Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.
Am J Ind Med. 2024 Dec;67(12):1077-1088. doi: 10.1002/ajim.23668. Epub 2024 Oct 14.
Contemporary asbestos exposure occurs during construction, remediation, and maintenance involving asbestos-containing materials (ACM), as compared to the historical exposure scenarios of asbestos mining and milling. The Ontario Asbestos Workers Register (AWR) was established in 1986 to track asbestos exposure among construction workers. This study reports on the risk of asbestos-related diseases (ARD) among workers in the AWR.
AWR registrants were linked probabilistically with administrative health databases (1986-2019) to identify cases of ARD including both cancer and chronic respiratory disease. Follow-up began at AWR enrollment and continued prospectively. Incidence rates were compared to the general population using standardized incidence ratios (SIRs). Associations between ACM exposure and ARD were estimated among AWR registrants using Poisson regression.
In total, 26,204 (81%) registrants were linked successfully. Common industries of employment were construction (62%), manufacturing (19%) and education (8%). Among men and women mesothelioma (M:SIR 6.83 [95% CI = 5.56-8.31]; W:SIR 19.2 [3.86-56.1]) and pulmonary fibrosis (M:SIR 14.1 [12.2-16.2]; W:SIR 9.25 [2.49-23.7]) rates were higher than the general population. Asbestosis risk was elevated among men (M:SIR 11.2 [9.59-13.1]). Workers with longer reported exposures (≥140 h) had increased rates of lung cancer (RR 1.34 [1.10-1.63]), mesothelioma (RR 2.83 [1.75-4.58]), asbestosis (RR 3.07 [2.12-4.43]), chronic obstructive pulmonary disease (RR 1.42 [1.29-1.57]), and pulmonary fibrosis (RR 1.88 [1.35-2.62]).
Exposure to asbestos in construction and building maintenance continues to contribute to ARD incidence. Despite a Canadian ban on asbestos in new products, exposures to existing ACM will persist from construction activities. The AWR offers an opportunity for ongoing surveillance of resulting ARD in Ontario.
与石棉采矿和碾磨的历史暴露场景相比，当代石棉暴露发生在涉及含石棉材料（ACM）的建筑、修复和维护期间。安大略石棉工人登记册（AWR）于 1986 年成立，旨在追踪建筑工人的石棉暴露情况。本研究报告了 AWR 中工人与石棉相关疾病（ARD）的风险。
通过概率将 AWR 登记册与行政健康数据库（1986-2019 年）进行链接，以确定包括癌症和慢性呼吸道疾病在内的 ARD 病例。随访从 AWR 登记开始，并持续进行前瞻性随访。使用标准化发病比（SIR）将发病率与普通人群进行比较。使用泊松回归估计 AWR 登记册中 ACM 暴露与 ARD 之间的关联。
共有 26204 名（81%）登记册成功链接。常见的就业行业包括建筑（62%）、制造业（19%）和教育（8%）。在男性和女性中，间皮瘤（M：SIR 6.83[95%CI=5.56-8.31]；W：SIR 19.2[3.86-56.1]）和肺纤维化（M：SIR 14.1[12.2-16.2]；W：SIR 9.25[2.49-23.7]）的发病率高于普通人群。男性石棉肺风险升高（M：SIR 11.2[9.59-13.1]）。报告的暴露时间较长（≥140 小时）的工人肺癌（RR 1.34[1.10-1.63]）、间皮瘤（RR 2.83[1.75-4.58]）、石棉肺（RR 3.07[2.12-4.43]）、慢性阻塞性肺疾病（RR 1.42[1.29-1.57]）和肺纤维化（RR 1.88[1.35-2.62]）的发病率均升高。
建筑和建筑维护中的石棉暴露继续导致 ARD 发病率上升。尽管加拿大禁止在新产品中使用石棉，但建筑活动仍将持续存在对现有 ACM 的暴露。AWR 为安大略省正在进行的 ARD 监测提供了机会。
