title: Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma.
abstract: OBJECTIVE
  To estimate the proportion of pleural mesothelioma cases that can be attributed to asbestos exposure in France including non-occupational exposure.
  
  
  METHODS
  A population-based case-control study including 437 incident cases and 874 controls was conducted from 1998 to 2002. Occupational and non-occupational asbestos exposure was assessed retrospectively by two expert hygienists. ORs of pleural mesothelioma for asbestos-exposed subjects compared to non-exposed subjects, and population-attributable risk (ARp) of asbestos exposure were estimated using a conditional logistic regression.
  
  
  RESULTS
  A clear dose-response relationship was observed between occupational asbestos exposure and pleural mesothelioma (OR=4.0 (99% CI 1.9 to 8.3) for men exposed at less than 0.1 f/mL-year vs. 67.0 (99% CI 25.6 to 175.1) for men exposed at more than 10 f/mL-year). The occupational asbestos ARp was 83.1% (99% CI 74.5% to 91.7%) for men and 41.7% (99% CI 25.3% to 58.0%) for women. A higher risk of pleural mesothelioma was observed in subjects non-occupationally exposed to asbestos compared to those never exposed. The non-occupational asbestos ARp for these subjects was 20.0% (99% CI -33.5% to 73.5%) in men and 38.7% (99% CI 8.4% to 69.0%) in women. When considering all kinds of asbestos exposure, ARp was 87.3% (99% CI 78.9% to 95.7%) for men and 64.8% (99% CI 45.4% to 84.3%) for women.
  
  
  CONCLUSIONS
  Our study suggests that the overall ARp in women is largely driven by non-occupational asbestos exposure arguing for the strong impact of such exposure in pleural mesothelioma occurrence. Considering the difficulty in assessing domestic or environmental asbestos exposure, this could explain the observed difference in ARp between men and women.
authors: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique Equipe sante environnement, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Equipe sante environnement, Bordeaux, France.
authors: A
authors: A
authors: Lacourt
authors: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique Equipe sante environnement, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Equipe sante environnement, Bordeaux, France.
authors: C
authors: C
authors: Gramond
authors: Departement Sante Travail, Institut de Veille Sanitaire, Equipe Associee en Sante Travail, Bordeaux, France Registre Multicentrique a Vocation Nationale des Mesotheliomes Pleuraux (MESONAT), Hopital de la Cote de Nacre, Caen, France.
authors: P
authors: P
authors: Rolland
authors: Departement Sante Travail, Institut de Veille Sanitaire, Equipe Associee en Sante Travail, Bordeaux, France Registre Multicentrique a Vocation Nationale des Mesotheliomes Pleuraux (MESONAT), Hopital de la Cote de Nacre, Caen, France.
authors: S
authors: S
authors: Ducamp
authors: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique Equipe sante environnement, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Equipe sante environnement, Bordeaux, France.
authors: S
authors: S
authors: Audignon
authors: Service d'Oncologie Thoracique, Maladie de la Plèvre et Pneumologie Interventionnelle, Hopital Nord, Aix-Marseille Universite, Marseille, France.
authors: P
authors: P
authors: Astoul
authors: Institut Interuniversitaire de Medecine du Travail de Paris Ile de France, Créteil, France.
authors: S
authors: S
authors: Chamming's
authors: Registre Multicentrique a Vocation Nationale des Mesotheliomes Pleuraux (MESONAT), Hopital de la Cote de Nacre, Caen, France Departement Sante Travail, Institut de Veille Sanitaire, Saint Maurice, France.
authors: A
authors: A
authors: Gilg Soit Ilg
authors: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique Equipe sante environnement, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Equipe sante environnement, Bordeaux, France.
authors: M
authors: M
authors: Rinaldo
authors: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique Equipe sante environnement, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Equipe sante environnement, Bordeaux, France.
authors: C
authors: C
authors: Raherison
authors: Registre Multicentrique a Vocation Nationale des Mesotheliomes Pleuraux (MESONAT), Hopital de la Cote de Nacre, Caen, France Service d Anatomie Pathologique, Hopital de la Cote de Nacre, Caen, France.
authors: F
authors: F
authors: Galateau-Salle
authors: Departement Sante Travail, Institut de Veille Sanitaire, Equipe Associee en Sante Travail, Bordeaux, France Departement Sante Travail, Institut de Veille Sanitaire, Saint Maurice, France.
authors: E
authors: E
authors: Imbernon
authors: Institut Interuniversitaire de Medecine du Travail de Paris Ile de France, Créteil, France Faculte de Medecine, INSERM U955, Universite Paris-Est Creteil, Creteil, France.
authors: J C
authors: JC
authors: Pairon
authors: Departement Sante Travail, Institut de Veille Sanitaire, Saint Maurice, France.
authors: M
authors: M
authors: Goldberg
authors: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique Equipe sante environnement, Bordeaux, France INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Equipe sante environnement, Bordeaux, France.
authors: P
authors: P
authors: Brochard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000633:toxicity*; D016022:Case-Control Studies; D004781:Environmental Exposure; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology / Q000209:etiology*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010997:Pleural Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors
chemical_list: D001194:Asbestos