title: Predictors of lung cancer among former asbestos-exposed workers.
abstract: OBJECTIVE
  Despite extensive literature concerning the risk of lung cancer incidence among asbestos workers there is still lack of data specifying the association between the level of exposure and the frequency of cancer occurrence. The aim of the analysis was to assess the influence of smoking and selected factors related to occupational exposure on the risk of the incidence of lung cancer among the workers who were exposed to asbestos dust in the past.
  
  
  METHODS
  The assessment was performed based on the case-control studies carried out within a cohort including 7,374 former workers of asbestos processing plants, examined over the years 2000-2013. Analysis of the material was based on the calculation of the odds ratio (OR) using conditional logistic regression modeling, adjusted for cigarette smoking, cumulative exposure, branch and time since last exposure.
  
  
  RESULTS
  During the survey period there were 165 cases of lung cancer. Among the individuals who smoked, the relative risk of lung cancer incidence was twice as high in the persons smoking more than 20 pack-years (OR=2.23; 95% CI: 1.45-3.46) than it was in the case of the non-smokers. Analysis revealed that the risk of lung cancer in the group with the highest exposure was two times higher in comparison with the low cumulative asbestos exposure (OR=1.99; 95% CI: 1.22-3.25). The risk continued to increase until 30 years after cessation of asbestos exposure and started to decline many years after the last exposure. Influence of the mentioned above characteristics is particularly visible for tumors located in the lower parts of the lungs.
  
  
  CONCLUSIONS
  Our findings confirm the strong evidence that the lung cancer risk is associated with asbestos exposure and it increases along with the increasing exposure. A strategy of smoking cessation among the individuals exposed to asbestos dust would potentially have health promoting effects.
authors.affiliation: Nofer Institute of Occupational Medicine, Department of Occupational and Environmental Epidemiology, The Reference Center for Asbestos Exposure & Health Risk Assessment, Św. Teresy 8, 91-348, Łódź, Poland. Electronic address: beata_sn@imp.lodz.pl.
authors.forename: Beata
authors.initials: B
authors.lastname: Świątkowska
authors.affiliation: Nofer Institute of Occupational Medicine, Department of Occupational and Environmental Epidemiology, The Reference Center for Asbestos Exposure & Health Risk Assessment, Św. Teresy 8, 91-348, Łódź, Poland.
authors.forename: Zuzanna
authors.initials: Z
authors.lastname: Szubert
authors.affiliation: Nofer Institute of Occupational Medicine, Department of Occupational and Environmental Epidemiology, The Reference Center for Asbestos Exposure & Health Risk Assessment, Św. Teresy 8, 91-348, Łódź, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Sobala
authors.affiliation: Nofer Institute of Occupational Medicine, Department of Occupational and Environmental Epidemiology, The Reference Center for Asbestos Exposure & Health Risk Assessment, Św. Teresy 8, 91-348, Łódź, Poland.
authors.forename: Neonila
authors.initials: N
authors.lastname: Szeszenia-Dąbrowska
mesh_terms: D000328:Adult; D001194:Asbestos / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001194:Asbestos
keywords: Asbestos-exposed; Epidemiology; Occupational exposure; Smoking; Workers