Occupation and mesothelioma in Sweden. Updated incidence for men and women up to 27 years after asbestos ban

The authors updated the Swedish component of the Nordic Occupational Cancer (NOCCA) Study through 2009 in order to investigate the incidence of mesothelioma of the peritoneum and pleura in both sexes, and explored occupational exposures that may be associated with mesothelioma. The Swedish component of the NOCCA Study includes 6.78 million individuals. Data from this cohort was linked to the population-based Swedish Cancer Registry and Swedish Total Population Registry for three periods between 1961 and 2009 and then further linked to the Swedish NOCCA Job Exposure Matrix, which includes 25 carcinogenic substances and corresponding exposure levels for 280 occupations. Multivariate analysis was used to calculate standardised incidence ratios (SIR) for mesothelioma of the peritoneum and pleura by sex, occupational category, carcinogenic substance, and for multiple occupational exposures simultaneously. There were 3,716 incident of mesotheliomas recorded (21.1% women). We found a significantly increased risk of mesothelioma in 24 occupations, as well as a clear sex difference. Among men, increased risks of mesothelioma of the pleura were observed in male-dominated occupations, with the greatest increase among plumbers (SIR 4.99, 95% confidence interval [CI] 4.20-5.90). Among women, an increased risk was observed in sewing workers, canning workers, packers, cleaners, and postmen. In multivariate analysis controlling for multiple occupational exposures, significant associations were only observed between asbestos exposure and mesothelioma. The authors concluded that asbestos exposure was associated with mesothelioma incidence. As yet, the asbestos ban of 1982 shows no clear effect on the occurrence of mesothelioma in this cohort.

Authors: Plato N, Martinsen JI, Sparén P, Hillerdal G, Weiderpass E. ;Full Source: Epidemiological Health. 2016 Sep 20. doi: 10.4178/epih.e2016039. [Epub ahead of print] ;