Prediction of mesothelioma and lung cancer in a cohort of asbestos exposed workers.

Antonio Gasparrini ORCID logo; Anna Maria Pizzo; Giuseppe Gorini; Adele Seniori Costantini; Stefano Silvestri; Cesare Ciapini; Andrea Innocenti; Geoffrey Berry; (2008) Prediction of mesothelioma and lung cancer in a cohort of asbestos exposed workers. European journal of epidemiology, 23 (8). pp. 541-546. ISSN 0393-2990 DOI: 10.1007/s10654-008-9257-z
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BACKGROUND: Several papers have reported state-wide projections of mesothelioma deaths, but few have computed these predictions in selected exposed groups. OBJECTIVE: To predict the future deaths attributable to asbestos in a cohort of railway rolling stock workers. METHODS: The future mortality of the 1,146 living workers has been computed in term of individual probability of dying for three different risks: baseline mortality, lung cancer excess, mesothelioma mortality. Lung cancer mortality attributable to asbestos was calculated assuming the excess risk as stable or with a decrease after a period of time since first exposure. Mesothelioma mortality was based on cumulative exposure and time since first exposure, with the inclusion of a term for clearance of asbestos fibres from the lung. RESULTS: The most likely range of the number of deaths attributable to asbestos in the period 2005-2050 was 15-30 for excess of lung cancer, and 23-35 for mesothelioma. CONCLUSION: This study provides predictions of asbestos-related mortality even in a selected cohort of exposed subjects, using previous knowledge about exposure-response relationship. The inclusion of individual information in the projection model helps reduce misclassification and improves the results. The method could be extended in other selected cohorts.

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