Article Text

Original article
Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma
  1. A Lacourt1,2,
  2. C Gramond1,2,
  3. P Rolland3,4,
  4. S Ducamp3,4,
  5. S Audignon1,2,
  6. P Astoul5,
  7. S Chamming's6,
  8. A Gilg Soit Ilg4,7,
  9. M Rinaldo1,2,
  10. C Raherison1,2,
  11. F Galateau-Salle4,8,
  12. E Imbernon3,7,
  13. J C Pairon6,9,
  14. M Goldberg7,
  15. P Brochard1,2
  1. 1Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique Equipe sante environnement, Bordeaux, France
  2. 2INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Equipe sante environnement, Bordeaux, France
  3. 3Departement Sante Travail, Institut de Veille Sanitaire, Equipe Associee en Sante Travail, Bordeaux, France
  4. 4Registre Multicentrique a Vocation Nationale des Mesotheliomes Pleuraux (MESONAT), Hopital de la Cote de Nacre, Caen, France
  5. 5Service d'Oncologie Thoracique, Maladie de la Plèvre et Pneumologie Interventionnelle, Hopital Nord, Aix-Marseille Universite, Marseille, France
  6. 6Institut Interuniversitaire de Medecine du Travail de Paris Ile de France, Créteil, France
  7. 7Departement Sante Travail, Institut de Veille Sanitaire, Saint Maurice, France
  8. 8Service d Anatomie Pathologique, Hopital de la Cote de Nacre, Caen, France
  9. 9Faculte de Medecine, INSERM U955, Universite Paris-Est Creteil, Creteil, France
  1. Correspondence to Dr Aude Lacourt, ISPED ESSAT, 146 rue leo saignat, Bordeaux 33076, France; aude.lacourt{at}


Objectives To estimate the proportion of pleural mesothelioma cases that can be attributed to asbestos exposure in France including non-occupational exposure.

Methods A population-based case-control study including 437 incident cases and 874 controls was conducted from 1998 to 2002. Occupational and non-occupational asbestos exposure was assessed retrospectively by two expert hygienists. ORs of pleural mesothelioma for asbestos-exposed subjects compared to non-exposed subjects, and population-attributable risk (ARp) of asbestos exposure were estimated using a conditional logistic regression.

Results A clear dose-response relationship was observed between occupational asbestos exposure and pleural mesothelioma (OR=4.0 (99% CI 1.9 to 8.3) for men exposed at less than 0.1 f/mL-year vs 67.0 (99% CI 25.6 to 175.1) for men exposed at more than 10 f/mL-year). The occupational asbestos ARp was 83.1% (99% CI 74.5% to 91.7%) for men and 41.7% (99% CI 25.3% to 58.0%) for women. A higher risk of pleural mesothelioma was observed in subjects non-occupationally exposed to asbestos compared to those never exposed. The non-occupational asbestos ARp for these subjects was 20.0% (99% CI −33.5% to 73.5%) in men and 38.7% (99% CI 8.4% to 69.0%) in women. When considering all kinds of asbestos exposure, ARp was 87.3% (99% CI 78.9% to 95.7%) for men and 64.8% (99% CI 45.4% to 84.3%) for women.

Conclusions Our study suggests that the overall ARp in women is largely driven by non-occupational asbestos exposure arguing for the strong impact of such exposure in pleural mesothelioma occurrence. Considering the difficulty in assessing domestic or environmental asbestos exposure, this could explain the observed difference in ARp between men and women.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Files in this Data Supplement:

Linked Articles

  • Airwaves
    Andrew Bush Ian Pavord