Title
Occupational asbestos exposure and risk of oral cavity and pharyngeal cancer in the prospective Netherlands Cohort Study
Author
Offermans, N.S.M.
Vermeulen, R.
Burdorf, A.
Goldbohm, R.A.
Keszei, A.P.
Peters, S.
Kauppinen, T.
Kromhout, H.
van den Brandt, P.A.
Publication year
2014
Abstract
Objectives The evidence for an association between occupational asbestos exposure and pharyngeal cancer (PhC) is limited, while for oral cavity cancer (OCC) the literature is even sparser. We studied OCC and PhC risk both separately and combined (OCPC) in relation to occupational asbestos exposure, specifically addressing the influence of potential confounders, the existence of an exposure-response relation, and the presence of interaction between asbestos and smoking. Methods Using the prospective Netherlands Cohort Study (N=58 279 men, aged 55-69 years), we estimated asbestos exposure by linkage to a general population job-exposure matrix (DOMJEM) and a Finnish job-exposure matrix (FINJEM). After 17.3 years of follow-up, 58 OCC and 53 PhC cases were available for analysis. Results No association between asbestos and risk of OCC was observed for either JEM. Hazard ratios (HR) of PhC and OCPC increased after adjusting for confounders, particularly alcohol consumption and socioeconomic status. For PhC, a multivariable-adjusted increased HR was observed for "ever" versus "never" exposed to asbestos [HR 2.20, 95% confidence interval (95% CI) 1.08-4.49] when using FINJEM, but a trend of increased risks with higher cumulative exposure could not be demonstrated for either JEM. Results for OCPC showed patterns similar to those observed for PhC. None of the cancers showed a significant interaction between asbestos and smoking. Conclusions This prospective population-based study showed no convincing evidence of an association between asbestos and risk of OCC, PhC, and OCPC as an exposure-response relation was lacking, and results were not robust against the use of different JEM. However, the potentially increased HR of PhC and OCPC observed in this and previous studies warrant further research. Chemicals/CAS: asbestos, 1332-21-4. This work is licensed under a Creative Commons Attribution 4.0 International License.
Subject
ELSS - Earth, Life and Social Sciences
Behavioural Changes
Healthy Living
Healthy for Life
Confounder
Confounding
Exposure-response
Interaction
JEM
Job-exposure matrix
Populationbased study
Asbestos
Alcohol
Cancer
Cohort analysis
Consumption behavior
Digestive system disorder
Health risk
Occupational exposure
Risk factor
Smoking
Socioeconomic status
Adult
Aged
Alcohol consumption
Cancer patient
Cancer risk
Cancer staging
Cohort analysis
Female
Follow up
Human
Major clinical study
Male
Mouth cancer
Pharynx cancer
Population research
Prospective study
Social status
Netherlands
LS - Life Style
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http://resolver.tudelft.nl/uuid:53d5b08e-74c4-4d36-b50e-dfcf350aaeab
DOI
https://doi.org/10.5271/sjweh.3434
TNO identifier
513394
ISSN
1795-990X
Source
Scandinavian Journal of Work, Environment and Health, 40 (40), 420-427
Document type
article