Respiratory cancer in relation to occupational exposures among retired asbestos workers.

Respiratory cancer in relation to occupational exposures among retired asbestos workers. A cohort of 1348 men who completed their working lifetime in the asbestos industry and retired with an industry pension during the period 1941-67 was observed through 1969 for deaths. The average length of employment in the asbestos industry for these men was 25 years and all had exposures to asbestos dust. In some instances these exposures were very high and continued for many years. Mortality for this cohort of men after age 65 was 14-7 % higher than for the entire population of United States white men living at the same ages and time periods. This excess was due almost entirely to cancer and respiratory disease. The cancer excess was chiefly due to respiratory cancer where mortality was 2-7 times the expected. The respiratory disease excess was entirely due to asbestosis. A time-weighted measure of asbestos dust exposure at the time of retirement was calculated for each man. This was made up of the summed products of dust levels for each job (expressed in mppcf) and years at each level. This measure was directly related to the respiratory cancer excess at ages 65 and over, ranging from 1-7 times expected for men with less than 125 mppcf-years exposure to 5-6 times expected for men with 750 or more mppcf-years exposure. There appeared to be no direct relationship between asbestos dust exposure and respiratory cancer below 125 mppcf-years. Important increments in respiratory cancer mortality apparently occurred somewhere between 100 and 200 mppcf-years exposure. Separation of the effects of time from the effects of average dust level on respiratory cancer mortality showed that the contribution of each was about the same and that a time-weighted measure of asbestos dust appears to be an appropriate method for predicting respiratory cancer effects. There are relatively few studies on the dose-response relationship between asbestos dust and respiratory cancer. In a recent article McDonald et al. (1971) reported on the incidence of respiratory cancer deaths among Canadian asbestos miners in relation to their cumulative asbestos dust exposure.That study suggests that a definite dose-response relationship exists and that below certain measurable levels of asbestos dust there appears to be little or no carcinogenic response. Three earlier studies also suggested a dose-response relationship. Knox, Holmes, Doll, and Hill (1968) found, in a preliminary report, that after dust controls were introduced in a British asbestos textile plant …