title: Analysis of occupational asbestos exposure and lung cancer mortality using the g formula.
abstract: We employed the parametric G formula to analyze lung cancer mortality in a cohort of textile manufacturing workers who were occupationally exposed to asbestos in South Carolina. A total of 3,002 adults with a median age of 24 years at enrollment (58% male, 81% Caucasian) were followed for 117,471 person-years between 1940 and 2001, and 195 lung cancer deaths were observed. Chrysotile asbestos exposure was measured in fiber-years per milliliter of air, and annual occupational exposures were estimated on the basis of detailed work histories. Sixteen percent of person-years involved exposure to asbestos, with a median exposure of 3.30 fiber-years/mL among those exposed. Lung cancer mortality by age 90 years under the observed asbestos exposure was 9.44%. In comparison with observed asbestos exposure, if the facility had operated under the current Occupational Safety and Health Administration asbestos exposure standard of <0.1 fibers/mL, we estimate that the cohort would have experienced 24% less lung cancer mortality by age 90 years (mortality ratio = 0.76, 95% confidence interval: 0.62, 0.94). A further reduction in asbestos exposure to a standard of <0.05 fibers/mL was estimated to have resulted in a minimal additional reduction in lung cancer mortality by age 90 years (mortality ratio = 0.75, 95% confidence interval: 0.61, 0.92).
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.forename: David B
authors.initials: DB
authors.lastname: Richardson
authors.forename: Haitao
authors.initials: H
authors.lastname: Chu
authors.forename: Ashley I
authors.initials: AI
authors.lastname: Naimi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017632:Asbestos, Serpentine / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D033161:Government Regulation; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D019016:Mineral Fibers / Q000009:adverse effects; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis / Q000331:legislation & jurisprudence / Q000517:prevention & control; D013022:South Carolina / Q000453:epidemiology; D013783:Textile Industry / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States; D014489:United States Occupational Safety and Health Administration / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D017632:Asbestos, Serpentine; D019016:Mineral Fibers
keywords: asbestos; bias (epidemiology); epidemiologic methods; healthy worker effect; occupations
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