Quantitative risk assessment for lung cancer after exposure to bitumen fume

An international cohort of asphalt workers was assembled to study cancer risk after bitumen exposure. This article describes the combination of the exposure assessment with the exposure-response for a quantitative risk assessment for lung cancer mortality within the Dutch component of the study. We identified a retrospective cohort of 3,709 workers with at least one season of employment. Semi-quantitative exposure to bitumen fume was estimated by a job-exposure matrix. Exposure-response relations were fitted by Poisson regression, and excess lifetime risks through age 75 were calculated by a life table method. Working lifetime cumulative exposure to bitumen fume was calculated under different scenarios, representing past and future exposures. For workers with exposures accumulated in the past, excess risks for lung cancer varied from 7.8 to 14.3%. Calculations for future exposures resulted in considerably lower excess risks ranging from 0.6 to 2.6%. The calculated excess risks for lung cancer mortality after working lifetime exposure to bitumen fume depend strongly on when exposure was experienced and to some extent on the exposure-response model chosen, while confounding by smoking cannot be ruled out. Nevertheless, the excess lifetime risk for lung cancer in this Dutch cohort of asphalt workers is above benchmark risks as applied by the Dutch Health Council. Current exposure levels have decreased this risk considerably, but further exposure control may be required.