Mortality among British asbestos workers undergoing regular medical examinations (1971–2005)

Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire SK176RN, UK.
Occupational and environmental medicine (Impact Factor: 3.27). 04/2009; 66(7):487-95. DOI: 10.1136/oem.2008.043414
Source: PubMed


The Great Britain Asbestos Survey was established to monitor mortality among workers covered by regulations to control occupational exposure to asbestos. This study updates the estimated burden of asbestos-related mortality in the cohort, and identifies risk factors associated with mortality.
From 1971, workers were recruited during initially voluntary and later statutory medical examinations. A brief questionnaire was completed during the medical, and participants were flagged for death registrations. Standardised mortality ratios (SMRs) and proportional mortality ratios (PMRs) were calculated for deaths occurring before 2006. Poisson regression analyses were undertaken for diseases with significant excess mortality.
There were 15 496 deaths among 98 117 workers followed-up for 1 779 580 person-years. The SMR for all cause mortality was 141 (95% CI 139 to 143) and for all malignant neoplasms 163 (95% CI 159 to 167). The SMRs for cancers of the stomach (166), lung (187), peritoneum (3730) and pleura (968), mesothelioma (513), cerebrovascular disease (164) and asbestosis (5594) were statistically significantly elevated, as were the corresponding PMRs. In age and sex adjusted analysis, birth cohort, age at first exposure, year of first exposure, duration of exposure, latency and job type were associated with the relative risk of lung, pleural and peritoneal cancers, asbestosis and mesothelioma mortality.
Known associations between asbestos exposure and mortality from lung, peritoneal and pleural cancers, mesothelioma and asbestosis were confirmed, and evidence of associations with stroke and stomach cancer mortality was observed. Limited evidence suggested that asbestos-related disease risk may be lower among those first exposed in more recent times.

Download full-text


Available from: Damien Mcelvenny, Jul 14, 2014
  • Source
    • "Recruitment started in 1971 and continues to this day. The study is described in detail elsewhere (Harding and Wegerdt, 2007; Harding et al, 2009; Harding and Frost, 2010), and so is briefly summarised here. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: The Great Britain (GB) Asbestos Survey is a prospective cohort of asbestos workers in GB. The objective of this study was to investigate determinants of mesothelioma latency, paying particular attention to indicators of intensity of asbestos exposure such as occupation, sex, and presence of asbestosis. Methods: The analysis included members of the cohort who died with mesothelioma between 1978 and 2005. The primary outcome was the latency period defined as the time from first occupational exposure to asbestos to death with mesothelioma. Generalised gamma accelerated failure-time models were used to estimate time ratios (TRs). Results: After excluding missing data, there were 614 workers who died with mesothelioma between 1978 and 2005. Total follow-up time was 9280 person-years, with a median latency of 22.8 years (95% confidence interval (CI) 16.0–27.2 years). In the fully adjusted model, latency was around 29% longer for females compared with males (TR=1.29, 95% CI=1.18–1.42), and 5% shorter for those who died with asbestosis compared with those who did not (TR=0.95, 95% CI=0.91–0.99). There was no evidence of an association between latency and occupation. Conclusion: This study did not find sufficient evidence that greater intensity asbestos exposures would lead to shorter mesothelioma latencies.
    Full-text · Article · Aug 2013 · British Journal of Cancer
  • Source
    • "Literature search. We identified 15 references that met the criteria for inclusion in the meta-analysis (Acheson et al. 1982; Berry et al. 2000; Gardner et al. 1986; Germani et al. 1999; Harding et al. 2009; Magnani et al. 2008; Mamo 2004; McDonald et al. 2006; Newhouse and Sullivan 1989; Pira et al. 2007; Reid et al. 2009; Rösler et al. 1994; Szeszenia-Dabrowska et al. 2002; Tarchi et al. 1994; Wilczyńska et al. 2005) (Figure 1). In addition, we were able to obtain results from the investigators of three cohort studies that had not previously reported findings for ovarian cancer (Clin et al. 2009; Hein et al. 2007; Loomis et al. 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: A recent Monographs Working Group of the International Agency for Research on Cancer (IARC) concluded that there is sufficient evidence for a causal association between exposure to asbestos and ovarian cancer. We performed a meta-analysis to quantitatively evaluate this association. Searches of PubMed and unpublished data yielded a total of 18 cohort studies of women occupationally exposed to asbestos. Two authors independently abstracted data; any disagreement was resolved by consulting a third reviewer. All but one study reported standardized mortality ratios (SMRs) comparing observed numbers of deaths with expected numbers for the general population; the exception was a study that reported standardized incidence ratios. For simplicity, we refer to all effect estimates as SMRs. The overall pooled SMR estimate for ovarian cancer was 1.77 (95% confidence interval, 1.37-2.28), with a moderate degree of heterogeneity among the studies (I2 = 35.3%, p = 0.061). Effect estimates were stronger for cohorts compensated for asbestosis, cohorts with estimated lung cancer SMRs > 2.0, and studies conducted in Europe compared with other geographic regions. Effect estimates were similar for studies with and without pathologic confirmation, and we found no evidence of publication bias (Egger's test p-value = 0.162). Our study supports the IARC conclusion that exposure to asbestos is associated with increased risk of ovarian cancer.
    Full-text · Article · Jun 2011 · Environmental Health Perspectives
  • [Show abstract] [Hide abstract]
    ABSTRACT: A patient with known asbestosis and a recent chorea was admitted for analysis of increasing disturbances of mobility, memory and social unacceptable behavior. At physical examination only minor neurological signs were seen. Additional investigations (among others CT-brain and PET-scan) suggested early M. Alzheimer. Two months later, the patient was readmitted with pneumonia and delirium. A literature review revealed some reports of vague neurological symptoms. An association between asbestos and the disorders in this patient was considered unlikely . An approach is proposed for asbestosis patients with vague neurological and/or psychiatric symptoms.
    No preview · Article · Jun 2013 · Tijdschrift voor gerontologie en geriatrie
Show more