domestic and environmental mesothelioma risks case-control study

CONTENTS Section Page Executive summary ix 1 Introduction 1 2 Methods 3 2.1 Study design 3 2.2 Case and control ascertainment and data collection 3 2.3 Statistical methods 4 3 Results 9 3.1 Recruitment 9 3.2 Occupational exposure 14 3.3 Low exposure analysis 33 3.4 Summary analyses of all subjects 38 4 Discussion 43 4.1 Occupational exposure 43 4.2 Low-risk occupations 44 4.3 Non-occupational exposure 44 4.4 Background incidence rate 44 4.5 Latency, period of exposure and future trends 45 4.6 Risks to carpenters in the UK and elsewhere 46 4.7 Contribution of amosite to UK mesothelioma incidence 46 4.8 Speculations on the contribution of chrysotile 47 4.9 Current asbestos hazards 48 5 References 49 6 Appendix tables 53 v TABLES AND FIGURES Figure 3.2.1 Proportion of all men reporting asbestos exposure by year started job 29 Table 2.3.1 Highest mesothelioma proportional mortality ratios (PMRs) for males aged 16-74 in Great Britain, 1991-2000 5 Table 2.3.2 Classification of job categories with average national mesothelioma PMRs 6 Table 3.1.1 Study recruitment 10 Table 3.1.2 Source of mesothelioma and lung cancer case notification 11 Table 3.1.3 Response rates by deprivation 11 Table 3.1.4 Grounds of diagnosis of interviewed mesothelioma cases 12 Table 3.1.5 Median (and range) of age at interview 12 Table 3.1.6 Residential region at interview 13 Table 3.2.1 Interviewed mesothelioma cases and controls by job category, year of birth and sex 17 Table 3.2.2 Numbers of mesothelioma cases and controls who worked for at least 5 years in various occupations 18 Table 3.2.3 Odds ratios for males by age started work and total duration in high or medium risk occupations and in carpentry 22 Table 3.2.4 Odds ratios for males by duration of employment in high or medium risk occupations and in carpentry before and after age 30 22 Table 3.2.5 Odds ratios for males by weighted duration in high or medium risk occupations before and after age 30 23 Table 3.2.6 Job category and reported asbestos exposure in all men before age 30 24 Tables 3.2.7 a-g Reported contact with AIB, lagging and/or sprayed coatings before age 30 by job duration for each job category 26 Table 3.2.8 Type of reported direct (self) contact with AIB, lagging and/or sprayed coatings before age 30 by job category 28 Table 3.2.9 Numbers of male mesothelioma cases and controls by last job before interview and year of birth 30 Table 3.2.10 Main occupation while aged under 30 by last job before interview - all men 32 Table 3.3.1 Low risk occupational groups and reported asbestos exposure at work 33 Table 3.3.2 Univariate analysis of other reported occupational asbestos exposures before age 30 among men and women in low risk jobs 34 Table 3.3.3 Univariate analysis of DIY exposures among men and women in low risk jobs 34 Table 3.3.4 Univariate analysis of reported domestic exposures a mong men and women in low risk jobs 35 Table 3.3.5 Univariate analysis of residential exposures among men and women in low risk jobs 36 Table 3.3.6 Univariate analysis of smoking among men and women in low risk jobs and in all subjects 37 Table 3.4.1 Univariate analysis of reported domestic exposures among all subjects 39 Table 3.4.2 Mesothelioma cases in men and women attributed to asbestos exposure in each exposure category 40 Table 3.4.3 Male cases and controls born in 1950 or later who began work in 1970 or later, and numbers of cases attributed to asbestos exposure 41