title: Exposure-response estimate for lung cancer and asbestosis in a predominantly chrysotile-exposed Chinese factory cohort.
abstract: BACKGROUND
  Cumulative fiber exposures, predominantly chrysotile, were estimated in a Chinese asbestos worker cohort and exposure-response relationships with lung cancer mortality and cumulative incidence of asbestosis were determined.
  
  
  METHODS
  Individual time-dependent cumulative exposures were estimated for 577 asbestos workers, followed prospectively for 37 years. Occupational history and smoking data were obtained from company records and personal interviews; vital status and causes of death were ascertained from death registries and hospital records. Hazard ratios were generated for disease outcomes, with adjustments for smoking and age.
  
  
  RESULTS
  Median cumulative fiber exposure for the cohort was 132.6 fiber-years/ml (IQR 89.3-548.4). Exposure-response relationships were demonstrated for both disease outcomes, with nearly sixfold and threefold increased risks seen at the highest exposure level for lung cancer deaths and asbestosis, respectively.
  
  
  CONCLUSIONS
  Evidence using quantitative exposure estimates was provided for increased risks of lung cancer mortality and development of asbestosis in a predominantly chrysotile-exposed cohort.
authors.affiliation: Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.|IOM Singapore.
authors.forename: Midori N
authors.initials: MN
authors.lastname: Courtice
authors.affiliation: Hong Kong Occupational and Environmental Health Academy, Hong Kong, China.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Sihao
authors.initials: S
authors.lastname: Lin
authors.affiliation: Hong Kong Occupational and Environmental Health Academy, Hong Kong, China.
authors.forename: Ignatius Tak Sun
authors.initials: IT
authors.lastname: Yu
authors.affiliation: Aeolus, Inc., Albany, California.
authors.forename: D Wayne
authors.initials: DW
authors.lastname: Berman
authors.affiliation: Division of Public Health, Teikyo University Graduate School of Public Health, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Yano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017632:Asbestos, Serpentine / Q000633:toxicity*; D001195:Asbestosis / Q000453:epidemiology* / Q000209:etiology; D002681:China / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality*; D008297:Male; D066192:Manufacturing Industry; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D011446:Prospective Studies
chemical_list: D017632:Asbestos, Serpentine
keywords: Asbestos; asbestosis; cumulative fiber exposure; epidemiology; lung cancer