title: Occupational asbestos exposure and risk of pleural mesothelioma, lung cancer, and laryngeal cancer in the prospective Netherlands cohort study.
abstract: OBJECTIVE
  To study the association between occupational asbestos exposure and pleural mesothelioma, lung cancer, and laryngeal cancer, specifically addressing risk associated with the lower end of the exposure distribution, risk of cancer subtypes, and the interaction between asbestos and smoking.
  
  
  METHODS
  Using the Netherlands Cohort Study (n = 58,279 men, aged 55 to 69 years), asbestos exposure was estimated by linkage to job-exposure matrices. After 17.3 years of follow-up, 132 pleural mesothelioma, 2324 lung cancer, and 166 laryngeal cancer cases were available.
  
  
  RESULTS
  The multivariable-adjusted model showed overall positive associations between all levels of asbestos exposure and mesothelioma, lung cancer, and laryngeal cancer. Lung adenocarcinoma and glottis cancer showed only a positive association after prolonged higher asbestos exposure (hazard ratio per 10 years increment, 1.43 [95% confidence interval, 1.06 to 1.93] and 1.95 [95% confidence interval, 1.36 to 2.80], respectively). There was no statistically significant interaction between asbestos and smoking.
  
  
  CONCLUSIONS
  Asbestos levels encountered at the lower end of the exposure distribution may be associated with an increased risk of pleural mesothelioma, lung cancer, and laryngeal cancer.
authors.affiliation: From the Department of Epidemiology (Ms Offermans and Mr van den Brandt), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Institute for Risk Assessment Sciences (Dr Vermeulen and Mr Kromhout), Environmental Epidemiology Division, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care (Dr Vermeulen), University Medical Center, Utrecht, the Netherlands; Department of Public Health (Mr Burdorf), Erasmus MC, Rotterdam, the Netherlands; TNO (Dr Goldbohm), Leiden, the Netherlands; and Finnish Institute of Occupational Health (Dr Kauppinen), Helsinki, Finland.
authors.forename: Nadine S M
authors.initials: NS
authors.lastname: Offermans
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.forename: Timo
authors.initials: T
authors.lastname: Kauppinen
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
mesh_terms: D000368:Aged; D001194:Asbestos / Q000633:toxicity*; D002277:Carcinoma / Q000453:epidemiology* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D010997:Pleural Neoplasms / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001194:Asbestos