Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
Am J Respir Crit Care Med. 2013 May 1;187(9):977-82. doi: 10.1164/rccm.201210-1911OC.
Occupational coexposure to asbestos and other fibers or particles could modify the carcinogenicity of asbestos with regard to pleural mesothelioma.
To estimate associations between pleural mesothelioma and occupational mineral wool and silica exposure and to study the impact of occupational coexposure on the risk of pleural mesothelioma.
A total of 1,199 male cases and 2,379 control subjects were included in a French pooled case-control study. Complete job histories were collected, and occupational exposure to asbestos, mineral wool (MW), and silica were assessed by three French job exposure matrices. Unconditional logistic regression models adjusted for age, birth date, and occupational asbestos exposure were used to estimate odds ratios (OR) and 95% confidence intervals (CIs).
A significant association between mesothelioma and MW exposure was observed after adjustment for occupational asbestos exposure. OR for subjects exposed to less than 0.01 fibers·ml(-1)·yr(-1) was 1.6 (95% CI, 1.2-2.1) and increased to 2.5 (95% CI, 1.8-3.4) for subjects exposed to more than 0.32 fibers·ml(-1)·yr(-1). All ORs for silica exposure were around the null. Coexposure to either asbestos and MW or asbestos and silica seemed to increase the risk of pleural mesothelioma. ORs were 17.6 (95% CI, 11.8-26.2) and 9.8 (95% CI, 4.2-23.2) for subjects exposed to both asbestos and MW and for subjects exposed to both asbestos and silica, respectively, compared with 4.3 (95% CI, 1.9-9.8) for occupational asbestos exposure alone.
Our results are in favor of an increased risk of pleural mesothelioma for subjects exposed to both asbestos and MW or asbestos and silica.
职业性石棉和其他纤维或颗粒共同暴露可能会改变石棉对间皮瘤的致癌性。
评估间皮瘤与职业性矿棉和二氧化硅暴露之间的关联，并研究职业性共同暴露对间皮瘤风险的影响。
一项法国的病例对照研究共纳入了 1199 例男性病例和 2379 例对照。收集了完整的职业史，并通过三个法国职业暴露矩阵评估了石棉、矿棉（MW）和二氧化硅的职业暴露。采用调整年龄、出生日期和职业性石棉暴露的非条件逻辑回归模型来估计比值比（OR）和 95%置信区间（CI）。
在调整了职业性石棉暴露后，观察到间皮瘤与 MW 暴露之间存在显著关联。暴露于少于 0.01 纤维·ml(-1)·yr(-1)的受试者的 OR 为 1.6（95%CI，1.2-2.1），而暴露于大于 0.32 纤维·ml(-1)·yr(-1)的受试者的 OR 增加到 2.5（95%CI，1.8-3.4）。所有二氧化硅暴露的 OR 值均接近零。石棉和 MW 或石棉和二氧化硅的共同暴露似乎增加了患胸膜间皮瘤的风险。与单独职业性石棉暴露相比，暴露于石棉和 MW 的受试者的 OR 为 17.6（95%CI，11.8-26.2），暴露于石棉和二氧化硅的受试者的 OR 为 9.8（95%CI，4.2-23.2）。
我们的结果支持暴露于石棉和 MW 或石棉和二氧化硅的受试者患胸膜间皮瘤的风险增加。
