RESUMO
OBJECTIVES: Malignant mesothelioma (MM) is a rare and generally fatal cancer, usually caused by asbestos, although about 5-10% of cases report no asbestos exposure. This study aimed to identify sources whereby people in Western Australia (WA) may be unknowingly exposed to asbestos or to other exposures which may cause MM. METHODS: Cases with no known asbestos exposure were selected from the WA Mesothelioma Register (WAMR). Matched controls were selected from hospital patients admitted for conditions unrelated to asbestos. Occupational histories were coded by an industrial hygienist. Data were analyzed using conditional logistic regression. RESULTS: Thirty-eight MM participants and 134 controls were recruited. Risk of MM was increased (OR = 3.1, 95%CI 1.0-9.6) after no known, but likely, exposure to asbestos at work. CONCLUSIONS: Because of its extensive use, few people in WA have never been exposed to asbestos. Unrecognized exposure may cause most MM cases initially regarded as "no exposure." Am. J. Ind. Med. 60:432-436, 2017. © 2017 Wiley Periodicals, Inc.
Assuntos
Amianto/efeitos adversos , Exposição Ambiental/efeitos adversos , Neoplasias Pulmonares/etiologia , Mesotelioma/etiologia , Estudos de Casos e Controles , Humanos , Entrevistas como Assunto , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Mesotelioma Maligno , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Sistema de Registros , Fatores de Risco , Fumar , Austrália Ocidental/epidemiologiaAssuntos
Amianto/efeitos adversos , Asbestose/diagnóstico por imagem , Detecção Precoce de Câncer/estatística & dados numéricos , Exposição Ambiental/efeitos adversos , Neoplasias Pulmonares/diagnóstico por imagem , Fumar/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Asbestose/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Exposição Ocupacional/efeitos adversos , Guias de Prática Clínica como Assunto , Prevalência , Doses de Radiação , Radiografia Torácica/métodos , Fumar/epidemiologia , Tomografia Computadorizada por Raios X/métodos , Austrália Ocidental/epidemiologiaRESUMO
Owing to the high rates of malignant mesothelioma in workers exposed to crocidolite earlier at Wittenoom and evidence of protection against cancer by vitamin A, a population-based cancer prevention programme providing retinol supplements (25 000 IU/day) was commenced in 1990. The former workers at Wittenoom known to be alive and living in Western Australia in June 1990 constitute the study population. The participants were classified into two groups: those who received supplemental retinol (intervention group) and those who received none (comparison group). The relative rate of mesothelioma for those receiving retinol was estimated using Cox regression, adjusting for cumulative asbestos exposure and age at first exposure to asbestos. Nine hundred and twenty-eight former Wittenoom workers received retinol at some stage of the programme, whereas 1471 workers never received retinol (comparison group). Those who received retinol were younger, had a greater exposure to asbestos and smoked less than the comparison group. There were 65 cases of mesothelioma in the retinol group and 88 in the comparison group. After adjustment, the hazard ratio was 0.99 (95% confidence interval=0.70-1.41). This result did not alter when the participants who received only retinol once or those who received beta-carotene earlier were excluded from the analysis. In conclusion, this study provides little support for possible preventive effects of retinol against mesothelioma in workers exposed to blue asbestos.
