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Voormalige Australische asbest-werkers hebben een extra risico op het krijgen van longkanker tot 20 jaar na het stoppen met roken. De extra kans op longkanker van iemand die én heeft gerookt én asbestvezels heeft ingeademd is minder dan het product van de verhoging bij alleen roken en die bij alleen asbestblootstelling. Dit concludeerde Reid et al. na een onderzoek onder bijna 3000 ex-werknemers van de asbestmijnen in het Australische Wittenoom. In Wittenoom werd tussen 1943 en 1966 het meest gevaarlijke blauwe asbest (crocidoliet) gewonnen. Reid A., et al. (2006). The risk of lung cancer with increasing time since ceasing exposure to asbestos and quitting smoking. Occupational Environmental Medicine, Aug.63(8):509-12.
Reid A, de Klerk NH, Ambrosini GL, Berry G, Musk AW., (2006). The risk of lung cancer with increasing time since ceasing exposure to asbestos and quitting smoking. Occupational Environmental Medicine, Aug.63(8):509-12.

OBJECTIVES: To examine if the risk of lung cancer declines with increasing time since ceasing exposure to asbestos and quitting smoking, and to determine the relative asbestos effect between non-smokers and current smokers. METHODS: A cohort study of 2935 former workers of the crocidolite mine and mill at Wittenoom, who responded to a questionnaire on smoking first issued in 1979 and on whom quantitative estimates of asbestos exposure are known. Conditional logistic regression was used to relate asbestos exposure, smoking category, and risk of lung cancer. RESULTS: Eighteen per cent of the cohort reported never smoking. 66% of cases and 50% of non-cases were current smokers. Past smokers who ceased smoking within six years of the survey (OR = 22.1, 95% CI 5.6 to 87.0), those who ceased smoking 20 or more years before the survey (OR = 1.9, 95% CI 0.50 to 7.2), and current smokers (<20 cigarettes per day (OR = 6.8, 95% CI 2.0 to 22.7) or >20 cigarettes per day (OR = 13.2, 95% CI 4.1 to 42.5)) had higher risks of lung cancer compared to never smokers after adjusting for asbestos exposure and age. The asbestos effect between non-smokers and current smokers was 1.23 (95% CI 0.35 to 4.32). CONCLUSION: Persons exposed to asbestos and tobacco but who subsequently quit, remain at an increased risk for lung cancer up to 20 years after smoking cessation, compared to never smokers. Although the relative risk of lung cancer appears higher in never and ex-smokers than in current smokers, those who both smoke and have been exposed to asbestos have the highest risk. this study emphasises the importance of smoking prevention and smoking cessation programmes within this high risk cohort.

Volgens het ‘Hauptverband der gewerblichen Berufsgenossenschaften (HVBG)’ zijn er in Duitsland in 2005 1982 mensen overlijden door blootstelling aan niet-organische stoffen in het werk, vooral asbest. Met betrekking tot beroepsziekten in het algemeen meldt deze organisatie een geleidelijke afname van het aantal claims. Bron: Eurogip infomail, 38, 1 augustus 2006. Meer http://www.hvbg.de/d/pages/presse/preme/beitrag.html

18 van de 20 landen in het Midden Oosten importeren nog steeds asbest. Alleen Egypte en Saoedi Arabië hebben dit product inmiddels verboden. Geen enkel land in deze regio heeft ILO-verdrag nr. 162 geratificeerd: een verdrag dat landen verplicht werknemers tegen asbestblootstelling te beschermen. Iran en de Verenigde Arabische Emiraten zijn de grootste verbruikers in deze regio. Bron: International Ban Asbestos Secretariat, juli 2006. Meer www.ibas.btinternet.co.uk

Sinds 1980 zijn de sterftecijfers van 4187 ex-werknemers van een Poolse fabriek van asbestproducten vergeleken met de Poolse bevolking in het algemeen. Zowel longkanker als mesothelioom kwamen bij de asbestwerkers vaker voor. Bij vrouwen was het verschil nog groter, volgens de onderzoekers een aanwijzing dat vrouwen wellicht gevoeliger voor asbest zijn dan mannen. Er werd geen direct verband gevonden tussen het hebben van asbestose (een stoflongziekte) en een verhoogd risico op longkanker. Bron: Wilczynska U. et al., (2005) Mortality from malignant neoplasms among workers of an asbestos processing plant in Poland: results of prolonged observation. International Journal of Occupational Medicine and Environmental Health 18(4):313-26.
Wilczynska U, Szymczak W, Szeszenia-Dabrowska N., (2005). Mortality from malignant neoplasms among workers of an asbestos processing plant in Poland: results of prolonged observation. International Journal of Occupational Medicine and Environmental Health 18(4):313-26.

ABSTRACT

OBJECTIVES: The study on mortality from cancer among workers of an asbestos plant manufacturing asbestos yarn, cloth, cords, packings, stuffing, brake linings and asbestos-rubber sheets was launched in the 1980s. The present paper discusses the results of further tracing of asbestos workers of the same plant. MATERIALS AND METHODS: The study cohort covered 4497 workers employed at the asbestos plant in 1945-1980. The follow-up of the cohort continued until 31 December 1999. Deaths by causes were analyzed using standardized mortality ratio (SMR) calculated by the person-years method. The mortality pattern of the general population of Poland was used as reference. RESULTS: The availability of the cohort was 93.1% (2805 men and 1382 women were traced). Mortality from malignant neoplasms in total (281 deaths among men, SMR = 118, 95%CI: 105-133 and 135 deaths among women, SMR = 159, 95%CI: 133-188) as well as that from lung cancer (102 deaths among men, SMR = 126, 95%CI: 103-153 and 18 deaths among women, SMR = 259, 95%CI: 153-409) were significantly higher than in the general population. Unlike earlier stages of analysis, the present study revealed an increased risk of pleural mesothelioma (2 deaths among men, SMR = 510, 95%CI: 62-1842 and 3 deaths among women, SMR = 2033, 95%CI: 419-5941). Mortality analysis among workers with asbestosis and in those without diagnosed asbestosis, did not reveal direct association between the risk of asbestos-induced lung cancer and previously diagnosed asbestosis. CONCLUSIONS: The prolonged cohort tracing showed an increased risk of asbestos-related cancers. It concerned mainly workers hired by the plant between 1945-1955, when the working condition were most strenuous.

Australische onderzoekers constateerden dat mesothelioom bij medewerkers van een olie-raffinaderij meer dan gemiddeld voorkomt. Waarschijnlijk komt dit door blootstelling aan asbest, hoewel bij de betreffende groep geen verhoogde incidentie van longkanker gevonden werd, een vorm van kanker die ook een relatie heeft met asbestblootstelling. De onderzoekers concluderen daarom dat raffinaderijpersoneel dat met asbest heeft gewerkt geen verhoogd risico op longkanker heeft.

Bron: Gun RT et al., (2006). Update of mortality and cancer incidence in the Australian petroleum industry cohort. Occupational Environmental Medicine, 63(7):476-81.

Gun RT, Pratt N, Ryan P, Roder D. (2006). Update of mortality and cancer incidence in the Australian petroleum industry cohort. Occupational Environmental Medicine, 63(7):476-81.

OBJECTIVES: To update the analysis of the cohort mortality and cancer incidence study of employees in the Australian petroleum industry. METHODS: Employees of Australian Institute of Petroleum member companies were enrolled in the cohort in four industry-wide surveys between 1981 and 1999. Mortality of 16,547 males and 1356 females was determined up to 31 December 2001 and cancer incidence to 31 December 2000. Cause specific mortality and cancer incidence were compared with those of the Australian population by means of standardised mortality ratios (SMRs) and standardised incidence ratios (SIRs). Associations between increased incidence of specific cancers and employment in the petroleum industry were tested by trends according to period of first employment, duration of employment, latency, and hydrocarbon exposure, adjusting for personal smoking history where appropriate. RESULTS: There was a significant elevation of the incidence of mesothelioma (SIR 1.77, 95% CI 1.05 to 2.79), melanoma (SIR 1.37, 95% CI 1.19 to 1.58), and prostate cancer (SIR 1.18, 95% CI 1.04 to 1.34). The SIRs of all leukaemias and of acute non-lymphocytic leukaemia (ANLL) were not significantly different from unity, but all 11 ANLL cases were clustered in the middle to high hydrocarbon exposure categories. Tanker drivers had a significantly elevated incidence of kidney cancer (12 cases v 5.84 expected, SIR 2.05, 95% CI 1.06 to 3.59). Lung cancer incidence was significantly reduced (SIR 0.69, 95% CI 0.57 to 0.83) CONCLUSIONS: Most cases of mesothelioma are probably related to past exposure to asbestos in refineries. No occupational cause has been identified for the excess of melanoma, or prostatic or bladder cancer. The possibility of a causal relationship between cancer of the kidney and hydrocarbon exposure warrants further study. It is uncertain whether benzene exposures, particularly past levels of exposure, have been high enough to cause ANLL.

Yarborough vindt in zijn onderzoek geen ondersteuning voor de hypothese dat chrysotiel asbestvezels (wit asbest) mesothelioom kunnen veroorzaken. Deze conclusie baseert hij op analyse van resultaten van 71 epidemiologische cohort-studies van mensen die beroepsmatig aan ruwe asbestvezels zijn blootgesteld. Bron: Yarborough, C.M. (2006). Chrysotile as a cause of mesothelioma: an assessment based on epidemiology. Critical reviews in Toxicology Feb.36(2):165-87.
Yarborough, C.M. (2006). Chrysotile as a cause of mesothelioma: an assessment based on epidemiology. Critical reviews in Toxicology Feb.36(2):165-87.

AbstractThere has been a longstanding debate about the potential contribution of chrysotile asbestos fibers to mesothelioma risk. The failure to resolve this debate has hampered decisive risk communication in the aftermath of the collapse of the World Trade Center towers and has influenced judgments about bans on asbestos use. A firm understanding of any health risks associated with natural chrysotile fibers is crucial for regulatory policy and future risk assessments of synthesized nanomaterials. Although epidemiological studies have confirmed amphibole asbestos fibers as a cause of mesothelioma, the link with chrysotile remains unsettled. An extensive review of the epidemiological cohort studies was undertaken to evaluate the extent of the evidence related to free chrysotile fibers, with particular attention to confounding by other fiber types, job exposure concentrations, and consistency of findings. The review of 71 asbestos cohorts exposed to free asbestos fibers does not support the hypothesis that chrysotile, uncontaminated by amphibolic substances, causes mesothelioma. Today, decisions about risk of chrysotile for mesothelioma in most regulatory contexts reflect public policies, not the application of the scientific method as applied to epidemiological cohort studies.

Hagemeyer beschrijft in dit overzichtsartikel de Duitse geschiedenis en huidige situatie inzake asbestgebruik, blootstelling en asbestziekten. Duitsland was het eerste land dat in 1930 longkanker in combinatie met asbestose als een beroepsziekte erkende. Bron: Hagemeyer, O., Otten, H. & Kraus, T. (2006). Asbestos consumption, asbestos exposure and asbestos-related occupational diseases in Germany. Int Arch Occup Environ Health.

Hagemeyer, O., Otten, H. & Kraus, T. (2006). Asbestos consumption, asbestos exposure and asbestos-related occupational diseases in Germany. Int Arch Occup Environ Health, DOI 10.1007/s00420-006-00.

Abstract. Like in most industrial countries, asbestos is a leading cause of occupational diseases, especially malignant diseases, in Germany. Following the increased consumption of asbestos after World War I, the recognition of asbestos related diseases developed. At the end of the 1930s, Germany was the first country to accept lung cancer in combination with asbestosis as an occupational disease and to initiate the endeavor for reduction of asbestos dust exposure. Nevertheless after World War II the usage of asbestos increased dramatically. The ban of asbestos first came into force in 1993. Until this time several hundreds of thousands of workers had inhaled asbestos and the number of asbestos related

diseases increased. In this review the history and current status on asbestos consumption, asbestos exposure and asbestos related occupational diseases in Germany is presented

Tussen 1987 en 1992 werd in Finland het ‘Asbest Programma’ ingevoerd. Dit bestond uit 27 maatregelen die erop gericht waren de risico’s van asbestblootstelling zoveel mogelijk te beperken. De positieve gezondheidseffecten zijn op dit moment nog niet zichtbaar. Mensen worden namelijk gemiddeld pas 30 tot 40 jaar na de blootstelling aan asbest ziek en de piek in het asbestgebruik vond er in de jaren 70 plaats. In Finland zijn ca. 200.000 mensen in hun werk aan asbest blootgesteld. Momenteel overlijden ca. 150 mensen per jaar aan een vorm van asbestgerelateerde kanker. Bron: Huuskonen MS & Rantanen J. (2006). Finnish Institute of Occupational Health (FIOH): prevention and detection of asbestos-related diseases, 1987-2005. American Journal of Industrial Medicine, mar 49(3):215-20.
Huuskonen MS & Rantanen J. (2006). Finnish Institute of Occupational Health (FIOH): prevention and detection of asbestos-related diseases, 1987-2005. American Journal of Industrial Medicine, mar 49(3):215-20.

BACKGROUND: Between 1987 and 1992, the Finnish Institute of Occupational Health (FIOH) initiated and implemented the Asbestos Program that aimed at reducing asbestos-related risks. It was a cooperative effort between government authorities, labor market organizations, and health care and labor protection personnel.

METHODS: During the Program and its follow-up since 1993 several preventive actions were taken, and considerable new legislation and official instructions were issued.

RESULTS: Approximately 200,000 people in Finland have been exposed to asbestos in their work. Through the cooperative efforts of government, labor, health care and worker protection programs, the import of asbestos was ceased in 1993 with a few exceptions. Almost all imports ceased in 2005 following European Union directives. Regulation of asbestos abatement companies has been greatly increased. The occupational exposure limit has been reduced from 2.0 fibers/cm(3) to the present 0.1 fibers/cm(3). Asbestos-related diseases are closely monitored and education of health care providers regarding the occupational source of these conditions is now emphasized.

CONCLUSIONS: The success of the primary goal of the Program, a reduction in asbestos-related morbidity, will not be fully realized for many decades.

In Frankrijk overlijden jaarlijks 15.000 mensen aan een vorm van kanker door het werk. In de helft van deze gevallen is asbestblootstelling de oorzaak. Asbest werd in 1997 in Frankrijk verboden. Bron: Europees Vakbondsinstituut Hesa, 13 mei 2006. Meer http://hesa.etui-rehs.org/uk/newsevents/newsfiche.asp?pk=553

Neuberger deed van 1994 tot 1997 onderzoek onder plattelandsvrouwen uit het Amerikaanse middenwesten. Hij vond o.a dat asbestblootstelling een oorzaak geweest kan zijn voor longkanker bij de groep ‘niet rokers’: vrouwen die tijdens hun hele leven minder dan 100 sigaretten of korter dan 6 maanden hadden gerookt. Bron: Neuberger JS, et al. (2006). Risk factors for lung cancer in Iowa women: Implications for prevention. Cancer Detection and Prevention, Mar 30.
Neuberger JS, Mahnken JD, Mayo MS, Field RW (2006). Risk factors for lung cancer in Iowa women: Implications for prevention. Cancer Detection and Prevention, Mar 30.

Background: Multiple risk factors possibly associated with lung cancer were examined as part of a large-scale residential radon case-control study conducted in Iowa between 1994 and 1997. We were particularly interested in stratifying risk factors by smoking status. Relatively little risk factor information is available for Midwestern rural women.

Methods: Four hundred thirteen female lung cancer cases and 614 controls aged 40-84, who were residents of their current home for at least 20 years, were included. Risk factors examined included cigarette smoking, passive smoking, occupation, chemical exposure, previous lung disease, family history of cancer, and urban residence. Multiple logistic regression analysis was conducted after adjusting for age, education, and cumulative radon exposure.

Results: As expected, active cigarette smoking was the major risk factor for lung cancer. While cessation of smoking was significantly associated with a reduced risk for lung cancer, the risk remained significantly elevated for 25 years. Among all cases, asbestos exposure was a significant risk. Among ex-smokers, pack-year history predominated as the major risk. Among never smokers, a family history of kidney or bladder cancer were significant risk factors (OR=7.34, 95% CI=1.91-28.18. and OR=5.02, 95% CI=1.64-15.39, respectively), as was a history of previous lung disease (OR=2.28, 95% CI=1.24-4.18) and asbestos exposure. No statistically significant increase in lung cancer risk was found for occupation or urban residence.

Conclusions: Smoking prevention activities are urgently needed in rural areas of the United States. Relatives of individuals with smoking-related cancers are potentially at increased risk. Genetic risk factors should be more fully investigated in never smokers.