title: Cause-specific mortality in relation to chrysotile-asbestos exposure in a Chinese cohort.
abstract: BACKGROUND
  The carcinogenic potency of chrysotile asbestos remains a contentious topic, and more data are needed to address this issue. We examine cause-specific mortality, especially lung cancer, and its association with chrysotile-asbestos exposure in a Chinese cohort.
  
  
  METHODS
  A cohort of 577 workers from a chrysotile-textile plant was followed prospectively from 1972 to 2008. Occupational history, exposure information, and smoking data were obtained from company records and personal interviews; vital status and causes of death were ascertained from death registries and hospitals. Workers were classified into three exposure levels on the basis of exposure assessments of different workshops. Standardized Mortality Ratios (SMRs) were calculated in terms of exposure levels and other indices.
  
  
  RESULTS
  Among 259 identified deaths, 53 died from lung cancer, with an SMR of 4.08 (95% confidence interval 3.12, 5.33), and 96 from all cancers with an SMR of 2.09 (1.71, 2.55). In addition, two deaths from mesothelioma were observed. Increased mortality from respiratory diseases was also observed (SMR 3.38, 95% confidence interval 2.72, 4.21). Asbestos-exposure levels, exposure years, and birth cohorts showed a clear trend of risk for lung cancer and respiratory diseases.
  
  
  CONCLUSIONS
  The current analysis indicated that exposure to chrysotile asbestos was closely associated with excess mortality from lung cancer and respiratory diseases.
authors.affiliation: School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR, China.
authors.forename: Sihao
authors.initials: S
authors.lastname: Lin
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Wang
authors.forename: Ignatius T S
authors.initials: IT
authors.lastname: Yu
authors.forename: Eiji
authors.initials: E
authors.lastname: Yano
authors.forename: Midori
authors.initials: M
authors.lastname: Courtice
authors.forename: Hong
authors.initials: H
authors.lastname: Qiu
authors.forename: Mianzhen
authors.initials: M
authors.lastname: Wang
mesh_terms: D000328:Adult; D017632:Asbestos, Serpentine / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality*; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D011379:Prognosis; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D015996:Survival Rate
chemical_list: D017632:Asbestos, Serpentine