Steven Stellman - Insulation, asbestos, smoking habits, and lung cancer cell types

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      Publication Details (including relevant citation   information):

      Muscat, J. E., Stellman, S. D., Wynder, E. L. 27 (2)   257-69-

      Abstract: The association between occupational   exposure to asbestos and histological type of lung cancer was   analyzed in a multicenter hospital-based case-control study   (2,871 male cases and 5,240 male controls) conducted from   1981-1991. Twenty-two percent of cases and 18% of controls were   employed in asbestos-related occupations for at least 1 year.   Most of these asbestos jobs were in the construction field. The   odds ratio (OR) among current smokers was 1.0 [95% confidence   intervals (CI) 0.9 to 1.3]; for ex-smokers, the OR was 1.4 (95%   CI 1.1 to 1.6). In contrast, 10% of cases and 5% of controls   self-reported that they were chronically exposed to asbestos for   at least 1 year. Self-reported asbestos exposure was   significantly related to all lung cancer cell types among smokers   and ex-smokers, although a trend in the ORs with duration of   self-reported exposure was not found for current smokers. Among   48 cases and 52 controls reporting distinct exposure to building   insulation, the OR was 2.2 (95% CI 1.2 to 4.3) for current   smokers, and 1.8 (95% CI 0.9 to 3.6) for ex-smokers, compared to   subjects who were not exposed to building insulation and   asbestos. A nonsignificant association with self-reported   exposure to asbestos was observed for a small number of never   smokers (eight of 83 nonsmoking cases, OR = 2.0, 95% CI 0.9 to   4.6). When examining these results and their causal implications,   possible misclassification and reporting biases need to be   considered.

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