Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 1997 Apr;54(4):254–263. doi: 10.1136/oem.54.4.254

A meta-analysis of the relation between cumulative exposure to asbestos and relative risk of lung cancer.

T L Lash 1, E A Crouch 1, L C Green 1
PMCID: PMC1128699  PMID: 9166131

Abstract

OBJECTIVES: To obtain summary measures of the relation between cumulative exposure to asbestos and relative risk of lung cancer from published studies of exposed cohorts, and to explore the sources of heterogeneity in the dose-response coefficient with data available in these publications. METHODS: 15 cohorts in which the dose-response relation between cumulative exposure to asbestos and relative risk of lung cancer has been reported were identified. Linear dose-response models were applied, with intercepts either specific to the cohort or constrained by a random effects model; and with slopes specific to the cohort, constrained to be identical between cohorts (fixed effect), or constrained by a random effects model. Maximum likelihood techniques were used for the fitting procedures and to investigate sources of heterogeneity in the cohort specific dose-response relations. RESULTS: Estimates of the study specific dose-response coefficient (kappa 1.i) ranged from zero to 42 x 10(-3) ml/fibre-year (ml/f-y). Under the fixed effect model, a maximum likelihood estimate of the summary measure of the coefficient (k1) equal to 0.42 x 10(-3) (95% confidence interval (95% CI) 0.22 to 0.69 x 10(-3)) ml/f-y was obtained. Under the random effects model, implemented because there was substantial heterogeneity in the estimates of kappa 1.i and the zero dose intercepts (Ai), a maximum likelihood estimate of k1 equal to 2.6 x 10(-3) (95% CI 0.65 to 7.4 x 10(-3)) ml/f-y, and a maximum likelihood estimate of A equal to 1.36 (95% CI 1.05 to 1.76) were found. Industry category, dose measurements, tobacco habits, and standardisation procedures were identified as sources of heterogeneity. CONCLUSIONS: The appropriate summary measure of the relation between cumulative exposure to asbestos and relative risk of lung cancer depends on the context in which the measure will be applied and the prior beliefs of those applying the measure. In most situations, the summary measure of effect obtained under the random effects model is recommended. Under this model, potency, k1, is fourfold lower than that calculated by the United States Occupational Safety and Health Administration.

Full text

PDF
254

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amandus H. E., Wheeler R. The morbidity and mortality of vermiculite miners and millers exposed to tremolite-actinolite: Part II. Mortality. Am J Ind Med. 1987;11(1):15–26. doi: 10.1002/ajim.4700110103. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Dement J. M., Brown D. P., Okun A. Follow-up study of chrysotile asbestos textile workers: cohort mortality and case-control analyses. Am J Ind Med. 1994 Oct;26(4):431–447. doi: 10.1002/ajim.4700260402. [DOI] [PubMed] [Google Scholar]
  4. Dement J. M., Harris R. L., Jr, Symons M. J., Shy C. M. Exposures and mortality among chrysotile asbestos workers. Part II: mortality. Am J Ind Med. 1983;4(3):421–433. doi: 10.1002/ajim.4700040304. [DOI] [PubMed] [Google Scholar]
  5. Finkelstein M. M. Mortality among employees of an Ontario asbestos-cement factory. Am Rev Respir Dis. 1984 May;129(5):754–761. doi: 10.1164/arrd.1984.129.5.754. [DOI] [PubMed] [Google Scholar]
  6. Finkelstein M. M. Mortality among long-term employees of an Ontario asbestos-cement factory. Br J Ind Med. 1983 May;40(2):138–144. doi: 10.1136/oem.40.2.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hammond E. C., Selikoff I. J., Seidman H. Asbestos exposure, cigarette smoking and death rates. Ann N Y Acad Sci. 1979;330:473–490. doi: 10.1111/j.1749-6632.1979.tb18749.x. [DOI] [PubMed] [Google Scholar]
  8. Henderson V. L., Enterline P. E. Asbestos exposure: factors associated with excess cancer and respiratory disease mortality. Ann N Y Acad Sci. 1979;330:117–126. doi: 10.1111/j.1749-6632.1979.tb18712.x. [DOI] [PubMed] [Google Scholar]
  9. Hughes J. M., Weill H., Hammad Y. Y. Mortality of workers employed in two asbestos cement manufacturing plants. Br J Ind Med. 1987 Mar;44(3):161–174. doi: 10.1136/oem.44.3.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. McArthur B. R. A conveniently constructed dynamic calibration system. Am Ind Hyg Assoc J. 1980 Feb;41(2):151–152. doi: 10.1080/15298668091424528. [DOI] [PubMed] [Google Scholar]
  11. McDonald A. D., Fry J. S., Woolley A. J., McDonald J. C. Dust exposure and mortality in an American chrysotile asbestos friction products plant. Br J Ind Med. 1984 May;41(2):151–157. doi: 10.1136/oem.41.2.151. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McDonald A. D., Fry J. S., Woolley A. J., McDonald J. Dust exposure and mortality in an American chrysotile textile plant. Br J Ind Med. 1983 Nov;40(4):361–367. doi: 10.1136/oem.40.4.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. McDonald J. C., Liddell F. D., Dufresne A., McDonald A. D. The 1891-1920 birth cohort of Quebec chrysotile miners and millers: mortality 1976-88. Br J Ind Med. 1993 Dec;50(12):1073–1081. doi: 10.1136/oem.50.12.1073. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. McDonald J. C., Liddell F. D., Gibbs G. W., Eyssen G. E., McDonald A. D. Dust exposure and mortality in chrysotile mining, 1910-75. Br J Ind Med. 1980 Feb;37(1):11–24. doi: 10.1136/oem.37.1.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McDonald J. C., McDonald A. D., Armstrong B., Sebastien P. Cohort study of mortality of vermiculite miners exposed to tremolite. Br J Ind Med. 1986 Jul;43(7):436–444. doi: 10.1136/oem.43.7.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Neuberger M., Kundi M. Individual asbestos exposure: smoking and mortality--a cohort study in the asbestos cement industry. Br J Ind Med. 1990 Sep;47(9):615–620. doi: 10.1136/oem.47.9.615. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nicholson W. J., Perkel G., Selikoff I. J. Occupational exposure to asbestos: population at risk and projected mortality--1980-2030. Am J Ind Med. 1982;3(3):259–311. doi: 10.1002/ajim.4700030305. [DOI] [PubMed] [Google Scholar]
  18. Ohlson C. G., Hogstedt C. Lung cancer among asbestos cement workers. A Swedish cohort study and a review. Br J Ind Med. 1985 Jun;42(6):397–402. doi: 10.1136/oem.42.6.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Park R. M., Maizlish N. A., Punnett L., Moure-Eraso R., Silverstein M. A. A comparison of PMRs and SMRs as estimators of occupational mortality. Epidemiology. 1991 Jan;2(1):49–59. doi: 10.1097/00001648-199101000-00008. [DOI] [PubMed] [Google Scholar]
  20. Peto J., Doll R., Hermon C., Binns W., Clayton R., Goffe T. Relationship of mortality to measures of environmental asbestos pollution in an asbestos textile factory. Ann Occup Hyg. 1985;29(3):305–355. doi: 10.1093/annhyg/29.3.305. [DOI] [PubMed] [Google Scholar]
  21. Piolatto G., Negri E., La Vecchia C., Pira E., Decarli A., Peto J. An update of cancer mortality among chrysotile asbestos miners in Balangero, northern Italy. Br J Ind Med. 1990 Dec;47(12):810–814. doi: 10.1136/oem.47.12.810. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Seidman H., Selikoff I. J., Gelb S. K. Mortality experience of amosite asbestos factory workers: dose-response relationships 5 to 40 years after onset of short-term work exposure. Am J Ind Med. 1986;10(5-6):479–514. doi: 10.1002/ajim.4700100506. [DOI] [PubMed] [Google Scholar]
  23. Seidman H., Selikoff I. J., Hammond E. C. Short-term asbestos work exposure and long-term observation. Ann N Y Acad Sci. 1979;330:61–89. doi: 10.1111/j.1749-6632.1979.tb18710.x. [DOI] [PubMed] [Google Scholar]
  24. Weill H., Hughes J., Waggenspack C. Influence of dose and fiber type on respiratory malignancy risk in asbestos cement manufacturing. Am Rev Respir Dis. 1979 Aug;120(2):345–354. doi: 10.1164/arrd.1979.120.2.345. [DOI] [PubMed] [Google Scholar]
  25. Zeise L., Wilson R., Crouch E. A. Dose-response relationships for carcinogens: a review. Environ Health Perspect. 1987 Aug;73:259–306. doi: 10.1289/ehp.8773259. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES