title: Cancer Attributable to Asbestos Exposure in Shipbreaking Workers: A Matched-Cohort Study.
abstract: OBJECTIVE
  Long-term follow-up studies of asbestos-related cancer in shipbreaking workers are lacking. This study examines the relationship between cancer incidence and asbestos exposure among former Taiwan shipbreaking workers.
  
  
  METHODS
  A total of 4,427 shipbreaking workers and 22,135 population-based matched controls were successfully followed in this study. The study cohort was linked to the Taiwan Cancer Registry for new cancer cases. The adjusted hazard ratio (aHR) for cancer was calculated for the shipbreaking workers with Total Exposure Potential Scores (TEP) for asbestos.
  
  
  RESULTS
  Follow-up generated 109,932 person-years, with 940 deaths and 436 cancer cases, among 4,427 shipbreaking workers from 1985 to 2008. The high asbestos exposure group also had a statistically significant increase in the risk of overall cancer (aHR= 1.71; 95% CI: 1.42-2.05), esophagus cancer (aHR= 2.31; 95% CI: 1.00-5.41), liver and intrahepatic bile duct cancer (aHR= 1.60; 95% CI: 1.08-2.36), and trachea, bronchus, and lung cancer (aHR= 3.08; 95% CI: 1.80-5.25). Mesothelioma cases were found in the high asbestos exposure group. Moreover, overall cancer, esophagus cancer, and trachea, bronchus, and lung cancer were seen in a dose-dependent relationship with asbestos exposure.
  
  
  CONCLUSIONS
  This study presented the elevated trend of asbestos exposure with cancer incidence for overall cancer, esophagus cancer, and trachea, bronchus, and lung cancer among shipbreaking workers. Those workers previously exposed to asbestos should receive persistent monitoring in order to early detect adverse health outcomes.
authors.affiliation: National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Wei-Te
authors.initials: WT
authors.lastname: Wu
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Perng-Jy
authors.initials: PJ
authors.lastname: Tsai
authors.affiliation: National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Institute of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chun-Yuh
authors.initials: CY
authors.lastname: Yang
authors.affiliation: National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Saou-Hsing
authors.initials: SH
authors.lastname: Liou
authors.affiliation: National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Nursing, HungKuang University, Taichung, Taiwan.
authors.forename: Trong-Neng
authors.initials: TN
authors.lastname: Wu
mesh_terms: D000368:Aged; D001194:Asbestos / Q000633:toxicity*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D001194:Asbestos