Abstract
We studied exposure to asbestos, pulmonary fibrosis, fiber count, and fiber size in relation to the lobar origin of lung cancer in 90 consecutive patients. Among the 32 patients with a history of occupational exposure to asbestos, 22 were construction workers. The proportion of lower-lobe tumors increased with the duration of exposure from 45% in those working less than 15 years to 82% in those working 15 years or more in the construction trade, as compared with 25% in patients who were probably not exposed. The location of the tumor in the lower lobe was explained by the high number of total fibers [odds ratio (OR) = 9.0, CI = 2.3-34.6), of fibers 3 microns and longer (OR = 22.1, CI = 3.9-125), and fibers of anthophyllite (OR = 14.6, CI = 2.4-83.4) and crocidolite (OR = 7.0, CI = 1.2-41.2) when the effect of smoking and fibrosis was adjusted in the logistic regression analysis. The location of the tumor did not correlate with fibrosis, pack-years smoked, or the number of short (< 3 microns) fibers. Our findings suggest that asbestos causes an excess of lower-lobe tumors at a relatively low exposure level, independently of pulmonary fibrosis.
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- Auerbach O., Garfinkel L., Parks V. R., Conston A. S., Galdi V. A., Joubert L. Histologic type of lung cancer and asbestos exposure. Cancer. 1984 Dec 15;54(12):3017–3021. doi: 10.1002/1097-0142(19841215)54:12<3017::aid-cncr2820541233>3.0.co;2-9. [DOI] [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]
- Byers T. E., Vena J. E., Rzepka T. F. Predilection of lung cancer for the upper lobes: an epidemiologic inquiry. J Natl Cancer Inst. 1984 Jun;72(6):1271–1275. [PubMed] [Google Scholar]
- Case B. W., Sebastien P. Environmental and occupational exposures to chrysotile asbestos: a comparative microanalytic study. Arch Environ Health. 1987 Jul-Aug;42(4):185–191. [PubMed] [Google Scholar]
- Churg A. The distribution of amosite asbestos in the periphery of the normal human lung. Br J Ind Med. 1990 Oct;47(10):677–681. doi: 10.1136/oem.47.10.677. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Churg A., Wright J. L., DePaoli L., Wiggs B. Mineralogic correlates of fibrosis in chrysotile miners and millers. Am Rev Respir Dis. 1989 Apr;139(4):891–896. doi: 10.1164/ajrccm/139.4.891. [DOI] [PubMed] [Google Scholar]
- Churg A., Wright J., Wiggs B., Depaoli L. Mineralogic parameters related to amosite asbestos-induced fibrosis in humans. Am Rev Respir Dis. 1990 Dec;142(6 Pt 1):1331–1336. doi: 10.1164/ajrccm/142.6_Pt_1.1331. [DOI] [PubMed] [Google Scholar]
- Davis J. M., Cowie H. A. The relationship between fibrosis and cancer in experimental animals exposed to asbestos and other fibers. Environ Health Perspect. 1990 Aug;88:305–309. doi: 10.1289/ehp.9088305. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dodson R. F., Williams M. G., Jr, Corn C. J., Rankin T. L. A comparison of asbestos burden in non-urban patients with and without lung cancer. Cytobios. 1988;56(224):7–15. [PubMed] [Google Scholar]
- Edelman D. A. Does asbestosis increase the risk of lung cancer? Int Arch Occup Environ Health. 1990;62(5):345–349. doi: 10.1007/BF00381363. [DOI] [PubMed] [Google Scholar]
- Esmen N. A., Erdal S. Human occupational and nonoccupational exposure to fibers. Environ Health Perspect. 1990 Aug;88:277–286. doi: 10.1289/ehp.9088277. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Johansson L., Albin M., Jakobsson K., Mikoczy Z. Histological type of lung carcinoma in asbestos cement workers and matched controls. Br J Ind Med. 1992 Sep;49(9):626–630. doi: 10.1136/oem.49.9.626. [DOI] [PMC free article] [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]
- Karjalainen A., Anttila S., Heikkilä L., Karhunen P., Vainio H. Asbestos exposure among Finnish lung cancer patients: occupational history and fiber concentration in lung tissue. Am J Ind Med. 1993 Mar;23(3):461–471. doi: 10.1002/ajim.4700230309. [DOI] [PubMed] [Google Scholar]
- Kjuus H., Skjaerven R., Langård S., Lien J. T., Aamodt T. A case-referent study of lung cancer, occupational exposures and smoking. II. Role of asbestos exposure. Scand J Work Environ Health. 1986 Jun;12(3):203–209. doi: 10.5271/sjweh.2157. [DOI] [PubMed] [Google Scholar]
- Lippmann M. Asbestos exposure indices. Environ Res. 1988 Jun;46(1):86–106. doi: 10.1016/s0013-9351(88)80061-6. [DOI] [PubMed] [Google Scholar]
- Meurman L. O., Kiviluoto R., Hakama M. Combined effect of asbestos exposure and tobacco smoking on Finnish anthophyllite miners and millers. Ann N Y Acad Sci. 1979;330:491–495. doi: 10.1111/j.1749-6632.1979.tb18750.x. [DOI] [PubMed] [Google Scholar]
- Meurman L. O., Kiviluoto R., Hakama M. Mortality and morbidity among the working population of anthophyllite asbestos miners in Finland. Br J Ind Med. 1974 Apr;31(2):105–112. doi: 10.1136/oem.31.2.105. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mohr U., Rittinghausen S., Takenaka S., Ernst H., Dungworth D. L., Pylev L. N. Pathology of tumours in laboratory animals. Tumours of the lower respiratory tract and pleura in the rat. IARC Sci Publ. 1990;(99):275–299. [PubMed] [Google Scholar]
- Rubin A. H. Common problems in asbestos-related pulmonary diseases. Am J Ind Med. 1986;10(5-6):555–562. doi: 10.1002/ajim.4700100512. [DOI] [PubMed] [Google Scholar]
- Ruffie P., Hirsch A., Marteau D., Bignon J., Chrétien J. Etude étiologique et histologique de 448 cancers du poumon. Ann Med Interne (Paris) 1981;132(1):12–15. [PubMed] [Google Scholar]
- Wagner J. C., Newhouse M. L., Corrin B., Rossiter C. E., Griffiths D. M. Correlation between fibre content of the lung and disease in east London asbestos factory workers. Br J Ind Med. 1988 May;45(5):305–308. doi: 10.1136/oem.45.5.305. [DOI] [PMC free article] [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]