestos fiber count and fiber size.
abstract: We studied exposure to asbestos, pulmonary fibrosis, fiber count, and fiber size in relation to the lobar origin of lung cancer in 90 consecutive patients. Among the 32 patients with a history of occupational exposure to asbestos, 22 were construction workers. The proportion of lower-lobe tumors increased with the duration of exposure from 45% in those working less than 15 years to 82% in those working 15 years or more in the construction trade, as compared with 25% in patients who were probably not exposed. The location of the tumor in the lower lobe was explained by the high number of total fibers [odds ratio (OR) = 9.0, CI = 2.3-34.6), of fibers 3 microns and longer (OR = 22.1, CI = 3.9-125), and fibers of anthophyllite (OR = 14.6, CI = 2.4-83.4) and crocidolite (OR = 7.0, CI = 1.2-41.2) when the effect of smoking and fibrosis was adjusted in the logistic regression analysis. The location of the tumor did not correlate with fibrosis, pack-years smoked, or the number of short (< 3 microns) fibers. Our findings suggest that asbestos causes an excess of lower-lobe tumors at a relatively low exposure level, independently of pulmonary fibrosis.
authors.affiliation: Institute of Occupational Health, Helsinki, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Anttila
authors.forename: A
authors.initials: A
authors.lastname: Karjalainen
authors.forename: O
authors.initials: O
authors.lastname: Taikina-aho
authors.forename: P
authors.initials: P
authors.lastname: Kyyrönen
authors.forename: H
authors.initials: H
authors.lastname: Vainio
mesh_terms: D001194:Asbestos / Q000009:adverse effects* / Q000378:metabolism; D005260:Female; D005355:Fibrosis; D006801:Humans; D008168:Lung / Q000378:metabolism / Q000473:pathology; D008175:Lung Neoplasms / Q000209:etiology / Q000473:pathology*; D008297:Male; D016273:Occupational Exposure; D010316:Particle Size; D012907:Smoking; D013997:Time Factors
chemical_list: D001194:Asbestos