PT  - JOURNAL ARTICLE
AU  - Danila Azzolina
AU  - Dario Consonni
AU  - Daniela Ferrante
AU  - Dario Mirabelli
AU  - Stefano Silvestri
AU  - Ferdinando Luberto
AU  - Alessia Angelini
AU  - Francesco Cuccaro
AU  - Anna Maria Nannavecchia
AU  - Enrico Oddone
AU  - Massimo Vicentini
AU  - Francesco Barone-Adesi
AU  - Tiziana Cena
AU  - Lucia Mangone
AU  - Francesca Roncaglia
AU  - Orietta Sala
AU  - Simona Menegozzo
AU  - Roberta Pirastu
AU  - Sara Tunesi
AU  - Elisabetta Chellini
AU  - Lucia Miligi
AU  - Patrizia Perticaroli
AU  - Aldo Pettinari
AU  - Vittoria Bressan
AU  - Enzo Merler
AU  - Paolo Girardi
AU  - Lucia Bisceglia
AU  - Alessandro Marinaccio
AU  - Stefania Massari
AU  - Corrado Magnani
ED  - ,
TI  - Rate advancement measurement for lung cancer and pleural mesothelioma in asbestos-exposed workers
AID  - 10.1136/thorax-2021-217862
DP  - 2022 Nov 10
TA  - Thorax
PG  - thoraxjnl-2021-217862
4099  - http://thorax.bmj.com/content/early/2022/12/07/thorax-2021-217862.short
4100  - http://thorax.bmj.com/content/early/2022/12/07/thorax-2021-217862.full
AB  - Introduction Exposure to asbestos increases the risk of lung cancer and mesothelioma. Few studies quantified the premature occurrence of these diseases in asbestos-exposed workers. Focus on premature disease onset (rate advancement or acceleration) can be useful in risk communication and for the evaluation of exposure impact. We estimated rate advancement for total mortality, lung cancer and pleural mesothelioma deaths, by classes of cumulative asbestos exposure in a pooled cohort of asbestos cement (AC) workers in Italy.Method The cohort study included 12 578 workers from 21 cohorts, with 6626 deaths in total, 858 deaths from lung cancer and 394 from pleural malignant neoplasm (MN). Rate advancement was estimated by fitting a competitive mortality Weibull model to the hazard of death over time since first exposure (TSFE).Result Acceleration time (AT) was estimated at different TSFE values. The highest level of cumulative exposure compared with the lowest, for pleural MN AT was 16.9 (95% CI 14.9 to 19.2) and 33.8 (95% CI 29.8 to 38.4) years at TSFE of 20 and 40 years, respectively. For lung cancer, it was 13.3 (95% CI 12.0 to 14.7) and 26.6 (95% CI 23.9 to 29.4) years, respectively. As for total mortality, AT was 3.35 (95% CI 2.98 to 3.71) years at 20 years TSFE, and 6.70 (95% CI 5.95 to 7.41) at 40 years TSFE.Conclusion The current study observed marked rate advancement after asbestos exposure for lung cancer and pleural mesothelioma, as well as for total mortality.Data are available on reasonable request.