Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in the Netherlands Cohort Study

Offermans, Nadine S M; Vermeulen, Roel; Burdorf, Alex; Peters, Susan; Goldbohm, R. Alexandra; Koeman, Tom; Tongeren, Martie van; Kauppinen, Timo; Kant, IJmert; Kromhout, Hans; Brandt, Piet A. van den

doi:10.1136/oemed-2011-100556

Cited by 47 publications

(57 citation statements)

References 28 publications

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“…5 Exposure based on the probability 3 intensity of exposure (unit-years) per job. 6 Trends over the exposed subjects were added only if trends over all subjects were statistically significant in the full covariate model.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Several exposure variables were defined: ever versus never exposed to asbestos (yes/no), duration of exposure (years), cumulative exposure (CE; unit-years), ever versus never highly exposed to asbestos (yes/no) and duration of high exposure (years).…”

Section: Occupational Exposure Assessmentmentioning

confidence: 99%

“…6,7 Results are presented in the Supporting Information Tables S4-S6, as well as a brief comparison of results of both JEMs.…”

Section: Sensitivity Analysismentioning

confidence: 99%

“…6 Trends over the exposed subjects were added only if trends over all subjects were statistically significant in the full covariate model. Exposure dichotomized or categorized in never-exposed and tertiles (T) of exposed in the subcohort.…”

mentioning

confidence: 99%

“…6 Trends over the exposed subjects were added only if trends over all subjects were statistically significant in the full covariate model.…”

mentioning

confidence: 99%

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Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study

et al. 2014

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The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of potential confounders and the interaction between asbestos and smoking in relation to cancer risk. Using the Netherlands Cohort Study (n 5 58,279 men, aged 55-69 years at baseline), asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal, 486 gastric and 1,724 colorectal cancer cases were available for analysis. The models adjusted for age and family history of cancer showed that mainly (prolonged) exposure to high levels of asbestos was statistically significantly associated with risk of esophageal adenocarcinoma (EAC), total and distal colon cancer and rectal cancer. For overall gastric cancer and gastric non-cardia adenocarcinoma (GNCA), also exposure to lower levels of asbestos was associated. Additional adjustment for lifestyle confounders, especially smoking status, yielded non-significant associations with overall gastric cancer and GNCA in the multivariableadjusted model, except for the prolonged highly exposed subjects (tertile 3 vs. never: HR 2.67, 95% CI: 1.11-6.44 and HR 3.35, 95% CI: 1.33-8.44, respectively). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers. This prospective population-based study showed that (prolonged) high asbestos exposure was associated with overall gastric cancer, EAC, GNCA, total and distal colon cancer and rectal cancer.The International Agency for Research on Cancer evaluated the evidence for an association between asbestos exposure and gastric and colorectal cancer as limited, though for colorectal cancer they were evenly divided as to whether the evidence was strong enough to justify classification as sufficient. 1 For esophageal cancer, a relatively rare cancer, results of epidemiological studies on associations with asbestos are mixed and together with the fact that animal experiments do not support biological activity of asbestos at this site, the evidence was considered to be inadequate. 2 Therefore, the question remains whether asbestos entails an increased risk of developing gastrointestinal tumors, and if so, whether risk differs for relatively low and high exposure levels. As there are numerous other risk factors for gastrointestinal cancers, an additional question relates to the influence of potential confounders. Furthermore, cancer subtypes may have different etiologies and should be studied separately if possible. Finally, as for lung cancer, the question arises if interaction between asbestos and smoking is present in relation to gastrointestinal cancers. 1,2

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Section: Discussionmentioning

confidence: 99%

Section: Occupational Exposure Assessmentmentioning

confidence: 99%

“…6,7 Results are presented in the Supporting Information Tables S4-S6, as well as a brief comparison of results of both JEMs.…”

Section: Sensitivity Analysismentioning

confidence: 99%

mentioning

confidence: 99%

“…6 Trends over the exposed subjects were added only if trends over all subjects were statistically significant in the full covariate model.…”

mentioning