Objectives: Occupational exposure to asbestos is associated with increased mortality which, however, has not been thoroughly validated in a general population. We have aimed at exploring whether this association may be confirmed within a population-based setting after adjustment for confounders. Furthermore, the impact of tobacco consumption on the association between occupational exposure to asbestos and mortality is assessed. Material and Methods: We used data from 2072 (224 exposed) male participants of the Study of Health in Pomerania. Information on exposure to asbestos is based on a selfreport. Median follow-up time was 11.3 years. All-cause mortality and cause-specific mortality of exposed and non-exposed men were compared using mortality rate ratios, Kaplan-Meier analyses and multivariable Cox regression. Results: During the follow-up, 52 (23.2%) exposed and 320 (17.3%) non-exposed participants deceased. Exposed subjects had increased hazard ratios (HR) for all-cause mortality (HR=1.48, 95% CI: 1.1-2), benign lung disease mortality (HR=3, 95% CI: 1.18-7.62) and stomach cancer mortality (HR=4.59, 95% CI: 1.53-13.76). The duration of exposure (per 10 years) was associated with all-cause (HR=1.21, 95% CI: 1.07-1.36) and benign lung disease mortality (HR=1.68, 95% CI: 1.26-2.22). Smokers occupationally exposed to asbestos had the highest risk for all-cause (HR=3.70, 95% CI: 2.19-6.27) and cancer mortality (HR=4.56, 95% CI: 1.99-10.48) as compared to non-asbestos exposed non-smokers. Conclusion: Our results confirm associations of occupational exposure to asbestos with all-cause, benign lung disease, and stomach cancer mortality and underline the impact of joint effects of asbestos and smoking on mortality.
Currently various protocols regarding the site of waist circumference (WC) measurement are in place. This study aimed to analyze the effect of the site of WC measurement on visceral fat (VAT) estimation. WC was obtained at seven anatomical sites in 211 German volunteers (103 males) aged 23-81 using 3-dimensional photonic body scanning (PBS). At one site WC was additionally measured by tape. The quantity of VAT was assessed by magnetic resonance imaging (MRI). Models to estimate VAT based on WC were developed; the precision of the estimation is represented by R2. The influence of the applied method of WC assessment (tape vs. PBS) on the estimations is reported. Results show that the amount of estimated VAT and the precision of VAT estimation were dependent on the site of measurement. VAT was estimated most precisely by WC taken at the level of the lowest rib (WCrib: R²=0.75 females; 0.79 males), the minimum circumference (WCmin: R²=0.75 females; 0.77 males) and at the narrowest part of the torso (WCnar: R²=0.76 females; 0.77 males), and least precisely by WC assessed at the top of iliac crest (WCiliac: R²=0.61 females; 0.60 males). VAT estimates based on WC obtained by PBS were smaller and estimations were slightly less precise compared to estimates based on tape measures.
Our results indicate that the method and the site of waist measurement should be considered when estimating VAT based on WC. The implementation of a standardized protocol using either WCrib, WCmin or WCnar could improve the precision of VAT estimation.
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