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Asbestos is an environmental carcinogen and exposure has been linked with the development of lung cancer. The use of asbestos has been partially replaced by man-made vitreous fibres (MMVF). The aim of this case–control study was to quantify the contribution of asbestos and MMVF to the burden of lung cancer in men, while controlling for confounding factors.
Over 4000 participants in seven countries were asked about smoking, lifestyle factors and all jobs held for >1 year. For specific occupations the likelihood of exposure to MMVF or asbestos and the frequency and intensity of exposure was assessed.
Lung cancer risk following asbestos exposure differed between countries. For central and eastern Europe the odds ratio (OR) was 0.92 (95% CI 0.73 to 1.15), whereas for the UK it was 1.85 (93% CI 1.07 to 3.21), suggesting that in Europe asbestos exposure does not increase the risk of lung cancer, whereas it does in the UK. The OR for MMVF exposure was not increased in any of the countries.
This study suggests that occupational exposure to MMVF does not contribute to the lung cancer burden. The difference in risk between countries with regards to asbestos exposure may be explained by increased exposure in UK workers, the area of the UK chosen for study or that the peak exposure to asbestos in other countries occurred later and the true prevalence of lung cancer in these countries may not be realised yet.
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