title: Absence of radiographic asbestosis and the risk of lung cancer among asbestos-cement workers: Extended follow-up of a cohort.
abstract: BACKGROUND
  It has been a matter of controversy whether there is an increased risk of lung cancer among asbestos-exposed workers without radiographic asbestosis. A previous study of lung cancer risk among asbestos-cement workers has been updated with an additional 12 years of follow-up.
  
  
  METHODS
  Subjects had received radiographic examination at 20 and 25 years from first exposure to asbestos. Radiographs were interpreted by a single National Institute of Safety and Health (NIOSH)-certified B-reader using the 1971 International Labor Office (ILO) Classification of the pneumoconioses as reference standard. Asbestosis was defined as an ILO coding of 1/0 or higher. Standardized Mortality Ratios (SMRs) were calculated using the general population of Ontario as reference.
  
  
  RESULTS
  Among asbestos-cement workers without radiographic asbestosis at 20 years latency the lung cancer SMR was 3.84 (2.24-6.14). Among workers without asbestosis when examined at 25 years latency the SMR was 3.69 (1.59-7.26).
  
  
  CONCLUSIONS
  Workers from an Ontario asbestos-cement factory who did not have radiographic asbestosis at 20 or 25 years from first exposure to asbestos continued to have an increased risk of death from lung cancer during an additional 12 years of follow-up.
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Ontario, Canada. murray.finkelstein@utoronto.ca
authors.forename: Murray M
authors.initials: MM
authors.lastname: Finkelstein
mesh_terms: D000328:Adult; D000368:Aged; D001194:Asbestos / Q000633:toxicity*; D001195:Asbestosis / Q000000981:diagnostic imaging* / Q000401:mortality*; D002170:Canada / Q000453:epidemiology; D003252:Construction Materials / Q000633:toxicity*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011446:Prospective Studies; D011859:Radiography; D012306:Risk; D012907:Smoking; D013997:Time Factors
chemical_list: D001194:Asbestos