Attributable risk in men in two French case-control studies on mesothelioma and asbestos.
Pleural mesothelioma is a primary tumor of the pleura that is mainly due to asbestos exposure. To study the relationship between mesothelioma and occupational asbestos exposure in France, two case-control studies (A and B) were conducted. A substantial difference in the attributable risk in the population (AR(p)) was observed among men: 44.5% (95% CI: [32.6-56.4]) in study A and 83.2% (95% CI: [76.8-89.6]) in study B. As different exposure assessment expert methods were used, the main objective of this work was to re-estimate the AR(p) men in two case-control studies according to a common standardized exposure assessment by using a Job Exposure Matrix (JEM) and to assess the role of subjects' selection. The initial observed AR(p) difference was maintained: 36.3% (95% CI: [24.3-50.3]) in study A and 69.7% (95% CI: [51.7-83.2]) in study B. Further investigations highlighted the potential selection bias introduced in both studies, especially among controls. The AR(p) could be underestimated in study A and overestimated in study B. After weighting subjects according to distribution of socio-economic status in the general population for controls and according to distribution of socio-economic status of cases registered by the French National Mesothelioma Surveillance Program, re-estimated AR(p) values were 52.4% in study A and 70.2% in study B. These results provide additional information to describe the relationship between pleural mesothelioma and occupational asbestos exposure, but also confirm the importance of subjects' recruitment in case control studies, particularly control selection.
Lacourt
Aude
A
Laboratoire Santé Travail Environnement, EA 3672, Institut de Santé Publique, d'Épidémiologie et de Développement, Université Victor Segalen Bordeaux 2, 33076, Bordeaux, France. aude.lacourt@isped.u-bordeaux2.fr
Rolland
Patrick
P
Gramond
Céline
C
Astoul
Philippe
P
Chamming's
Soizick
S
Ducamp
Stéphane
S
Frenay
Catherine
C
Galateau-Sallé
Françoise
F
Gilg Soit Ilg
Anabelle
A
Imbernon
Ellen
E
Le Stang
Nolwenn
N
Pairon
Jean Claude
JC
Goldberg
Marcel
M
Iwatsubo
Yuriko
Y
Salmi
Louis-Rachid
LR
Brochard
Patrick
P
D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D018579:Patient Selection; D018570:Risk Assessment / Q000592:standards; D015983:Selection Bias
D001194:Asbestos
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