APPENDIX D
Cohort Results Tables

TABLE D.1 Pharyngeal Cancer and Exposure to Asbestos—Cohort Studies

Reference*

Study Population

Exposed Cases

Estimated RR (95% CI)

Mining

 

 

 

Reid et al. 2004

5,685 male crocidolite mining and milling workers in western Australia (incidence 1980-2000—pharynx)

16

1.88 (1.15-3.07)

Piolatto et al. 1990

1,058 male chrysotile miners in northern Italy (oropharynx)

6

2.31 (0.85-5.02)a

 

Duration of exposure (years)

 

 

 

< 10

5

4.55 (1.47-10.61)a

 

10-20

1

2.00 (0.05-11.14)a

 

> 20

0

0.0 (0.0-4.10)a

Sluis-Cremer et al. 1992

7,317 male amosite and crocidolite miners in South Africa (lip, oral cavity, pharynx)

10

2.14 (1.03-3.94)

 

Amosite subcohort

1

0.42 (0.0-1.97)

 

Crocidolite subcohort

5

2.94 (1.16-6.18)

Insulation Manufacture/Insulators (laggers)

Berry et al. 2000

1,400 male asbestos factory workers in east London, UK (pharynx, buccal cavity) (laggers)

0

0.0 (0.0-8.79)a



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APPENDIX D Cohort Results Tables TABLE D.1 Pharyngeal Cancer and Exposure to Asbestos—Cohort Studies Exposed Estimated RR Reference* Study Population Cases (95% CI) Mining Reid et al. 5,685 male crocidolite mining and milling 16 1.88 (1.15-3.07) 2004 workers in western Australia (incidence 1980-2000—pharynx) 2.31 (0.85-5.02)a Piolatto 1,058 male chrysotile miners in northern 6 et al. 1990 Italy (oropharynx) Duration of exposure (years) 4.55 (1.47-10.61)a < 10 5 2.00 (0.05-11.14)a 10-20 1 0.0 (0.0-4.10)a > 20 0 Sluis-Cremer 7,317 male amosite and crocidolite miners in 10 2.14 (1.03-3.94) et al. 1992 South Africa (lip, oral cavity, pharynx) Amosite subcohort 1 0.42 (0.0-1.97) Crocidolite subcohort 5 2.94 (1.16-6.18) Insulation Manufacture/Insulators (laggers) 0.0 (0.0-8.79)a Berry et al. 1,400 male asbestos factory workers in east 0 2000 London, UK (pharynx, buccal cavity) (laggers) continues 271

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272 ASBESTOS TABLE D.1 Pharyngeal Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) 2.18 (1.62-2.91)a Selikoff and 17,800 male members of asbestos insulation 48 Seidman unions in Canada and US in 1967 1991 (oropharynx) Levin et al. 783 white male asbestos pipe insulation 1 1.07 (0.03-5.95) 1998 factory in Tyler, TX (pharynx, buccal cavity) Asbestos Textile Workers Pira et al. 1,966 textile employees in Italy (oral, 7 2.26 (0.90-4.65) 2005 pharynx) Duration of employment (years) 3.89 (1.06-9.96)a <1 4 2.52 (0.30-9.10)a 1 to < 5 2 5 to < 10 0 0 1.33 (0.03-7.41)a 10+ 1 Time since first employment (years) 3.36 (0.69-9.83)a < 15 3 3.63 (0.99-9.30)a 15 to < 25 4 25 to < 35 0 0 35+ 0 0 Time since last exposure (years) 1.86 (0.05-10.38)a Ongoing to < 3 1 1.79 (0.22-6.46)a 3 to < 15 2 4.72 (1.29-12.08)a 15 to < 25 4 25 to < 35 0 0 35+ 0 0 Age at first exposure (years) < 25 0 0 2.57 (0.31-9.27)a 25 to < 35 2 2.62 (0.85-6.12)a 35+ 5 Sex 2.54 (1.0-5.23)a 889 men 7 1,077 women 0 0 Asbestos Cement Raffn et al. 7,996 male asbestos-cement industry 13 0.79 (0.42-1.35) 1989 workers in Denmark (buccal cavity, pharynx) (incidence) 0 (0-1.37)b Giaroli et al. 3,341 male asbestos-cement workers in Italy 0 1994 (mouth, pharynx)

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273 APPENDIX D TABLE D.1 Pharyngeal Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Hughes 5,492 male asbestos-cement manufacturing et al. 1987 plant employees in New Orleans, LA (buccal, pharynx) 0.90 (0.45-1.61)a Plants combined (20 year lag) 11 1.13 (0.37-2.64)a Plant 1 5 0.77 (0.28-1.67)a Plant 2 6 1.83 (0.37-5.19)a Parnes 1990 2,057 male brake-lining and disk- 3 manufacturing workers in Albany, NY (buccal cavity, pharynx) Generic “Asbestos Workers” Berry et al. Asbestos factory workers in east London, 2000 UK (buccal cavity, pharynx) 2.17 (0.70-5.07)a 3,000 men 5 1.59 (0.04-8.84)a Low/mod < 2 years 1 2.04 (0.05-11.37)a Low/mod > 2 years 1 2.94 (0.36-10.62)a Severe < 2 years 2 2.00 (0.05-11.14)a Severe > 2 years 1 0.00 (0.00-7.10)a 700 women 0 1.39 (0.45-3.24)a Enterline 1,074 white male production and 5 et al. 1987 maintenance workers at US asbestos company (buccal cavity, pharynx) Other Occupations with Substantial Asbestos Exposure 2.65 (0.72-6.86)b Battista 734 male railway carriage construction and 3 et al. 1999 repair workers in Italy (mouth, pharynx) Puntoni 3,984 male shipyard workers in Genoa, Italy 16 0.97 (0.56-1.58) et al. 2001 (oropharynx) NOTE: CI = Confidence interval; RR = relative risk. Figures are for mortality unless otherwise indicated. Data points included in meta-analyses are bolded. * Full citations can be found in the reference list for Chapter 6. a95% CIs calculated with standard methods from observed and expected numbers pre- sented in original paper. b90% CIs reported.

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274 ASBESTOS TABLE D.2 Laryngeal Cancer and Exposure to Asbestos—Cohort Studies Exposed Estimated RR Reference* Study Population Cases (95% CI) Patients with Asbestos-Related Disease Germani 631 women compensated for asbestosis 1 8.09 (0.21-45.08) et al. 1999 in Italy 0.0 (0.0-60.10)a Textile industry (n = 276) 0 Asbestos cement industry (n = 278) 1 16.09 (0.42- 89.66) Karjalainen Asbestos-related disease patients in Finland et al. 1999 (incidence) Men 1,287 with asbestosis 5 4.2 (1.4-9.8) 4,708 with benign pleural disease 1 0.5 (0.0-2.7) Women 89 with asbestosis 0 0 (0.0-340.0) 179 with benign pleural disease 0 0 (0.0-460.0) 0.43 (0.01-2.40)a Szesznia- 902 male workers compensated for 1 Dabrowska asbestosis in Poland et al. 2002 Mining Armstrong 6,505 male crocidolite miners and millers in 2 0.68 (0.17-2.74) et al. 1988 Western Australia (mortality to 1980) Reid et al. 5,685 male crocidolite mining and milling 19 1.82 (1.16-2.85) 2004 workers in western Australia (incidence 1980-2000) 1.11 (0.79-1.55)a Liddell et al. 8,923 male chrysotile miners and millers in 36 1997 Quebec (mortality 1950-1992) 1.04 (0.70-1.48)a Cumulative exposure to age 55 (million 30 particles per cubic foot-yrs) among 7,728 living to age 55 1.03 (0.66-1.53)a < 300 24 1.45 (0.58-2.99)a <3 7 1.71 (0.63-3.72)a 3 to < 10 6 0.51 (0.06-1.84)a 10 to < 30 2 0.34 (0.01-1.89)a 30 to < 60 1 1.11 (0.23-3.24)a 60 to < 100 3 0.59 (0.07-2.13)a 100 to < 200 2 1.45 (0.30-4.24)a 200 to < 300 3

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275 APPENDIX D TABLE D.2 Laryngeal Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) 1.08 (0.40-2.35)a > 300 6 3.12 (0.85-7.99)a 300 to < 400 4 0.64 (0.08-2.31)a 400 to < 1000 2 0.00 (0.00-3.24)a 1000+ 0 Meurman Anthophyllite asbestos miners in Finland et al. 1994 (incidence) 736 men (3+ months of exposed time) 4 1.75 (0.48-4.47) Moderate exposure 1 1.33 (0.03-7.40) Heavy exposure 3 1.95 (0.40-5.69) 5+ years of exposed time 2 3.03 (0.37-10.9) Moderate exposure 0 0 (0.00-36.2) Heavy exposure 2 3.60 (0.44-13.0) 167 women (3+ months of exposed time) 0 0 (0.00-123.0) 2.67 (1.15-5.25)a Piolatto 1,058 male chrysotile miners in 8 et al. 1990 northern Italy Duration of exposure (years) 2.31 (0.48-6.75)a < 10 3 0 (0.00-6.15)a 10-20 0 4.55 (1.47-10.61)a > 20 5 Age at first exposure (years) 3.57 (1.16-8.34)a < 30 5 1.88 (0.39-5.48)a 30+ 3 Time since first exposure (years) 4.00 (0.48-14.44)a < 20 2 2.50 (0.30-9.02)a 20-30 2 2.35 (0.64-6.02)a ≥ 30 4 Time since last exposure (years) 4.00 (0.48-14.44)a Ongoing 2 4.29 (0.88-12.53)a ≤ 10 3 1.67 (0.34-4.87)a > 10 3 Cumulative dust exposure (fiber-years) 1.43 (0.04-7.96)a < 100 1 2.22 (0.27-8.02)a 100-400 2 3.85 (1.25-8.98)a > 400 5 Sluis-Cremer 7,317 male amosite and crocidolite miners in 5 1.86 (0.60-4.34) et al. 1992 South Africa Amosite subcohort 2 1.44 (0.25-4.52) Crocidolite subcohort 3 3.09 (0.84-7.98) continues

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276 ASBESTOS TABLE D.2 Laryngeal Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Insulation Manufacture/Insulators (laggers) 1.70 (1.01-2.69)a Selikoff and 17,800 male members of asbestos insulation 18 Seidman unions in Canada and US in 1967 1991 0.00 (0.0-15.38)a Berry et al. 1,400 male asbestos factory workers in east 0 2000 London, UK (laggers) Levin et al. 753 white male workers in asbestos pipe 1 2.21 (0.06-12.29) 1998 insulation factory in Tyler, TX Asbestos Textile Workers Pira et al. 1,966 textile employees in Italy 7 2.38 (0.95-4.90) 2005 Duration of employment (years) 1.05 (0.03-5.87)a <1 1 3.98 (0.82-11.63)a 1 to < 5 3 3.90 (0.47-14.09)a 5 to < 10 2 1.38 (0.03-7.67)a 10+ 1 Time since first employment (years) 1.06 (0.03-5.92)a < 15 1 0.98 (0.02-5.46)a 15 to < 25 1 7.32 (2.37-17.09)a 25 to < 35 5 35+ 0 0 Time since last exposure (years) Ongoing to < 3 0 0 2.71 (0.56-7.93)a 3 to < 15 3 2.67 (0.32-9.62)a 15 to < 25 2 4.99 (0.60-18.00)a 25 to < 35 2 35+ 0 0 Age at first exposure (years) 3.84 (0.10-21.38)a < 25 1 1.57 (0.04-8.76)a 25 to < 35 1 2.44 (0.79-5.71)a 35+ 5 Sex 2.46 (0.99-5.06)a 889 men 7 1,077 women 0 0 Peto et al. Asbestos textile factory workers in 1985 Rochdale, UK 0.0 (0.00-61.50)b 283 women 0 1.55 (0.42-3.97)b 3,211 men 4 < 10 years in scheduled areas Time since first employment 0.0 (0.00-4.24)b < 20 years 0 3.70 (1.01-9.48)b 20+ years 4

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277 APPENDIX D TABLE D.2 Laryngeal Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) 10+ years in scheduled areas Time since first employment 0.0 (0.00-19.42)b < 20 years 0 0.0 (0.00-8.20)b 20+ years 0 Dement 3,022 asbestos textile plant workers in 4 1.55 (0.53-3.55) et al. 1994 South Carolina White males 3 2.31 (0.63-5.96) 0.0 (0.00-12.72)b White females 0 Black males 1 1.02 (0.05-4.84) Asbestos Cement Raffn et al. 7,996 male asbestos-cement industry 14 1.66 (0.91-2.78) 1989 workers in Denmark (incidence) Duration of employment, 15 years latency < 5 years 2 0.81 (0.09-2.94) ≥ 5 years 6 2.27 (0.83-4.95) First employment 1928-40, 15 years 5 5.50 (1.77-12.82) latency Giaroli et al. 3,341 male asbestos-cement workers in Italy 2 0.82 (0.15-2.59) 1994 Botta et al. Asbestos-cement workers in Italy 1991 2,608 men 5 0.70 (0.23-1.64) 0.0 (0.00-369.0)b 759 women 0 Smailyte 1,285 male asbestos-cement producers in 7 1.4 (0.7-2.9) et al. 2004 Lithuania (incidence) Duration of employment (years) 0.0 (0.0-4.1)b <1 0 1-4 3 1.6 (0.5-4.8) 5-9 2 3.0 (0.8-12.5) ≥ 10 2 1.3 (0.4-5.7) 1.4 (0.29-4.09)a 25+ years since first exposure 3 0.91 (0.02-5.06)b Gardner 2,090 chrysotile asbestos cement products 1 et al. 1986 workers in England Hughes 5,492 male asbestos-cement manufacturing et al. 1987 plant employees in New Orleans, LA 0.56 (0.11-1.62)a Plants combined (20 year lag) 3 1.00 (0.12-3.61)a Plant 1 2 0.30 (0.01-1.64)a Plant 2 1 continues

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278 ASBESTOS TABLE D.2 Laryngeal Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Friction Materials 8.54 (1.76-24.97)a Finkelstein 1,314 male workers in automotive parts 3 1989 factory in Ontario Duration of employment (years) 0.00 (0.00-36.27)a 1 to < 20 0 ≥ 20 3 11.90 (2.46- 34.79)a Berry 1994 9,104 male friction materials factory workers in the UK 6 0.64 (0.23-1.39) 4.03 (0.80-11.39)a Parnes et al. 2,057 male brake-lining and disk- 3 1990 manufacturing workers in Albany, NY Duration of employment (years) 6.64 (0.76-22.70)a 0-4 2 2.24 (0.06-12.41)a 5+ 1 Generic “Asbestos Workers” Berry et al. Asbestos factory workers in east 2000 London, UK 2.05 (0.42-6.01)a 3,000 men 3 0.00 (0.00-5.27)a Low/mod 0 4.65 (0.56-16.79)a Severe < 2 years 2 3.03 (0.08-16.88)a Severe > 2 years 1 0.00 (0.00-26.36)a 700 women 0 1.14 (0.14-4.13)a Enterline 1,074 white male production and 2 et al. 1987 maintenance workers at US asbestos company Other Occupations with Substantial Asbestos Exposure Finkelstein 25,285 male pipe-trade workers in Ontario and Verma 20+ years since start of membership 14 1.32 (0.72-2.21) 2004 (latency) Tola et al. 7,775 male shipyard workers in Finland 24 1.20 (0.77-1.79) 1988 (incidence) 2.40 (0.95-5.05)c Battista 734 male railway carriage construction and 5 et al. 1999 repair workers in Italy Puntoni 3,984 male shipyard workers in Genoa, Italy 32 1.64 (1.12-2.32) et al. 2001 Time since first exposure (years) 1.36 (0.44-3.17)a 0-19 5 0.93 (0.25-2.38)a 20-29 4 1.58 (0.58-3.44)a 30-39 6 2.20 (1.28-3.52)a ≥ 40 17

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279 APPENDIX D TABLE D.2 Laryngeal Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Duration of exposure (years) 1.14 (0.42-2.48)a 0-14 6 1.59 (0.69-3.13)a 15-24 8 1.96 (1.16-3.10)a ≥ 25 18 Age at hire (years) 2.36 (1.32-3.89)a 0-24 15 1.89 (0.87-3.59)a 25-34 9 0.96 (0.41-1.89)a ≥ 35 8 2.36 (1.48-3.57)a Period of hire ≤ 1940 22 8.52 (1.76-24.91)a Insulation workers 3 NOTE: CI = Confidence interval; RR = relative risk. Figures are for mortality unless otherwise indicated. Data points included in meta-analyses are bolded. * Full citations can be found in the reference list for Chapter 6. a95% CIs calculated with standard methods from observed and expected numbers pre- sented in original paper. bSMR and 95% CIs calculated with standard methods from observed and expected num- bers presented in original paper. c90% CIs reported.

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280 ASBESTOS TABLE D.3 Esophageal Cancer and Exposure to Asbestos—Cohort Studies Exposed Estimated RR Reference* Study Population Cases (95% CI) Patients with Asbestos-Related Disease Karjalainen Asbestos-related disease patients in Finland et al. 1999 (incidence) Men 1,287 with asbestosis 1 1.0 (0.0-5.5) 4,708 with benign pleural disease 1 0.5 (0.0-2.7) Women 89 with asbestosis 1 10.5 (0.3-58.2) 179 with benign pleural disease 0 0.0 (0.0-92.6) 0.65 (0.01-2.40)a Szesznia- 902 male workers compensated for 1 Dabrowska asbestosis in Poland et al. 2002 Mining Armstrong 6,505 male crocidolite miners and millers in 3 0.72 (0.23-2.22) et al. 1988 Western Australia (mortality to 1980) Reid et al. 5,685 male crocidolite mining and milling 2004 workers in western Australia Incidence 10 1.11 (0.60-2.07) Mortality 8 0.89 (0.44-1.78) 0.73 (0.35-1.34)a McDonald 5,335 chrysotile miners and millers in 10 et al. 1993 Quebec (1976-1988) Meurman Anthophyllite asbestos miners in Finland et al. 1994 (incidence) 736 men (3+ months of exposed time) 3 1.99 (0.41-5.81) Moderate exposure 1 1.70 (0.04-9.44) Heavy exposure 2 2.18 (0.26-7.88) 5+ years of exposed time 2 5.00 (0.61-18.1) Moderate exposure 0 0 (0.00-61.0) Heavy exposure 2 5.92 (0.72-21.4) 167 women (3+ months of exposed time) 1 2.86 (0.07-15.9) Moderate exposure 1 8.68 (0.22-48.4) Heavy exposure 0 0 (0.00-16.1) Insulation Manufacture/Insulators (laggers) 1.68 (1.13-2.40)a Selikoff and 17,800 male members of asbestos insulation 30 Seidman unions in Canada and US in 1967 1991 0.49 (0.01-2.70)b Seidman 820 men producing amosite asbestos 1 et al. 1986 insulation in Paterson, NJ, US

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281 APPENDIX D TABLE D.3 Esophageal Continues Exposed Estimated RR Reference* Study Population Cases (95% CI) 0.71 (0.02-3.98)b Selikoff 632 male insulation workers in New York 1 et al. 1979 and New Jersey, US before 1943 0.0 (0.00-9.04)a <35 years 0 1.00 (0.03-5.57)b 35 + years 1 1.00 (0.12-3.61)a Acheson 4,820 male insulation board factory workers 2 et al. 1984 in Uxbridge, UK 0.0 (0.00-4.79)b Berry et al. 1,400 male asbestos factory workers in east 0 2000 London, UK (laggers) Levin et al. 753 white male workers in asbestos pipe 2 2.32 (0.28-8.39) 1998 insulation factory in Tyler, TX Asbestos Textile Workers Peto et al. Asbestos textile factory workers in 1985 Rochdale, UK 0.0 (0.00-11.53)b 283 women 0 1.67 (0.83-2.99)b 3,211 men 11 < 10 years in scheduled areas Time since first employment 1.11 (0.13-4.01)b < 20 years 2 1.92 (0.70-4.17)b 20+ years 6 10+ years in scheduled areas Time since first employment 0.0 (0.00-9.71)b < 20 years 0 2.36 (0.49-6.91)b 20+ years 3 Asbestos Cement Albin et al. Asbestos cement workers in southern 23 1.0 (0.5-2.0) 1990 Sweden (esophagus, stomach, duodenum— too broad for meta-analysis) ≥ 40 fiber-years/ml na 1.7 (0.2-3.3) 0.29 (0.01-1.59)b Gardner 2,090 chrysotile asbestos cement products 1 et al. 1986 workers in England 0.93 (0.48-1.62)a Hughes 5,492 male employees at two asbestos- 12 et al. 1987 cement manufacturing plants in New Orleans, LA (20 year lag) Duration of exposure (20 year lag) 0.88 (0.35-1.80)a ≤ 1 year 7 1.25 (0.26-3.65)a > 1 year - 5 years 3 0.0 (0.00-4.61)a > 5 years - 15 years 0 1.11 (0.13-4.01)a > 15 years 2 continues

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286 ASBESTOS TABLE D.4 Stomach Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Dement 3,022 asbestos textile plant workers in 9 0.90 (0.47-1.56) et al. 1994 South Carolina White males 3 0.77 (0.21-2.00) 0.00 (0.00-1.55)b White females 0 Black males 6 1.60 (0.69-3.15) Asbestos Cement Raffn et al. 7,996 male asbestos-cement industry 43 1.43 (1.03-1.93) 1989 workers in Denmark (incidence) Duration of employment, 15 years latency < 5 years 13 1.77 (0.94-3.02) ≥ 5 years 15 1.27 (0.70-2.07) First employment 1928-40, 15 years 8 1.69 (0.73-3.33) latency Botta et al. Asbestos-cement workers in Italy 1991 2,608 men 17 0.81 (0.47-1.30) 759 women 4 1.36 (0.37-3.48) Smailyte Asbestos-cement producers in Lithuania et al. 2004 (incidence) 602 women 4 1.2 (0.4-3.2) 1,285 men 14 0.9 (0.5-1.5) Duration of employment (years) <1 1 0.4 (0.1-2.6) 1-4 8 1.4 (0.7-2.8) 5-9 2 0.8 (0.2-3.3) ≥ 10 3 0.6 (0.2-1.9) 25+ years since first exposure 4 0.6 Albin et al. Asbestos cement workers in southern 23 1.0 (0.5-2.0) 1990 Sweden (esophagus, stomach, duodenum— grouping too broad for inclusion in meta-analysis) ≥ 40 fiber-years/ml na 1.7 (0.2-3.3) 1.09 (0.61-1.81)b Gardner 2,090 chrysotile asbestos cement products 15 et al. 1986 workers in England 1.13 (0.71-1.71)a Hughes 5,492 male asbestos-cement manufacturing 22 et al. 1987 plant employees in New Orleans, LA (20 year lag) Duration of exposure (20 year lag) ≤ 1 year 14 1.20 > 1 year-5 years 5 1.35 > 5 years-15 years 2 1.54 > 15 years 1 0.37

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287 APPENDIX D TABLE D.4 Stomach Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Friction Materials 0.58 (0.32-0.98)a Kogan et al. 2,834 friction product workers in Yaroslavl, 14 1993 Russia 0.45 (0.09-1.33)a Males 3 0.70 (0.35-1.25)a Females 11 Generic “Asbestos Workers” 2.40 (1.60-3.47)a Zhu and 5,893 chrysotile factory workers in China 28 Wang 1993 4.40 (1.43-10.27)b Pang et al. Chrysotile asbestos plant workers in China 5 7.87 (2.55-18.38)b 1997 160 men 5 0.00 (0.00-7.37)b 370 women 0 Woitowitz Asbestos-exposed workers in Germany et al. 1986 (esophagus/stomach—too broad for meta) 1.82 (0.97-3.12)a 3,070 workers with exposure after 1972 13 1.42 (0.17-5.13)a 665 workers with exposure complete 2 by 1972 Berry et al. Asbestos factory workers in east 2000 London, UK 1.24 (0.77-1.89)a 3,000 men 21 0.89 (0.24-2.29)a Low/mod < 2 years 4 0.82 (0.17-2.39)a Low/mod > 2 years 3 1.82 (0.83-3.44)a Severe < 2 years 9 1.30 (0.42-3.03)a Severe > 2 years 5 1.42 (0.46-3.32)a 700 women 5 1.50 (0.04-8.31)a Low/mod 1 0.51 (0.01-2.84)a Severe < 2 years 1 3.41 (0.70-9.97)a Severe > 2 years 3 1.20 (0.55-2.28)a Acheson 1,327 women in gas-mask manufacture in 9 et al. 1982 Lancashire, UK 1.00 (0.66-1.46)a Hodgson 31,150 male asbestos workers in England 27 and Jones and Wales, UK 1986 Cumulative exposure (years) 1.50 (0.55-3.27)a < 10 6 1.16 (0.56-2.14)a 10-20 10 0.77 (0.38-1.38)a ≥ 20 11 1.80 (1.10-2.78)a Enterline 1,074 white male production and 20 et al. 1987 maintenance workers at US asbestos company continues

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288 ASBESTOS TABLE D.4 Stomach Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Other Occupations with Substantial Asbestos Exposure Finkelstein 25,285 male pipe-trade workers in Ontario and Verma 20+ years since start of membership 21 0.67 (0.41-1.02) 2004 (latency) Tola et al. 7,775 male shipyard workers in Finland 63 0.80 (0.61-1.02) 1988 (incidence) 1.31 (0.77-2.08)c Battista 734 male railway carriage construction and 13 et al. 1999 repair workers in Italy Puntoni 3,984 male shipyard workers in Genoa, Italy 67 1.14 (0.89-1.45) et al. 2001 0.88 (0.18-2.58)b Sanden et al. 3,787 male shipyard workers in Sweden 3 1987 (incidence) 1.07 (0.22-3.13)b 20 year latency 3 0.77 (0.02-4.28)b Heavy exposure 1 NOTE: CI = Confidence interval; na = not available; RR = relative risk. Figures are for mortal- ity unless otherwise indicated. Data points included in meta-analyses are bolded. * Full citations can be found in the reference list for Chapter 6. a95% CIs calculated with standard methods from observed and expected numbers pre- sented in original paper. bSMR and 95% CIs calculated with standard methods from observed and expected num- bers presented in original paper. c90% CIs reported.

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289 APPENDIX D TABLE D.5 Colorectala Cancer and Exposure to Asbestos—Cohort Studies Exposed Estimated RR Reference* Study Population Cases (95% CI) Patients with Asbestos-Related Disease Germani 631 women compensated for asbestosis in 11 2.18 (1.09-3.90) et al. 1999 Italy (large and small intestine, plus rectum) Colon and sigma 8 2.38 (1.03-3.90) Textile industry (n = 276) 5 3.67 (1.20-8.60) Asbestos cement industry (n = 278) 2 1.16 (0.14-4.21) Rectum 1 0.62 (0.02-3.45) Textile industry (n = 276) 0 0.0 Asbestos cement industry (n = 278) 0 0.0 Karjalainen Asbestos-related disease patients in Finland et al. 1999 (incidence) 1.1 (0.7-1.7)c Men—colorectal 23 1.0 (0.5-1.9)c Colon 11 1,287 with asbestosis 3 0.9 (0.2-2.5) 4,708 with benign pleural disease 8 1.1 (0.5-2.1) 1.2 (0.6-2.2)c Rectum 12 1,287 with asbestosis 4 1.3 (0.3-3.2) 4,708 with benign pleural disease 8 1.2 (0.5-2.4) 4.2(0.9-12.3)c Women—colon only 3 89 with asbestosis 2 4.6 (0.6-16.5) 179 with benign pleural disease 1 3.4 (0.1-1.91) Szesznia- Workers compensated for asbestosis in Dabrowska Poland 0.66 (0.14-1.92)c et al. 2002 902 men—colorectal 3 0.51 (0.01-2.84)b Colon 1 Rectum, anus 2 0.77 (0.09-2.78) 1.38(0.29-4.04)c 489 women—colorectal 3 Colon 2 1.99 (0.24-7.19) 0.86 (0.02-4.79)b Rectum, anus 1 Aliyu et al. 3,897 male participants in the Beta-Carotene 85 2.0 (1.6-2.5) 2005 and Retinol Efficacy Trial (colorectal) 1,847 with pleural abnormality: positive 51 1.40 (0.88-2.23) 24 with radiographic profusion: 3/2 to 3/+ 1 1.38 (0.18-10.6) 156 with >40 years in high-risk trade 3 0.49 (0.12-2.00) 707 with >41 years since first exposure 29 1.20 (0.48-3.04) continues

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290 ASBESTOS TABLE D.5 Colorectala Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Mining Armstrong 6,505 male crocidolite miners and millers in 14 0.70 (0.41-1.18) et al. 1988 Western Australia (mortality to 1980) Reid et al. 5,685 male crocidolite mining and milling 2004 workers in western Australia Incidence (1979-2000) 88 1.05 (0.85-1.29) Mortality 49 1.31 (0.99-1.74) 0.82 (0.65-1.04)b McDonald 5,335 chrysotile miners and millers in 73 et al. 1993 Quebec (1976-1988) Meurman Anthophyllite asbestos miners in Finland et al. 1994 with more than 3 months exposure (incidence) 736 men—colorectal 3 0.55 (0.11-1.60) Moderate exposure 2 1.06 (0.13-3.82) Heavy exposure 1 0.28 (0.01-1.56) 5+ years of exposed time (212 men) 2 1.27 (0.15-4.60) Moderate exposure 1 3.85 (0.10-21.4) Heavy exposure 1 0.76 (0.02-4.25) 2.61 (0.71-6.69)c 167 women—colorectal 4 Colon 3 3.45 (0.71-10.1) 3.14 (0.08-17.4)b Moderate exposure 1 Heavy exposure 2 3.66 (0.44-13.2) Rectum 1 1.52 (0.04-8.44) Moderate exposure 0 0.00 (0.00-15.2) Heavy exposure 1 2.39 (0.06-13.3) 0.91 (0.33-1.98)b Piolatto 1,058 male chrysotile miners in northern 6 et al. 1990 Italy (intestinal) Duration of exposure (years) 1.03 (0.21-3.02)b < 10 3 0.00 (0.00-2.84)b 10-20 0 1.30 (0.27-3.81)b > 20 3

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291 APPENDIX D TABLE D.5 Colorectala Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Insulation Manufacture/Insulators (laggers) 1.37 (1.14-1.64)b Selikoff and 17,800 male members of asbestos insulation 121 Seidman unions in Canada and US in 1967 1991 1.85 (1.16-2.80)b Seidman 820 men producing amosite asbestos 22 et al. 1986 insulation in Paterson, NJ, US 2.77 (1.76-4.16)c Selikoff 632 male insulation workers in New York 23 et al. 1979 and New Jersey, US before 1943 Duration of exposure (years) 0.00 (0.00-18.45)c < 20 0 3.68 (1.48-7.59)c 20-35 7 2.58 (1.48-4.19)c > 35 16 1.31 (0.63-2.42)b Acheson 4,820 male insulation board factory workers 10 et al. 1984 in Uxbridge, UK 1.37 (0.50-2.98)b Colon 6 1.24 (0.34-3.17)b Rectum 4 2.86 (1.23-5.63)b Berry et al. 1,400 male asbestos factory workers in east 8 2000 London, UK (laggers) 4.32 (1.73-8.90)b Colon 7 0.85 (0.02-4.72)b Rectum 1 1.67 (0.61-3.63)b Levin et al. 753 white male workers in asbestos pipe 6 1998 insulation factory in Tyler, TX Colon 6 2.07 (0.76-4.51) 0.0 (0.00-5.27)b Rectum 0 Asbestos Textile Workers Pira et al. 1,966 textile employees in Italy 16 1.45 (0.83-2.35) 2005 Duration of employment (years) 2.23 (0.89-4.59)b <1 7 0.35 (0.01-1.95)b 1 to < 5 1 1.46 (0.30-4.28)b 5 to < 10 3 1.67 (0.54-3.89)b 10+ 5 Time since first employment (years) 0.86 (0.10-3.10)b < 15 2 0.55 (0.07-1.98)b 15 to < 25 2 2.24 (0.89-4.58)b 25 to < 35 7 2.64 (0.32-9.54)b 35+ 5 continues

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292 ASBESTOS TABLE D.5 Colorectala Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Time since last exposure (years) 0.00 (0.0-2.69)b During to < 3 0 1.34 (0.43-3.13)b 3 to < 15 5 1.83 (0.67-3.98)b 15 to < 25 6 1.52 (0.31-4.45)b 25 to < 35 3 2.91 (0.35-10.51)b 35+ 2 Age at first exposure (years) 1.63 (0.34-4.77)b < 25 3 0.75 (0.09-2.71)b 25 to < 35 2 1.68 (0.84-3.01)b 35+ 11 Sex 1.39 (0.67-2.56)b 889 men 10 1.56 (0.57-3.40)b 1,077 women 6 Peto et al. Asbestos textile factory workers in 1985 Rochdale, UK 1.98 (0.54-5.07)b 283 women 4 0.75 (0.46-1.16)c 3,211 men 20 < 10 years in scheduled areas 0.60 (0.19-1.40) c < 20 years since first employment 5 0.68 (0.29-1.33) c 20+ years since first employment 8 10+ years in scheduled areas 1.18 (0.14-4.25)c < 20 years since first employment 2 1.03 (0.33-2.40)c 20+ years since first employment 5 Asbestos Cement Raffn et al. 7,887 male asbestos-cement industry 102 1.22 (0.99-1.48) 1996 workers in Denmark (incidence) Years since first employment 0-14 23 1.02 (0.65-1.53) > 15 79 1.29 (1.02-1.61) first employed 1928-1950 39 1.47 (1.05-2.01) Botta et al. Asbestos-cement workers in Italy 1991 2,608 men 11 0.65 (0.33-1.17) 759 women 7 1.80 (0.72-3.70)

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293 APPENDIX D TABLE D.5 Colorectala Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Smailyte Asbestos-cement producers in Lithuania et al. 2004a (incidence) 602 women 3 0.8 (0.1-1.8) 1,285 men 17 1.6 (1.0-2.6) Duration of employment (years) <1 4 2.2 (0.8-5.7) 1-4 2 0.5 (0.2-2.1) 5-9 3 1.8 (0.6-5.6) ≥ 10 8 2.4 (1.2-4.7) 1.6 (0.6-3.3) b 25+ years since first exposure 7 Albin et al. 1,465 male asbestos-cement workers in 26 1.5 (0.7-3.0) 1990 southern Sweden (mortality 1927-1986) ≥ 40 fiber-years/ml na 3.4 (1.2-9.5) 1.47 (0.96-2.15)b Jakobsson 981 male industrial workers in Sweden 26 et al. 1994 (asbestos cement) (incidence 1958-1989) Right colon 12 2.38 (1.23-4.16) Left colon 1 0.22 (0.00-1.18) Rectum 13 1.65 (0.88-2.83) 0.71 (0.36-1.28)c Gardner 2,090 chrysotile asbestos cement products 11 et al. 1986 workers in England 0.65 (0.24-1.42)c Colon 6 0.81 (0.26-1.88)c Rectum 5 Hughes 5,492 male asbestos-cement manufacturing et al. 1987 plant employees in New Orleans, LA 0.90 (0.56-1.38)b Plants combined (20 year lag) 21 1.20 (0.58-2.21)b Plant 1 10 0.73 (0.36-1.31)b Plant 2 11 Duration of exposure (20 year lag) 0.79 (0.39-1.41)b ≤ 1 year 11 1.11 (0.36-2.59)b > 1 year - 5 years 5 0.67 (0.02-3.74)b > 5 years - 15 years 1 1.21 (0.33-3.09)b > 15 years 4 Generic “Asbestos Workers” Woitowitz Asbestos-exposed workers in Germany 0.79 (0.26-1.84)b et al. 1986 3,070 workers with exposure after 1972 5 2.15 (0.44-6.29)b 665 workers with exposure complete by 3 1972 continues

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294 ASBESTOS TABLE D.5 Colorectala Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Berry et al. Asbestos factory workers in east London, 2000 UK 1.36 (0.85-2.06)c 3,000 men 22 Colon 1.21 (0.25-3.54)c Low/mod < 2 years 3 1.49 (0.31-4.36)c Low/mod > 2 years 3 1.11 (0.23-3.25)c Severe < 2 years 3 4.06 (1.75-8.00)c Severe > 2 years 8 Rectum 1.06 (0.13-3.82)c Low/mod < 2 years 2 0.00 (0.00-2.38)c Low/mod > 2 years 0 1.46 (0.30-4.28)c Severe < 2 years 3 0.00 (0.00-2.41)c Severe > 2 years 0 1.19 (0.48-2.44)c 700 women 7 Colon 0.00 (0.00-5.13)c Low/mod 0 0.87 (0.11-3.15)c Severe < 2 years 2 1.00 (0.03-5.57)c Severe > 2 years 1 Rectum 0.00 (0.00-10.85)c Low/mod 0 3.70 (1.01-9.48)c Severe < 2 years 4 0.00 (0.00-7.85)c Severe > 2 years 0 0.54 (0.31-0.88)c Hodgson 31,150 male asbestos workers in England 16 and Jones and Wales, UK 0.36 (0.13-0.78)b 1986 Colon—cumulative exposure (years) 6 0.40 (0.01-2.23)b < 10 1 0.36 (0.04-1.31)b 10-20 2 0.54 (0.11-1.57)c ≥ 20 3 0.77 (0.37-1.43)b Rectum—cumulative exposure (years) 10 0.52 (0.01-2.93)b < 10 1 0.47 (0.06-1.72)b 10-20 2 1.03 (0.41-2.12)b ≥ 20 7 Enterline 1,074 white male production and 1.15 (0.73-1.73)b et al. 1987 maintenance workers at US asbestos 23 company 0.98 (0.54-1.65)b Colon 14 1.59 (0.73-3.02)b Rectum 9

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295 APPENDIX D TABLE D.5 Colorectala Continued Exposed Estimated RR Reference* Study Population Cases (95% CI) Other Occupations with Substantial Asbestos Exposure Finkelstein 25,285 male pipe-trade workers in Ontario and Verma 20+ years since start of membership (latency) 96 1.16 (0.94-1.42) 2004 Tola et al. 7,775 male shipyard workers in Finland 35 0.79 (0.55-1.10) 1988 (incidence) 0.93 (0.41-1.84)d Battista 734 male railway carriage construction and 6 et al. 1999 repair workers in Italy Puntoni 3,984 male shipyard workers in Genoa, Italy 59 1.00 (0.76-1.29) et al. 2001 Sanden et al. 3,787 male shipyard workers in Sweden 3 0.38 (0.08-1.1) 1987 (incidence) 0.45 (0.09-1.33)c Rectum 3 0.65 (0.08-2.33)c Heavy or very heavy exposure 2 0.00 (0.00-3.00)c Colon 0 NOTE: CI = Confidence interval; na = not available; RR = relative risk. Figures are for mortal- ity unless otherwise indicated. Data points included in meta-analyses are bolded. * Full citations can be found in the reference list for Chapter 6. aStatistics from original paper presented here; when RRs were calculated for colon and rectum separately, combined RRs for colorectal cancer were derived for use in meta-analysis. b95% CIs calculated with standard methods from observed and expected numbers pre- sented in original paper. cSMR and 95% CIs calculated with standard methods from observed and expected num- bers presented in original paper. d90% CIs reported.

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