Abstract
Lung cancer originates most commonly in the upper lobes in the general population but among workers with asbestosis it is most common in the lower lobes. Published data on lobar distribution were used to estimate the probabilities that lung cancer among asbestos workers is attributable to exposure to asbestos. This attribution varies directly with the relative risk. Critical values of the relative risk at which attribution of lung cancer to asbestos equalled its attribution to other causes, mainly smoking, were calculated. At a relative risk above 2.81 upper lobe cancers were more likely to be due to asbestos than not. For middle and lower lobe cancers, the critical relative risk was 1.55. These critical values were compared with published standardised mortality ratios reported for cohorts of workers with asbestosis. Since the ratios ranged from 6.3 to 9.1, the probability that lung cancer in such cases is due to asbestos is high regardless of lobe of origin. In many cohorts unstratified by the presence or absence of asbestosis the risk ratios are below one or both of these critical values. Since risk ratios are so high among workers with asbestosis, the ratios must be lower for workers without asbestosis than the overall ratios for unstratified cohorts. Therefore, the critical values may be useful in workers without asbestosis among such cohorts to estimate the upper limit of the probability that lung cancer in a given lobe is due to exposure to asbestos.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Berry G. Mortality of workers certified by pneumoconiosis medical panels as having asbestosis. Br J Ind Med. 1981 May;38(2):130–137. doi: 10.1136/oem.38.2.130. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Boyland E. Tumour initiators, promoters, and complete carcinogens. Br J Ind Med. 1985 Oct;42(10):716–718. doi: 10.1136/oem.42.10.716. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Browne K. Is asbestos or asbestosis the cause of the increased risk of lung cancer in asbestos workers? Br J Ind Med. 1986 Mar;43(3):145–149. doi: 10.1136/oem.43.3.145. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GARLAND L. H., BEIER R. L., COULSON W., HEALD J. H., STEIN R. L. The apparent sites of origin of carcinomas of the lung. Radiology. 1962 Jan;78:1–11. doi: 10.1148/78.1.1. [DOI] [PubMed] [Google Scholar]
- Hobbs M. S., Woodward S. D., Murphy B., Musk A. W., Elder J. E. The incidence of pneumoconiosis, mesothelioma and other respiratory cancer in men engaged in mining and milling crocidolite in Western Australia. IARC Sci Publ. 1980;(30):615–625. [PubMed] [Google Scholar]
- Jacob G., Anspach M. Pulmonary neoplasia among Dresden asbestos workers. Ann N Y Acad Sci. 1965 Dec 31;132(1):536–548. doi: 10.1111/j.1749-6632.1965.tb41134.x. [DOI] [PubMed] [Google Scholar]
- Kannerstein M., Churg J. Pathology of carcinoma of the lung associated with asbestos exposure. Cancer. 1972 Jul;30(1):14–21. doi: 10.1002/1097-0142(197207)30:1<14::aid-cncr2820300104>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
- LULU D. J., LAWSON L. J. CARCINOMA OF THE LUNG. A REVIEW OF 321 CASES. Arch Surg. 1964 Feb;88:213–217. doi: 10.1001/archsurg.1964.01310200051012. [DOI] [PubMed] [Google Scholar]
- Mossman B. T., Cameron G. S., Yotti L. P. Cocarcinogenic and tumor promoting properties of asbestos and other minerals in tracheobronchial epithelium. Carcinog Compr Surv. 1985;8:217–238. [PubMed] [Google Scholar]
- Schlesinger R. B., Lippmann M. Particle deposition in casts of the human upper tracheobronchial tree. Am Ind Hyg Assoc J. 1972 Apr;33(4):237–251. doi: 10.1080/0002889728506636. [DOI] [PubMed] [Google Scholar]
- Weiss W., Boucot K. R. The Philadelphia Pulmonary Neoplasm Research Project. Early roentgenographic appearance of bronchogenic carcinoma. Arch Intern Med. 1974 Aug;134(2):306–311. [PubMed] [Google Scholar]
- Weiss W. Lung cancer and occupational lung disease. Clin Chest Med. 1981 May;2(2):289–300. [PubMed] [Google Scholar]
- Whitwell F., Newhouse M. L., Bennett D. R. A study of the histological cell types of lung cancer in workers suffering from asbestosis in the United Kingdom. Br J Ind Med. 1974 Oct;31(4):298–303. doi: 10.1136/oem.31.4.298. [DOI] [PMC free article] [PubMed] [Google Scholar]