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Occupation and risk of malignant pleural mesothelioma: A case-control study in Spain
A Agudo1, C A González, M J Bleda
1IREC (Institute of Epidemiology and Clinical Research), Mataro, Spain. agudo@csm.scs.es
Background:
The association of mesothelioma and asbestos exposure is well known, but some data suggest that probably many people are still being exposed to asbestos without knowing it.
Methods:
Between 1993 and 1996, 132 cases (77% males) of histologically confirmed malignant pleural mesothelioma and 257 controls, residents in two provinces of Spain (Barcelona and C¿adiz), were interviewed. They were classified according to their probability and intensity of occupational asbestos exposure by a panel of industrial hygienists, based on a detailed occupational history.
Results:
Age and sex-adjusted odds ratio (OR) for the highest probability of exposure to asbestos was 13.2 (95% confidence interval 6.4-27.3), and 27.1 (9. 28-79.3) for high intensity. A dose-response trend was observed for both, probability and intensity. Overall, 61% of cases and 42% of controls had ever worked in an occupation with risk of asbestos exposure, with an OR of 2.59 (1.60-4.22). In our population 62% of cases could be attributed to occupational asbestos exposure.
Conclusions:
A high risk of pleural mesothelioma due to occupational asbestos exposure is confirmed, but there is still a sizeable proportion for which no evidence of occupational exposure was found. Most of these cases could be due to other sources of asbestos exposure, mainly domestic or environmental.
Insights
Occupational asbestos exposure significantly increases malignant pleural mesothelioma risk. A substantial portion of cases, however, stem from non-occupational asbestos sources like domestic or environmental exposure.
Area of Science:
- Epidemiology
- Occupational Health
- Environmental Health
Background:
- The link between asbestos exposure and mesothelioma is established.
- Undiagnosed asbestos exposure may affect many individuals.
- Identifying asbestos exposure sources is crucial for public health.
Purpose of the Study:
- To quantify the risk of malignant pleural mesothelioma from occupational asbestos exposure.
- To investigate the role of asbestos exposure intensity and probability.
- To explore non-occupational asbestos exposure as a cause of mesothelioma.
Main Methods:
- A case-control study involving 132 mesothelioma patients and 257 controls in Spain (1993-1996).
- Detailed occupational histories were collected and assessed by industrial hygienists.
- Exposure probability and intensity were evaluated to determine risk.
Main Results:
- High probability and intensity of occupational asbestos exposure showed significantly increased odds ratios for mesothelioma.
- A clear dose-response relationship was observed for both exposure probability and intensity.
- 62% of mesothelioma cases in this population were attributable to occupational asbestos exposure.
Conclusions:
- Occupational asbestos exposure is a confirmed major risk factor for pleural mesothelioma.
- A significant proportion of mesothelioma cases lack identified occupational exposure.
- Domestic and environmental asbestos exposure are likely contributors to mesothelioma incidence.