title: Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden.
abstract: BACKGROUND
  We have conducted a population-based study of pleural mesothelioma patients with occupational histories and measured asbestos lung burdens in occupationally exposed workers and in the general population. The relationship between lung burden and risk, particularly at environmental exposure levels, will enable future mesothelioma rates in people born after 1965 who never installed asbestos to be predicted from their asbestos lung burdens.
  
  
  METHODS
  Following personal interview asbestos fibres longer than 5 µm were counted by transmission electron microscopy in lung samples obtained from 133 patients with mesothelioma and 262 patients with lung cancer. ORs for mesothelioma were converted to lifetime risks.
  
  
  RESULTS
  Lifetime mesothelioma risk is approximately 0.02% per 1000 amphibole fibres per gram of dry lung tissue over a more than 100-fold range, from 1 to 4 in the most heavily exposed building workers to less than 1 in 500 in most of the population. The asbestos fibres counted were amosite (75%), crocidolite (18%), other amphiboles (5%) and chrysotile (2%).
  
  
  CONCLUSIONS
  The approximate linearity of the dose-response together with lung burden measurements in younger people will provide reasonably reliable predictions of future mesothelioma rates in those born since 1965 whose risks cannot yet be seen in national rates. Burdens in those born more recently will indicate the continuing occupational and environmental hazards under current asbestos control regulations. Our results confirm the major contribution of amosite to UK mesothelioma incidence and the substantial contribution of non-occupational exposure, particularly in women.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Gilham
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Rake
authors.affiliation: Health and Safety Laboratory, Buxton, UK.
authors.forename: Garry
authors.initials: G
authors.lastname: Burdett
authors.affiliation: Department of Histopathology, Royal Brompton and Harefield Hospitals NHS Foundation Trust, and National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Nicholson
authors.affiliation: Department of Cellular Pathology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Leslie
authors.initials: L
authors.lastname: Davison
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Angelo
authors.initials: A
authors.lastname: Franchini
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK Medical Research Council Clinical Trials Unit, Kingsway, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Carpenter
authors.affiliation: Health and Safety Executive, Bootle, UK.
authors.forename: John
authors.initials: J
authors.lastname: Hodgson
authors.affiliation: Health and Safety Executive, Bootle, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Darnton
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Julian
authors.initials: J
authors.lastname: Peto
mesh_terms: D000328:Adult; D000368:Aged; D017639:Asbestos, Amosite / Q000009:adverse effects / Q000032:analysis; D017636:Asbestos, Amphibole / Q000009:adverse effects* / Q000032:analysis; D017638:Asbestos, Crocidolite / Q000009:adverse effects / Q000032:analysis; D017632:Asbestos, Serpentine / Q000009:adverse effects / Q000032:analysis; D001195:Asbestosis / Q000150:complications; D004651:Employment; D005260:Female; D006801:Humans; D008168:Lung / Q000737:chemistry / Q000473:pathology; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008654:Mesothelioma / Q000139:chemically induced* / Q000473:pathology; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D019016:Mineral Fibers / Q000009:adverse effects / Q000032:analysis; D009784:Occupational Diseases / Q000139:chemically induced* / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects*; D010997:Pleural Neoplasms / Q000139:chemically induced* / Q000473:pathology; D018570:Risk Assessment
chemical_list: D017636:Asbestos, Amphibole; D017632:Asbestos, Serpentine; D019016:Mineral Fibers; D017638:Asbestos, Crocidolite; D017639:Asbestos, Amosite