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Gastrointestinal cancer mortality of workers in occupations with high asbestos exposures
Author(s) -
Kang SeongKyu,
Burnett Carol A.,
Freund Eugene,
Walker James,
Lalich Nina,
Sestito John
Publication year - 1997
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/(sici)1097-0274(199706)31:6<713::aid-ajim7>3.0.co;2-r
Subject(s) - medicine , asbestos , mesothelioma , cancer , death certificate , lung cancer , colorectal cancer , asbestosis , cause of death , oncology , gastroenterology , disease , pathology , lung , materials science , metallurgy
Asbestos, which is a well‐known risk factor for lung cancer and malignant mesothelioma, has also been suggested as a gastrointestinal (GI) carcinogen. This study was conducted to assess the relationship between high asbestos exposure occupations and the occurrence of GI cancer. Death certificate data were analyzed from 4,943,566 decedents with information on occupation and industry from 28 states from 1979 through 1990. Elevated proportionate mortality ratios (PMRs) for mesothelioma were used to identify occupations potentially having many workers exposed to asbestos. All PMRs were age‐adjusted and sex‐ and race‐specific. The PMRs for GI cancers in white males were then calculated for these occupations after excluding mesothelioma, lung cancer, and non‐malignant respiratory disease from all deaths. We identified 15,524 cases of GI cancer in the 12 occupations with elevated PMRs for mesothelioma. When these occupations were combined, the PMRs for esophageal, gastric, and colorectal cancer were significantly elevated at 108 (95% confidence interval = 107–110), 110 (106–113), and 109 (107–110), respectively. Esophageal cancer was elevated in sheet metal workers and mechanical workers. Gastric cancer was elevated in supervisors in production and managers. Colorectal cancer was elevated in mechanical and electrical and electronic engineers. However, high exposure occupations like insulation, construction painter supervisors, plumbers, furnace operators, and construction electricians showed no elevations of GI cancers. In conclusion, this death certificate study supports an association between asbestos exposure and some GI cancer, however the magnitude of this effect is very small. Am. J. Ind. Med. 31:713–718, 1997. © 1997 Wiley‐Liss, Inc.