NYC-WTC_000195068

NYC 9/11 Public Portal Document

' ASBESTOS MEDITEXT ® - Medical Management Page 11 of 15

1. BRONCHOGENIC CARCINOMA is a major cause of death in asbestos-exposed workers (estimated to affect 20 to 25 percent of heavily exposed workers) because of the combined risks of smoking and asbestos (Gefter & Conant, 1988). 2. The latency period ranges from 15 to 35 years following exposure (Gefter & Conant, 1988). The prevalence is greater in those persons handling finished products than in miners or millers (Dark & Pingleton, 1983). 3. Adenocarcinomas are most frequently seen (ATSDR, 1990; Dark & Pingleton, 1983; Gefter & Conant, 1988; Mollo et al, 1990; Talcott et al, 1989). Other tumors were characterized as adenomas and squamous cell carcinomas (ATSDR, 1995). 4. There are no diagnostic clinical or radiographic features to indicate that a given lung cancer has been caused by asbestos (Gefter & Conant, 1988). However, most asbestos- related tumors are peripheral lower lobe lesions (Gefter & Conant, 1988; Kaijalainen et al, 1993). 5. Risk estimates for bronchogenic cancer among workers with asbestosis or significant exposure to asbestos have not been consistently high. This variability can be due to methodological differences, or to individual differences in susceptibility. a. A case-control study of 175 lung cancer patients and 176 controls showed a strong and significant association between asbestos exposure and small cell carcinoma (Relative Risk = 3) and a weaker, but equally significant, association with adenocarcinoma (RR = 2.2) (Kjuus et al, 1986). b. Although an increased mortality and morbidity from respiratory cancer was noted in a cohort of asbestos cement workers compared to unexposed industrial workers, the overall risk for respiratory cancer (excluding mesothelioma) was not increased compared to the general population (Albin et al, 1990). c. Deaths from lung cancer in asbestos cement workers were not significantly different after adjustments for age and smoking (Standardized Mortality Ratio (SMR) decreased from 1.7 to 1.04) (Neuberger & Kundi, 1990). d. Necropsy studies of 339 amphibole asbestos miners stressed the significant association between asbestosis (and not merely asbestos exposure) and bronchial cancer (Sluis-Cremer & Bezuidenhout, 1989). e. The risk for lung cancer was higher in persons with radiologic evidence of pulmonary fibrosis, but the risk was also elevated in persons with asbestos exposure and no fibrosis (Wilkinson et al, 1995). f. A case control study failed to confirm asbestos exposure, but concluded that there was no association between lung cancer and the duration of employment in automotive parts factories (Finkelstein, 1989). g. Excess risk for cancer of the lung (Relative Risk 1.8; 95 percent Confidence Interval = 1.54 to 2.1), pleura (RR = 5.46,95 percent; CI = 2.62 to 10.05), and mediastinum (RR = 5; 95 percent CI = 1.01 to 14.61) were found in a cohort study of 7,996 men and 584 women employed in the Danish asbestos cement industry where fiber levels were more than 0.5 to 2 fiber/mL (Raffn et al, 1989). F. LARYNX CARCINOMA 1. Risk estimates for laryngeal cancer among workers with asbestosis or significant exposure to asbestos have not been consistently high. This variability could be due to methodological differences, or to differences in individual susceptibility. a. A matched case-control interview study that corrected for potential confounding by cigarette smoking and alcohol consumption showed a nonsignificant but elevated risk (Relative Risk = 1.46; 95 percent Confidence Interval = 0.98 to 2.18) for laryngeal carcinoma among those with occupational asbestos exposure (i.e., among boilermakers, sheetmetal workers, pipefitters/plumbers, and carpenters)

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