Health effects of asbestos exposure with special reference to job type

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A cohort study for 37 years follow-up was undertaken in an asbestos textile plant in China, where only chrysotile had been used. Cox proportional hazard ratio (HR) of cause-specific mortality was estimated, while taking into account age, smoking, and asbestos exposure level. In asbestos workers, HRs for mortality by all causes, all cancers, lung cancer, and respiratory diseases were 2.05 (95% CI:1.56 to 2.68), 1.89 (1.25 to 2.87), 3.31(1.60 to 6.87), and 3.23 (1.68 to 6.22), respectively. By a case-control study within a cohort in the same plant, we found 5 times elevation of the incidence of lung cancer among high exposed non-smoking workers but it was 3 times for smokers with low asbestos exposure. However, it elevated to more than10 times when workers smoke and exposed to high level of asbestos, suggesting the synergistic effects of the two for lung cancer. Also in a chrysotile miners cohort in China, mortality by lung cancer and non-malignant pulmonary diseases were elevated.