Prediction of mesothelioma and lung cancer in a cohort of asbestos exposed workers.
BACKGROUND
Several papers have reported state-wide projections of mesothelioma deaths, but few have computed these predictions in selected exposed groups.


OBJECTIVE
To predict the future deaths attributable to asbestos in a cohort of railway rolling stock workers.


METHODS
The future mortality of the 1,146 living workers has been computed in term of individual probability of dying for three different risks: baseline mortality, lung cancer excess, mesothelioma mortality. Lung cancer mortality attributable to asbestos was calculated assuming the excess risk as stable or with a decrease after a period of time since first exposure. Mesothelioma mortality was based on cumulative exposure and time since first exposure, with the inclusion of a term for clearance of asbestos fibres from the lung.


RESULTS
The most likely range of the number of deaths attributable to asbestos in the period 2005-2050 was 15-30 for excess of lung cancer, and 23-35 for mesothelioma.


CONCLUSIONS
This study provides predictions of asbestos-related mortality even in a selected cohort of exposed subjects, using previous knowledge about exposure-response relationship. The inclusion of individual information in the projection model helps reduce misclassification and improves the results. The method could be extended in other selected cohorts.
Gasparrini
Antonio
A
Public and Environmental Health Research Unit (PEHRU), London School of Hygiene & Tropical Medicine, London, UK. antonio.gasparrini@lshtm.ac.uk
Pizzo
Anna Maria
AM
Gorini
Giuseppe
G
Seniori Costantini
Adele
A
Silvestri
Stefano
S
Ciapini
Cesare
C
Innocenti
Andrea
A
Berry
Geoffrey
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects*; D002423:Cause of Death / Q000639:trends*; D015331:Cohort Studies; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008654:Mesothelioma / Q000401:mortality*; D008875:Middle Aged; D009784:Occupational Diseases / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*; D010997:Pleural Neoplasms / Q000401:mortality*; D011890:Railroads; D012042:Registries; D018570:Risk Assessment
D001194:Asbestos