Occupational exposure to asbestos and risk of cholangiocarcinoma: a population-based case–control study in four Nordic countries
ObjectivesTo assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).MethodsWe conducted a case–control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring...
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| Published in | Occupational and environmental medicine (London, England) Vol. 75; no. 3; pp. 191 - 198 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BMJ
01.03.2018
BMJ Publishing Group LTD BMJ Publishing Group |
| Series | Original article |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1351-0711 1470-7926 1470-7926 |
| DOI | 10.1136/oemed-2017-104603 |
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| Abstract | ObjectivesTo assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).MethodsWe conducted a case–control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work.ResultsWe observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1–4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0–9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0–14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC.ConclusionsOur study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed. |
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| AbstractList | ObjectivesTo assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).MethodsWe conducted a case–control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work.ResultsWe observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1–4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0–9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0–14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC.ConclusionsOur study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed. To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). We conducted a case-control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work. We observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1-4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0-9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0-14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC. Our study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed. To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).OBJECTIVESTo assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).We conducted a case-control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work.METHODSWe conducted a case-control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work.We observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1-4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0-9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0-14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC.RESULTSWe observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1-4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0-9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0-14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC.Our study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed.CONCLUSIONSOur study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed. Objectives To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). Methods We conducted a case-control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work. Results We observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1-4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0-9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0-14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC. Conclusions Our study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed. Objectives To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). Methods We conducted a case–control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ ml × years) was assessed by applying the NOCCA jobexposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work. Results We observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1–4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0–9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0–14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC. Conclusions Our study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed. |
| Author | Kjaerheim, Kristina Straif, Kurt Biasco, Guido Curti, Stefania Pukkala, Eero Tryggvadottir, Laufey Sparen, Pär Violante, Francesco Saverio Mattioli, Stefano Weiderpass, Elisabete Brandi, Giovanni Farioli, Andrea Martinsen, Jan Ivar |
| AuthorAffiliation | 4 ‘G. Prodi’ Interdepartmental Center for Cancer Research , University of Bologna , Bologna , Italy 7 Icelandic Cancer Registry , Reykjavik , Iceland 9 Department of Community Medicine, Faculty of Health Sciences , University of Tromsø, The Arctic University of Norway , Tromsø , Norway 10 Genetic Epidemiology Group, Folkhälsan Research Center , Helsinki , Finland 6 Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden 3 Department of Experimental, Diagnostic, and Specialty Medicine , S. Orsola-Malpighi University Hospital , Bologna , Italy 5 Department of Research, Cancer Registry of Norway , Institute of Population-Based Cancer Research , Oslo , Norway 11 Faculty of Social Sciences , University of Tampere , Tampere , Finland 2 International Agency for Research on Cancer , Lyon , France 1 Department of Medical and Surgical Sciences (DIMEC) , University of Bologna , Bologna , Italy 12 Finnish Cancer Registry, Institute for Statistical and Epidemiologica |
| AuthorAffiliation_xml | – name: 2 International Agency for Research on Cancer , Lyon , France – name: 5 Department of Research, Cancer Registry of Norway , Institute of Population-Based Cancer Research , Oslo , Norway – name: 8 Faculty of Medicine , University of Iceland , Reykjavik , Iceland – name: 9 Department of Community Medicine, Faculty of Health Sciences , University of Tromsø, The Arctic University of Norway , Tromsø , Norway – name: 11 Faculty of Social Sciences , University of Tampere , Tampere , Finland – name: 12 Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research , Helsinki , Finland – name: 6 Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden – name: 4 ‘G. Prodi’ Interdepartmental Center for Cancer Research , University of Bologna , Bologna , Italy – name: 3 Department of Experimental, Diagnostic, and Specialty Medicine , S. Orsola-Malpighi University Hospital , Bologna , Italy – name: 10 Genetic Epidemiology Group, Folkhälsan Research Center , Helsinki , Finland – name: 1 Department of Medical and Surgical Sciences (DIMEC) , University of Bologna , Bologna , Italy – name: 7 Icelandic Cancer Registry , Reykjavik , Iceland |
| Author_xml | – sequence: 1 givenname: Andrea surname: Farioli fullname: Farioli, Andrea email: s.mattioli@unibo.it organization: Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy – sequence: 2 givenname: Kurt surname: Straif fullname: Straif, Kurt email: s.mattioli@unibo.it organization: International Agency for Research on Cancer, Lyon, France – sequence: 3 givenname: Giovanni surname: Brandi fullname: Brandi, Giovanni email: s.mattioli@unibo.it organization: ’G.Prodi' Interdepartmental Center for Cancer Research, University of Bologna, Bologna, Italy – sequence: 4 givenname: Stefania surname: Curti fullname: Curti, Stefania email: s.mattioli@unibo.it organization: Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy – sequence: 5 givenname: Kristina surname: Kjaerheim fullname: Kjaerheim, Kristina email: s.mattioli@unibo.it organization: Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway – sequence: 6 givenname: Jan Ivar surname: Martinsen fullname: Martinsen, Jan Ivar email: s.mattioli@unibo.it organization: Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway – sequence: 7 givenname: Pär surname: Sparen fullname: Sparen, Pär email: s.mattioli@unibo.it organization: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden – sequence: 8 givenname: Laufey surname: Tryggvadottir fullname: Tryggvadottir, Laufey email: s.mattioli@unibo.it organization: Faculty of Medicine, University of Iceland, Reykjavik, Iceland – sequence: 9 givenname: Elisabete surname: Weiderpass fullname: Weiderpass, Elisabete email: s.mattioli@unibo.it organization: Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland – sequence: 10 givenname: Guido surname: Biasco fullname: Biasco, Guido email: s.mattioli@unibo.it organization: ’G.Prodi' Interdepartmental Center for Cancer Research, University of Bologna, Bologna, Italy – sequence: 11 givenname: Francesco Saverio surname: Violante fullname: Violante, Francesco Saverio email: s.mattioli@unibo.it organization: Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy – sequence: 12 givenname: Stefano surname: Mattioli fullname: Mattioli, Stefano email: s.mattioli@unibo.it organization: Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy – sequence: 13 givenname: Eero surname: Pukkala fullname: Pukkala, Eero email: s.mattioli@unibo.it organization: Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland |
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| Snippet | ObjectivesTo assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).MethodsWe conducted a case–control study... To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). We conducted a case-control study nested in the... Objectives To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). Methods We conducted a case-control... To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).OBJECTIVESTo assess the association between... Objectives To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC). Methods We conducted a case–control... |
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| SubjectTerms | Aged Aged, 80 and over Alcohol Asbestos Asbestos - adverse effects Bile Duct Neoplasms - chemically induced Bile Duct Neoplasms - epidemiology Cancer Case studies Case-Control Studies Censuses Cholangiocarcinoma Cholangiocarcinoma - chemically induced Cholangiocarcinoma - epidemiology Codes Disease Emigration Epidemiology Exposure Female Finland - epidemiology Health risk assessment Humans Iceland - epidemiology Logistic Models Male Mesothelioma Middle Aged Mortality Norway - epidemiology Occupational exposure Occupational Exposure - adverse effects Occupational Exposure - statistics & numerical data Occupational health Occupations Odds Ratio ORIGINAL ARTICLE Population Population studies Population-based studies Printing industry Publishing - statistics & numerical data Regression analysis Regression models Risk Factors Studies Sweden - epidemiology VOCs Volatile organic compounds Workers Workplace |
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| Title | Occupational exposure to asbestos and risk of cholangiocarcinoma: a population-based case–control study in four Nordic countries |
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