| 1. |
- Albin, Maria, et al.
(författare)
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Mineral fibres, fibrosis, and asbestos bodies in lung tissue from deceased asbestos cement workers
- 1990
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Ingår i: British Journal of Industrial Medicine. - 0007-1072. ; 47:11, s. 767-774
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Tidskriftsartikel (refereegranskat)abstract
- Lung tissue from 76 deceased asbestos cement workers (seven with mesothelioma) exposed to chrysotile asbestos and small amounts of amphiboles, has been studied by transmission electron microscopy, together with lung tissue from 96 controls. The exposed workers with mesothelioma had a significantly higher total content of asbestos fibre in the lungs than those without mesothelioma, who in turn, had higher concentrations than the controls (medians 189, 50, and 29 x 10(6) fibres/g (f/g]. Chrysotile was the major type of fibre. The differences were most pronounced for the amphibole fibres (62, 4.7, and 0.15 f/g), especially crocidolite (54, 1.8 and less than 0.001 f/g), but were evident also for tremolite (2.9, less than 0.001, and less than 0.001 f/g) and anthophyllite (1.7, less than 0.001, and less than 0.001 f/g). For amosite, there was no statistically significant difference between lungs from workers with and without mesothelioma; the lungs of workers had, however, higher concentrations than the controls. Strong correlations were found between duration of exposure and content of amphibole fibres in the lungs. Asbestos bodies, counted by light microscopy, were significantly correlated with the amphibole but not with the chrysotile contents. Fibrosis was correlated with the tremolite but not the chrysotile content in lungs from both exposed workers and controls. Overall, similar results were obtained using fibre counts and estimates of mass.
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| 2. |
- Albin, Maria, et al.
(författare)
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Mortality and cancer morbidity in cohorts of asbestos cement workers and referents
- 1990
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Ingår i: British Journal of Industrial Medicine. - 0007-1072. ; 47:9, s. 602-610
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Tidskriftsartikel (refereegranskat)abstract
- Total and cause specific mortality and cancer morbidity were studied among 1929 asbestos cement workers with an estimated median cumulative exposure of 2.3 fibre (f)-years/ml (median intensity 1.2 f/ml, predominantly chrysotile). A local reference cohort of 1233 industrial workers and non-case referents from the exposed cohort were used for comparisons. The risk for pleural mesothelioma was significantly increased (13 cases out of 592 deaths in workers with at least 20 years latency). No case of peritoneal mesothelioma was found. A significant dose response relation was found for cumulative exposure 40 years or more before the diagnosis, with a multiplicative relative risk (RR) of 1.9 for each f-year/ml. No relation was found with duration of exposure when latency was accounted for. There was a significant overrisk in non-malignant respiratory disease (RR = 2.6). The overall risks for respiratory cancer, excluding mesothelioma, and for gastrointestinal cancer were not significantly increased. Surprisingly, colorectal cancer displayed a clear relation with cumulative dose, with an estimated increase of 1.6% in the incidence density ratio for each f-year/ml (but not with duration of exposure).
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| 3. |
- Jakobsson, Kristina, et al.
(författare)
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Asbestos, cement, and cancer in the right part of the colon
- 1994
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Ingår i: Occupational and Environmental Medicine. - 1470-7926. ; 51:2, s. 95-101
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE--The aim was to investigate associations between exposure to mineral fibres and dust, and cancer in subsites within the large bowel. DESIGN--Pooled retrospective cohort studies. SUBJECTS AND SETTINGS--Blue collar workers, employed for at least one year in different trades; asbestos cement or cement workers (n = 2507), other industrial workers (n = 3965), and fishermen (n = 8092). MAIN OUTCOME MEASURES--Standardised incidence ratios (SIRs, national reference rates) were calculated for cause specific cancer morbidity between 1958 and 1989. The observation period began 15 years after first employment. RESULTS--The asbestos cement and cement workers had a slightly increased risk of colorectal cancer (SIR 1.5; 95% confidence interval (95% CI) 1.1-2.0). This was due to an increase only in the right part of the colon (SIR 2.5; 95% CI 1.6-3.8). The ratio of right (7th revision of the International Classification of Diseases ICD-7) 1530-1531)/left (ICD-7 1532-1533) colon cancer among the asbestos cement and cement workers of 4.8 differed significantly from the ratio both among the other blue collar workers (0.4) and among the fishermen (1.5). As the sensitivity and accuracy was insufficient, mortality data did not show the excess of cancers in the right part of the colon. CONCLUSIONS--An increased incidence of cancer in the right part of the colon was evident in the asbestos cement and cement workers. The distribution of cancers within the colon was noticeably different from that in other blue collar workers, indicating that our findings cannot be explained by socioeconomic confounding factors. A detailed and appropriate disease classification, based on incidence data, is necessary in order not to obscure or underestimate effects of exposure in epidemiological studies on colorectal cancer.
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| 4. |
- Jakobsson, Kristina, et al.
(författare)
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Gastrointestinal cancer among cement workers. A case-referent study
- 1990
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Ingår i: International Archives of Occupational and Environmental Health. - 1432-1246. ; 62:4, s. 337-340
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Tidskriftsartikel (refereegranskat)abstract
- A matched case-referent study was conducted to investigate the risk of gastrointestinal cancer in cement workers. All male cases of cancer in esophagus, stomach, colon and rectum in the period 1922-1988 from two parishes surrounding a cement plant were identified. For each case, four referents were chosen, matched to age and year of death. Employment in the cement plant was confirmed as from plant records or job title noted in the parish books. Of 25 cases with a definite colorectal tumour, 40% had been blue-collar cement workers for 25 years or more, compared with 20% of their referents [odds ratio (OR) 3.2; 95% confidence limits (CI) 1.1-9.4]. There were indications of a dose (time of employment)-response relationship. For 18 cases with an esophageal or stomach tumour, the OR for those ever employed as cement workers was 3.2 (CI 1.0-11), but short-term employment predominated, thus making a causal relationship less likely.
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| 5. |
- Jakobsson, Kristina, et al.
(författare)
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Genetic polymorphism for glutathione-S-transferase mu in asbestos cement workers
- 1994
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Ingår i: Occupational and Environmental Medicine. - 1470-7926. ; 51:12, s. 812-816
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE--To investigate whether a lack of glutathione-S-transferase mu (GSTM1) activity was related to an increased risk for adverse outcome after asbestos exposure. METHODS--A study was made of 78 male former asbestos cement workers, with retrospective cohort data on exposure, radiographical findings, and lung function. Venous blood samples were obtained for the analysis of GSTM1 polymorphism by the polymerase chain reaction technique. Chest x ray films were classified according to the International Labour Organisation (ILO) 1980 classification. Vital capacity (VC) and forced expiratory volume during 1 s (FEV1) were determined. Individual estimates of asbestos exposure were calculated, and expressed as duration of exposure, average exposure intensity, and cumulative dose. Data on smoking were obtained from interviews. RESULTS--The lung function in the study group was reduced, compared with reference equations. 23% of the workers had small opacities > or = 1/0, 29% circumscribed pleural thickenings, 14% diffuse thickenings, and 12% obliterated costophrenic angles. 54% of the workers were GSTM1 deficient. They were comparable with the other workers in age, follow up time (median 30 years), and duration of exposure (median 18 years), but had a slightly higher cumulated dose (median 18 v 10 fibre-years) than the others. Neither in radiographical changes nor lung function variables were there any differences between the different GSTM1 groups. The findings were similar when smoking habits and estimated asbestos exposure were taken into account. CONCLUSIONS--We could not show that lack of GSTM1 activity was related to an increased risk for radiographical or lung function changes in a group of asbestos cement workers, followed up for a long period after the end of exposure.
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| 6. |
- Jakobsson, Kristina, et al.
(författare)
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Mortality and cancer morbidity among cement workers
- 1993
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Ingår i: British Journal of Industrial Medicine. ; 50:3, s. 72-264
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore associations between exposure to cement dust and cause specific mortality and tumour morbidity, especially gastrointestinal tumours. DESIGN: A retrospective cohort study. SUBJECTS AND SETTING: 2400 men, employed for at least 12 months in two Swedish cement factories. MAIN OUTCOME MEASURES: Cause specific morality from death certificates (1952-86). Cancer morbidity from tumour registry information (1958-86). Standardised mortality rates (SMRs; national reference rates) and standardised morbidity incidence rates (SIRs; regional reference rates) were calculated. RESULTS: An increased risk of colorectal cancer was found > or = 15 years since the start of employment (SIR 1.6, 95% confidence interval (95% CI) 1.1-2.3), mainly due to an increased risk for tumours in the right part of the colon (SIR 2.7, 95% CI 1.4-4.8), but not in the left part (SIR 1.0, 95% CI 0.3-2.5). There was a numerical increase of rectal cancer (SIR 1.5, 95% CI 0.8-2.5). Exposure (duration of blue collar employment)-response relations were found for right sided colon cancer. After > or = 25 years of cement work, the risk was fourfold (SIR 4.3, 95% CI 1.7-8.9). There was no excess of stomach cancer or respiratory cancer. Neither total mortality nor cause specific mortality were significantly increased. CONCLUSIONS: Diverging risk patterns for tumours with different localisations within the large bowel were found in the morbidity study. Long term exposure to cement dust was a risk factor for right sided colon cancer. The mortality study did not show this risk.
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| 7. |
- Johansson, L, et al.
(författare)
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Histological type of lung carcinoma in asbestos cement workers and matched controls
- 1992
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Ingår i: British Journal of Industrial Medicine. - 0007-1072. ; 49:9, s. 626-630
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Tidskriftsartikel (refereegranskat)abstract
- Histological types of lung carcinoma were examined in a case series of workers exposed to asbestos cement dust (n = 29) and matched controls (n = 87). The proportion of adenocarcinomas was 31% among the exposed subjects and 15% among the controls (mid-p = 0.05). Among workers with high exposure the proportion of adenocarcinoma was even higher (45%, 5/11; mid-p = 0.03). The proportion of peripheral tumours tended to be higher among exposed cases than controls (24 v 12%, mid-p = 0.12). Lobe of origin did not differ, however, between exposed cases and controls. Thus the study indicates an association between the degree of exposure to asbestos and adenocarcinoma of the lung, and a peripheral rather than central localisation of the tumours, but with virtually the same distribution of lobe of origin as in the general population.
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