Published ahead of print on June 23, 2005, doi:10.1164/rccm.200412-1731OC
Am. J. Respir. Crit. Care Med., Volume 172, Number 8, October 2005, 1019-1025
A more recent version of this article appeared on October 15, 2005
Submitted on December 22, 2004
Accepted on June 19, 2005
Residential Proximity to Naturally Occurring Asbestos and Mesothelioma Risk in California
Xue-lei Pan1, Howard W Day2, Wei Wang3, Laurel A Beckett1, and Marc B Schenker1*
1 Department of Public Health Sciences, University of California at Davis, Davis, CA, USA,
2 Department of Geology, University of California at Davis, Davis, CA, USA,
3 Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: mbschenker{at}ucdavis.edu.
Rationale: Little is known about environmental exposure to low levels of naturally occurring asbestos (NOA) and malignant mesothelioma (MM) risk. Objectives: To conduct a cancer registry based case-control study of residential proximity to NOA with MM in California. Methods: Incident MM cases (n=2908) aged 35+ years diagnosed between 1988 and 1997 were selected from the California Cancer Registry (CCR) and frequency-matched to pancreatic cancer controls (n=2908) by 5-year age group and sex. Controls were selected by stratified random sampling from 28,123 incident pancreatic cancers in the same time period. We located 93.7% of subjects at the house or street level at initial diagnosis. Individual occupational exposure to asbestos was derived from the longest held occupation, available for 74% of MM cases and 63% of pancreatic cancers. Occupational exposure to asbestos was determined by a priori classification and confirmed by association with mesothelioma. Main Results: The adjusted odds ratios and 95% confidence intervals (CIs) for low, medium, and high probabilities of occupational exposures to asbestos were 1.71 (1.32-2.21), 2.51 (1.91-3.30), and 14.94 (8.37- 26.67), respectively. Logistic regression analysis from a subset of 1133 mesothelioma cases and 890 pancreatic cancer controls showed that the odds of mesothelioma decreased approximately 6.3% for every 10 kilometer farther from the nearest asbestos source, an odds ratio of 0.937 (95% CI=0.895-0.982), adjusted for age, sex, and occupational exposure to asbestos. Conclusions: These data support the hypothesis that residential proximity to NOA is significantly associated with increased risk of MM in California.
Key words: Cancer Registry case-control study; naturally occurring asbestos; occupational exposure to asbestos; malignant mesothelioma; GIS
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