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NYC 9/11 Public Portal Document

' ASBESTOS MEDITEXT ® - Medical Management Page 12 of 15

(Brown et al, 1988). b. A case control study failed to confirm asbestos exposure, but concluded that there was no association between laryngeal cancer and the duration of employment in automotive parts factories (Finkelstein, 1989). c. The cross-sectional and longitudinal data derived from personnel in a brake manufacturing plant did not support asbestos as an etiologic factor for laryngeal cancer, but an irritant effect of asbestos was suggested (Fames, 1990). d. An excess risk of laryngeal cancer (RR = 5.5; 95 percent CI = 1.77 to 12.82) was found among a group of workers first employed in the Danish asbestos cement industry where fiber levels were more than 0.5 to 2 fiber/mL from 1928 to 1940 (Raffn et al, 1989). e. After correcting for smoking and alcohol consumption, workers heavily exposed to asbestos (with lung cancer relative risk estimates of 4.06 and 3.28) also had high relative risk estimates for laryngeal cancer (RR = 1.91; 90 percent CI = 1 to 3.34 and RR = 3.75; 90 percent CI = 1.01 to 9.68, respectively) (Smith et al, 1990). 2. No clear dose-response relationship with laryngeal cancer was noted when asbestos exposure in the Texas Gulf Coast was analyzed by duration of exposure, but a positive gradient was found when asbestos was categorized by intensity of exposure (Brown et al, 1988). G. GASTRIC CARCINOMA 1. Risk estimates for gastrointestinal cancer among workers with asbestosis or significant exposure to asbestos have not been consistently high, and have been noticeably much lower than those reported for lung cancer and mesothelioma (Talcott & Antman, 1988). This variability can be due to methodological differences or to different individual susceptibilities. a. A review of published studies on independent cohorts of asbestos workers showed no consistently higher standardized mortality ratios (SMRs) among exposed compared to unexposed populations and no apparent dose-response relationship was observed (Edelman, 1988). b. A meta-analysis and review of published cohort data stratified cohorts by dose and showed that significant asbestos exposure (as indicated by a lung cancer standardized mortality ratio (SMR) of at least 200) is associated with an elevated gastrointestinal cancer SMR (Frumkin & Berlin, 1988). c. A case control study did not confirm asbestos exposure, but concluded that there was no association between gastrointestinal cancer and duration of employment in automotive parts factories (Finkelstein, 1989). d. Excess risk for gastric cancer (Relative Risk =1.43; 95 percent Confidence Interval = 1.03 to 1.93) was 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 fibers/mL (Raffn et al, 1989). e. No overall excess risk from cancer of the upper and lower gastrointestinal tract was found in a cohort of asbestos cement workers compared to a local reference cohort of unexposed industrial workers (Albin et al, 1990). Another case-control study also failed to find an association between colon cancer and asbestos exposure (Garabrant et al, 1992). f. Norwegian lighthouse keepers, who consumed cistern drinking water contaminated with asbestos from runoff from asbestos-cement roof tiles for two decades, had an excess risk of stomach cancer, but not malignant mesothelioma (Andersen et al, 1993). g. Colorectal cancer occurred with an estimated increase of 1.6 percent in the

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NYC-WTC_000195080