title: Exposure to asbestos and lung and pleural cancer mortality among pulp and paper industry workers.
abstract: We studied the mortality from lung and pleural cancers in a cohort of 62,937 male workers employed for at least 1 year in the pulp and paper industry in 13 countries during 1945 to 1996. Mill departments were classified according to probability and level of exposure to asbestos on the basis of available dust measurements and mill-specific information on exposure circumstances. Thirty-six percent of workers were classified as ever exposed to asbestos. Standardized mortality ratios of lung cancer were 0.99 (95% confidence interval [CI], 0.90 to 1.08) among unexposed and 1.00 (95% CI, 0.90 to 1.11) among ever exposed workers. The number of pleural cancer deaths among unexposed workers was 10; that among exposed workers was 14, most of which occurred among maintenance workers. In internal analyses, a trend in mortality from either neoplasm was suggested for estimated cumulative exposure to asbestos, weighted for the individual probability of exposure within the department and for duration of exposure (relative risk for lung cancer for 0.78+ f/cc-years, as compared with < or = 0.01 f/cc-years: 1.44; 95% CI, 0.85 to 2.45; corresponding relative risk for pleural cancer: 2.43; 95% CI, 0.43 to 13.63). Despite a possible nondifferential misclassification of exposure and outcome, this study suggests that the carcinogenic effect of asbestos can be detected among workers employed in industries such as the pulp and paper industry, in which it is not considered to be a major hazard.
authors.affiliation: International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69008 Lyon, France.
authors.forename: Rafael
authors.initials: R
authors.lastname: Carel
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Timo
authors.initials: T
authors.lastname: Kauppinen
authors.forename: Kay
authors.initials: K
authors.lastname: Teschke
authors.forename: Aage
authors.initials: A
authors.lastname: Andersen
authors.forename: Paavo
authors.initials: P
authors.lastname: Jäppinen
authors.forename: Neil
authors.initials: N
authors.lastname: Pearce
authors.forename: Bo Andreassen
authors.initials: BA
authors.lastname: Rix
authors.forename: Alain
authors.initials: A
authors.lastname: Bergeret
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.forename: Bodil
authors.initials: B
authors.lastname: Persson
authors.forename: Irena
authors.initials: I
authors.lastname: Szadkowska-Stanczyk
authors.forename: Danuta
authors.initials: D
authors.lastname: Kielkowski
authors.forename: Paul
authors.initials: P
authors.lastname: Henneberger
authors.forename: Reiko
authors.initials: R
authors.lastname: Kishi
authors.forename: Luiz Augusto
authors.initials: LA
authors.lastname: Facchini
authors.forename: Maria
authors.initials: M
authors.lastname: Sala
authors.forename: Didier
authors.initials: D
authors.lastname: Colin
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001194:Asbestos / Q000009:adverse effects*; D002423:Cause of Death; D015331:Cohort Studies; D006801:Humans; D007221:Industry; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality*; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D010209:Paper; D010997:Pleural Neoplasms / Q000209:etiology / Q000401:mortality*; D012306:Risk
chemical_list: D000395:Air Pollutants, Occupational; D001194:Asbestos