To analyze occupation, expert-evaluated cumulative exposure, and radiographic abnormalities as indicators of asbestos-related cancer risk we followed 16,696 male construction workers for cancer in 1990–2000. We calculated standardized incidence ratios (SIR) in comparison to the Finnish population and relative risks (RR) in a multivariate analysis in comparison to the internal low-exposure category of each indicator. Overall, the risk was increased for mesothelioma (SIR 2.0, 95% CI = 1.0–3.3), but not for lung cancer (SIR 1.1, 95% CI = 0.9–1.2). Radiographic lung fibrosis indicated a 2-fold and a high value of the exposure index a 3-fold RR of lung cancer, while there was no risk among those with pleural plaques. The risk of lung cancer was the highest in insulators (RR 3.7, 95% CI = 1.4–9.9). Occupation, expert-evaluated cumulative exposure, and lung fibrosis are useful indicators of lung cancer risk among construction workers
From the Uusimaa Regional Institute of Occupational Health, Helsinki, Finland (Dr Koskinen, Dr Reijula); the Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland (Dr Pukkala); and the Finnish Institute of Occupational Health, Department of Epidemiology and Biostatistics, Helsinki, Finland (Dr Martikainen, Dr Karjalainen).
Address correspondence to: Dr Antti Karjalainen, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland; e-mail: firstname.lastname@example.org.
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