Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Public Health, Hyogo Medical University, Hyogo, Japan.
Cancer Sci. 2023 Jul;114(7):2973-2985. doi: 10.1111/cas.15802. Epub 2023 Apr 23.
A causal relationship between mesothelioma and occupational asbestos exposure is well known, while some studies have shown a relationship to non-occupational exposures. The aim of this study was to quantify the risk of mesothelioma death associated with neighborhood asbestos exposure due to a large-scale asbestos-cement (AC) plant in Amagasaki, Japan, adjusting properly risk factors including occupational exposures. We conducted a nested case-control study in which a fixed population of 143,929 residents who had been living in Amagasaki City between 1975 and 2002 were followed from 2002 to 2015. All 133 cases and 403 matched controls were interviewed about their occupational, domestic, household, and neighborhood asbestos exposures. Odds ratios (ORs) for mesothelioma death associated with the neighborhood exposure were estimated by a conditional logistic-regression model. For quantitative assessments for neighborhood exposure, we adopted cumulative indices for individuals' residential histories at each residence-specific asbestos concentration multiplied by the duration during the potential exposure period of 1957-1975 (crocidolite). We observed an increasing, dose-dependent risk of mesothelioma death associated with neighborhood exposure, demonstrating that ORs in the highest quintile category were 21.4 (95% confidence interval [CI] 5.8-79.2) for all, 23.7 (95% CI 3.8-147.2) for males, and 26.0 (95% CI 2.8-237.5) for females compared to the lowest quintile, respectively. A quantitative assessment for risk of mesothelioma deaths, adjusting for occupational and non-occupational exposures separately, showed a dose-dependent association with neighborhood exposure and no substantial gender differences in magnitude.
间皮瘤与职业石棉暴露之间存在因果关系，这是众所周知的，而一些研究表明也与非职业暴露有关。本研究的目的是量化日本兵库县尼崎市一家大型石棉水泥（AC）工厂导致的社区石棉暴露与间皮瘤死亡风险之间的关系，适当调整包括职业暴露在内的风险因素。我们进行了一项巢式病例对照研究，其中 1975 年至 2002 年间居住在尼崎市的 143929 名固定人群从 2002 年随访至 2015 年。对所有 133 例病例和 403 例匹配对照进行了职业、家庭、家庭和社区石棉暴露情况的访谈。通过条件逻辑回归模型估计了与社区暴露相关的间皮瘤死亡的比值比（OR）。对于社区暴露的定量评估，我们采用了个体在每个特定住所的石棉浓度下的居住历史的累积指数，乘以潜在暴露期（1957-1975 年）期间的持续时间（青石棉）。我们观察到与社区暴露相关的间皮瘤死亡风险呈递增、剂量依赖性，表明最高五分位组的 OR 分别为所有人群的 21.4（95%置信区间[CI] 5.8-79.2）、男性的 23.7（95% CI 3.8-147.2）和女性的 26.0（95% CI 2.8-237.5），与最低五分位组相比。在分别调整职业和非职业暴露后，对间皮瘤死亡风险进行定量评估，结果显示与社区暴露存在剂量依赖性关联，且在程度上无明显的性别差异。
