Abstract
OBJECTIVES: To estimate the relations between exposure to both tobacco smoke and crocidolite and the incidence of various histological types of lung cancer. METHODS: In 1979 all former workers from the Wittenoom asbestos industry who could be traced were sent a questionnaire on smoking history. Of 2928 questionnaires sent, satisfactory replies were received from 2400 men and 149 women. Of the men, 80% had smoked at some time and 50% still smoked. Occupational exposure to crocidolite was known from employment records and follow up was maintained through death and cancer registries in Australia with histological diagnoses obtained from the relevant State Cancer Registry. Conditional logistic regression was used to estimate the effects of tobacco and asbestos exposure on incidence of different cell types of lung cancer in a nested case-control design. RESULTS: Between 1979 and 1990, 71 cases of lung cancer occurred among men in this cohort: 27% squamous cell carcinoma, 31% adenocarcinoma, 18% small cell carcinoma, 11% large cell carcinoma, and 13% unclassified or indeterminate. Two of the classified cases and one unclassified case had never smoked. The incidence of both squamous and adenocarcinoma types of lung cancer were greatest in ex-smokers and in those subjects with the highest levels of exposure to crocidolite. After adjustment for smoking habit, the increase in incidence of lung cancer with increasing exposure to crocidolite was greater for squamous cell carcinoma than for adenocarcinoma. CONCLUSIONS: The results from this study have shown significant exposure-response effects for exposure to crocidolite, and both adenocarcinoma and squamous cell carcinoma of the lung. They also provide some further evidence against the theory that parenchymal fibrosis induced by asbestos is a necessary precursor to asbestos induced lung cancer.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Armstrong B. K., de Klerk N. H., Musk A. W., Hobbs M. S. Mortality in miners and millers of crocidolite in Western Australia. Br J Ind Med. 1988 Jan;45(1):5–13. doi: 10.1136/oem.45.1.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Baker J. E., Reutens D. C., Graham D. F., Sterrett G. F., Musk A. W., Hobbs M. S., Armstrong B. K., de Klerk N. H. Morphology of bronchogenic carcinoma in workers formerly exposed to crocidolite at Wittenoom Gorge in Western Australia. Int J Cancer. 1986 Apr 15;37(4):547–550. doi: 10.1002/ijc.2910370412. [DOI] [PubMed] [Google Scholar]
- Becher H., Jedrychowski W., Wahrendorf J., Basa-Cierpialek Z., Flak E., Gomola K. Effect of occupational air pollutants on various histological types of lung cancer: a population based case-control study. Br J Ind Med. 1993 Feb;50(2):136–142. doi: 10.1136/oem.50.2.136. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Berry G., Newhouse M. L., Antonis P. Combined effect of asbestos and smoking on mortality from lung cancer and mesothelioma in factory workers. Br J Ind Med. 1985 Jan;42(1):12–18. doi: 10.1136/oem.42.1.12. [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]
- DOLL R., HILL A. B. MORTALITY IN RELATION TO SMOKING: TEN YEARS' OBSERVATIONS OF BRITISH DOCTORS. Br Med J. 1964 May 30;1(5395):1399–1410. doi: 10.1136/bmj.1.5395.1399. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morabia A., Wynder E. L. Cigarette smoking and lung cancer cell types. Cancer. 1991 Nov 1;68(9):2074–2078. doi: 10.1002/1097-0142(19911101)68:9<2074::aid-cncr2820680939>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
- Raffn E., Lynge E., Korsgaard B. Incidence of lung cancer by histological type among asbestos cement workers in Denmark. Br J Ind Med. 1993 Jan;50(1):85–89. doi: 10.1136/oem.50.1.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vena J. E., Byers T. E., Cookfair D., Swanson M. Occupation and lung cancer risk. An analysis by histologic subtypes. Cancer. 1985 Aug 15;56(4):910–917. doi: 10.1002/1097-0142(19850815)56:4<910::aid-cncr2820560436>3.0.co;2-4. [DOI] [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]
- Wilkinson P., Hansell D. M., Janssens J., Rubens M., Rudd R. M., Taylor A. N., McDonald C. Is lung cancer associated with asbestos exposure when there are no small opacities on the chest radiograph? Lancet. 1995 Apr 29;345(8957):1074–1078. doi: 10.1016/s0140-6736(95)90817-x. [DOI] [PubMed] [Google Scholar]
- de Klerk N. H., Musk A. W., Armstrong B. K., Hobbs M. S. Smoking, exposure to crocidolite, and the incidence of lung cancer and asbestosis. Br J Ind Med. 1991 Jun;48(6):412–417. doi: 10.1136/oem.48.6.412. [DOI] [PMC free article] [PubMed] [Google Scholar]