Er is een sterke relatie tussen de omvang van blootstelling aan chrysotiel-asbest en het risico op longkanker en asbestose. Dit is de conclusie van een analyse van de sterfte-cijfers van 3072 arbeiders die tussen 1916 en 1977 in een textielfabriek in het Amerikaanse South Carolina met deze soort asbest in aanraking waren geweest. Bron: Hein, M.J., et al. (2007). Follow-up study of chrysotile textile workers: cohort mortality and exposure-response. Occup. Environ. Med 2007.64.616-625.
Hein, M.J., et al. (2007). Follow-up study of chrysotile textile workers: cohort mortality and exposure-response. Occup. Environ. Med 2007.64.616-625.
OBJECTIVES: This report provides an update of the mortality experience of a cohort of South Carolina asbestos textile workers.
METHODS: A cohort of 3072 workers exposed to chrysotile in a South Carolina asbestos textile plant (1916-77) was followed up for mortality through 2001. Standardised mortality ratios (SMRs) were computed using US and South Carolina mortality rates. A job exposure matrix provided calendar time dependent estimates of chrysotile exposure concentrations. Poisson regression models were fitted for lung cancer and asbestosis. Covariates considered included sex, race, age, calendar time, birth cohort and time since first exposure. Cumulative exposure lags of 5 and 10 years were considered by disregarding exposure in the most recent 5 and 10 years, respectively.
RESULTS: A majority of the cohort was deceased (64%) and 702 of the 1961 deaths occurred since the previous update. Mortality was elevated based on US referent rates for a priori causes of interest including all causes combined (SMR 1.33, 95% CI 1.28 to 1.39). all cancers (SMR 1.27, 95% CI 1.16 to 1.39). oesophageal cancer (SMR 1.87, 95% CI 1.09 to 2.99). lung cancer (SMR 1.95, 95% CI 1.68 to 2.24). ischaemic heart disease (SMR 1.20, 95% CI 1.10 to 1.32). and pneumoconiosis and other respiratory diseases (SMR 4.81, 95% CI 3.84 to 5.94). Mortality remained elevated for these causes when South Carolina referent rates were used. Three cases of mesothelioma were observed among cohort members. Exposure-response modelling for lung cancer, using a linear relative risk model, produced a slope coefficient of 0.0198 (fibre-years/ml) (standard error 0.00496), when cumulative exposure was lagged 10 years. Poisson regression modelling confirmed significant positive relations between estimated chrysotile exposure and lung cancer and asbestosis mortality observed in previous updates of this cohort.
CONCLUSIONS: This study confirms the findings from previous investigations of excess mortality from lung cancer and asbestosis and a strong exposure-response relation between estimated exposure to chrysotile and mortality from lung cancer and asbestosis.