Occupation and risk of malignant pleural mesothelioma: A case-control study in Spain

• Published in: American journal of industrial medicine Vol. 37; no. 2; pp. 159 - 168
• Main Authors: Agudo, Antonio, González, Carlos A., Bleda, María J., Ramírez, José, Hernández, Santos, López, Francisca, Calleja, Asunción, Panadès, Rafael, Turuguet, Domènec, Escolar, Antonio, Beltrán, Manuel, González-Moya, José E.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.02.2000; Wiley-Liss
• Subjects: Adult; Aged; Aged, 80 and over; asbestos; Asbestos - adverse effects; Biological and medical sciences; Case-Control Studies; Chemical and industrial products toxicology. Toxic occupational diseases; Chemical compounds (mineral, organic); Chemical, physic and infectious diseases; Female; Humans; Inorganic dusts (pneumoconiosises) and organic dusts (byssinosis etc.); Male; Medical sciences; mesothelioma; Mesothelioma - epidemiology; Middle Aged; Occupational Diseases - epidemiology; Occupational Exposure; Occupational medicine; Pleural Neoplasms - epidemiology; Public health. Hygiene-occupational medicine; Spain; Spain - epidemiology; Toxicology; Spain; Human; Malignant mesothelioma; Asbestos; Respiratory disease; Toxicity; Risk factor; Pleural disease; Malignant tumor; Case control study; Occupational exposure; Pleura
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/(SICI)1097-0274(200002)37:2<159::AID-AJIM1>3.0.CO;2-0

Background The association of mesothelioma and asbestos exposure is well known, but some data suggest that probably many people are still being exposed to asbestos without knowing it. Methods Between 1993 and 1996, 132 cases (77% males) of histologically confirmed malignant pleural mesothelioma and 257 controls, residents in two provinces of Spain (Barcelona and Cádiz), were interviewed. They were classified according to their probability and intensity of occupational asbestos exposure by a panel of industrial hygienists, based on a detailed occupational history. Results Age and sex‐adjusted odds ratio (OR) for the highest probability of exposure to asbestos was 13.2 (95% confidence interval 6.4–27.3), and 27.1 (9.28–79.3) for high intensity. A dose–response trend was observed for both, probability and intensity. Overall, 61% of cases and 42% of controls had ever worked in an occupation with risk of asbestos exposure, with an OR of 2.59 (1.60–4.22). In our population 62% of cases could be attributed to occupational asbestos exposure. Conclusions A high risk of pleural mesothelioma due to occupational asbestos exposure is confirmed, but there is still a sizeable proportion for which no evidence of occupational exposure was found. Most of these cases could be due to other sources of asbestos exposure, mainly domestic or environmental. Am. J. Ind. Med. 37:159–168, 2000. © 2000 Wiley‐Liss, Inc.