title: Occupational asbestos exposure and lung cancer--a systematic review of the literature.
abstract: The objective of this study was to evaluate the scientific literature concerning asbestos and lung cancer, emphasizing low-level exposure. A literature search in PubMed and Embase resulted in 5,864 citations. Information from included studies was extracted using SIGN. Twenty-one statements were evidence graded. The results show that histology and location are not helpful in differentiating asbestos-related lung cancer. Pleural plaques, asbestos bodies, or asbestos fibers are useful as markers of asbestos exposure. The interaction between asbestos and smoking regarding lung cancer risk is between additive and multiplicative. The findings indicate that the association between asbestos exposure and lung cancer risk is basically linear, but may level off at very high exposures. The relative risk for lung cancer increases between 1% and 4% per fiber-year (f-y)/mL, corresponding to a doubling of risk at 25-100 f-y/mL. However, one high-quality case-control study showed a doubling at 4 f-y/mL.
authors.affiliation: a Department of Occupational and Environmental Medicine , Odense University Hospital , Odense , Denmark.
authors.forename: Lene Snabe
authors.initials: LS
authors.lastname: Nielsen
authors.forename: Jesper
authors.initials: J
authors.lastname: Bælum
authors.forename: Jesper
authors.initials: J
authors.lastname: Rasmussen
authors.forename: Søren
authors.initials: S
authors.lastname: Dahl
authors.forename: Karen Ege
authors.initials: KE
authors.lastname: Olsen
authors.forename: Maria
authors.initials: M
authors.lastname: Albin
authors.forename: Niels Christian
authors.initials: NC
authors.lastname: Hansen
authors.forename: David
authors.initials: D
authors.lastname: Sherson
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001194:Asbestos / Q000009:adverse effects*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000209:etiology*; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D000395:Air Pollutants, Occupational; D001194:Asbestos