title: Case-control study of pleural mesothelioma in workers with social security in Mexico.
abstract: BACKGROUND
  Environmental and occupational exposure to asbestos in Mexico in the past has been a cause of deaths and health damages. Its magnitude is unknown to date. Our objective was to identify the proportion of cases of malignant pleural mesothelioma (MPM) that can be attributed to and occupational exposure to asbestos.
  
  
  METHODS
  We carried out a case-control study of MPM in 472 workers insured by the Mexican Institute of Social Security, all Valley of Mexico residents, with 119 incident cases and 353 controls. Cases were histologically confirmed. Participants were questioned concerning their occupational history and sociodemographic data. Assignment to one of the four exposures was performed qualitatively by an expert hygienist. Odds ratios (ORs) and attributable risks (ARs) were calculated using a non-conditional logistic regression model.
  
  
  RESULTS
  A total of 80.6% of cases and 31.5% of controls had occupational exposure to asbestos. ORs were adjusted for age and gender and by exposure category, and exhibited an increase with probability of exposure as follows: 3.7(95% CI 1.3-10.4) for the likely category and 14.3(95% CI 8-26) for the certain category; AR in the group occupationally exposed to asbestos was 83.2%, and the population AR was 44%.
  
  
  CONCLUSIONS
  Our results show that the relationship between industrial uses of all forms of asbestos is generating an increase in mesothelioma-related diseases and deaths among Mexican workers. As a public health policy, Mexico should prohibit the use of asbestos in all production processes with the aim of controlling the epidemic and preventing the occurrence of new cases of MPM.
authors.affiliation: Instituto Mexicano del Seguro Social, Mexico City, Mexico. gpeaguilarm@gmail.com
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Aguilar-Madrid
authors.forename: Eduardo
authors.initials: E
authors.lastname: Robles-Pérez
authors.forename: Cuauhtémoc Arturo
authors.initials: CA
authors.lastname: Juárez-Pérez
authors.forename: Isabel
authors.initials: I
authors.lastname: Alvarado-Cabrero
authors.forename: Flavio Gerardo
authors.initials: FG
authors.lastname: Rico-Méndez
authors.forename: Kelly-García
authors.initials: KG
authors.lastname: Javier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D019458:Insurance Coverage; D016015:Logistic Models; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology* / Q000473:pathology; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000145:classification; D016017:Odds Ratio; D010997:Pleural Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D012943:Social Security; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D001194:Asbestos