Exposure to asbestos and lung and pleural cancer mortality among pulp and paper industry workers

Rafael Carel, Paolo Boffetta, Timo Kauppinen, Kay Teschke, Aage Andersen, Paavo Jäppinen, Neil Pearce, Bo Andreassen Rix, Alain Bergeret, David Coggon, Bodil Persson, Irena Szadkowska-Stanczyk, Danuta Kielkowski, Paul Henneberger, Reiko Kishi, Luiz Augusto Facchini, Maria Sala, Didier Colin, Manolis Kogevinas

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15 Scopus citations


We studied the mortality from lung and pleural cancers in a cohort of 62, 937 male workers employed for at least 1 year in the pulp and paper industry in 13 countries during 1945 to 1996. Mill departments were classified according to probability and level of exposure to asbestos on the basis of available dust measurements and mill-specific information on exposure circumstances. Thirty-six percent of workers were classified as ever exposed to asbestos. Standardized mortality ratios of lung cancer were 0.99 (95 % confidence interval [CI], 0.90 to 1.08) among unexposed and 1.00 (95 % CI, 0.90 to 1.11) among ever exposed workers. The number of pleural cancer deaths among unexposed workers was 10; that among exposed workers was 14, most of which occurred among maintenance workers. In internal analyses, a trend in mortality from either neoplasm was suggested for estimated cumulative exposure to asbestos, weighted for the individual probability of exposure within the department and for duration of exposure (relative risk for lung cancer for 0.78+ f/cc-years, as compared with ≤ 0.01 f/cc-years: 1.44; 95 % CI, 0.85 to 2.45; corresponding relative risk for pleural cancer: 2.43; 95% CI, 0.43 to 13.63). Despite a possible nondifferential misclassification of exposure and outcome, this study suggests that the carcinogenic effect of asbestos can be detected among workers employed in industries such as the pulp and paper industry, in which it is not considered to be a major hazard.

Original languageEnglish
Pages (from-to)579-584
Number of pages6
JournalJournal of Occupational and Environmental Medicine
Issue number6
StatePublished - 1 Jan 2002

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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