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Temporal Patterns of Exposure to Asbestos and Risk of Asbestosis: An Analysis of a Cohort of Asbestos Textile Workers

Farioli, Andrea, MD, PhD; Violante, Francesco, S., MD; La Vecchia, Carlo, MD; Negri, Eva, MMath; Pelucchi, Claudio, MSc; Spatari, Giovanna, MD; Boffetta, Paolo, MD, MPH; Pira, Enrico, MD

Journal of Occupational and Environmental Medicine: January 12, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/JOM.0000000000001260
Original Article: PDF Only

Objective: The aim of the study was to assess the risk of asbestosis death based on the temporal pattern of exposure to asbestos.

Methods: We followed up a cohort of asbestos textile workers, employed in 1946 to 1984, until November 2013. We measured the duration of the employment, the time since last employment (TSLE), the age, and the year of first employment. Hazard ratios (HR) were estimated through multivariable Cox regression models.

Results: We observed 51 asbestosis deaths among 1823 workers. The HR of asbestosis death increased with exposure duration (HR 2.4 for ≥15 years compared with <5 years, P trend = 0.014) and declined with TSLE (HR 0.3 for ≥25 compared with <5 years, P = 0.004). The risk of asbestosis mortality strongly declined for exposure starting after 1968.

Conclusions: The risk of asbestosis death strongly declines in the decades after cessation of the exposure.

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Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy (Dr Farioli and Dr Violante); Department of Clinical Sciences and Community Health, Milan University, Milan, Italy (Dr La Vecchia and Mr Pelucchi); Department of Biomedical and Clinical Sciences, Milan University, Milan, Italy (Ms Negri); Department of Environmental Science, Safety, Territory, Food and Health, Messina University, Messina, Italy (Dr Spatari); Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Boffetta); Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy (Dr Pira).

Address correspondence to: Paolo Boffetta, MD, MPH, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, NY 10029 (paolo.boffetta@mssm.edu).

AF and FSV equally contributed to this work.

This work was supported by internal funds of the participating institutions.

None of the authors has a direct financial interest related to this study. FSV, CLV, PB, and EP have acted as expert witnesses in litigations involving asbestos-related diseases.

Copyright © 2018 by the American College of Occupational and Environmental Medicine