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Diseases of the respiratory system (except for pneumoconiosis & similar) - 2,965 entries found

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CIS 03-184 Guidotti T.L.
Apportionment in asbestos-related disease for purposes of compensation
Workers' compensation systems attempt to evaluate claims for occupational disease on an individual basis using the best available guidelines. This may be difficult when there is more than one risk factor associated with the outcome, such as exposure to asbestos and cigarette smoking, and when the occupational exposure is not clearly responsible for the disease. Apportionment is an approach that involves an assessment of the relative contribution of work-related exposures to the risk of the disease or to the final impairment that arises for the disease. This review article discusses the concept of apportionment and applies it to asbestos-associated diseases. Apportionment, attractive as it may be as an approach to the adjudication of asbestos-related disease, is difficult to apply in practice. Even so, these models may serve as a general guide to the assessment of asbestos-related disease outcomes for purposes of compensation.
Industrial Health, Oct. 2002, Vol.40, No.4, p.295-311. Illus. 68 ref.

CIS 03-193 Karjalainen A., Martikainen R., Klaukka T.
The risk of asthma among Finnish patients with farmer's lung
Farmers and animal-husbandry workers notified in 1988-1999 for farmer's lung (n=1272) or other occupational diseases (n=5,045) to the Finnish Register of Occupational Diseases were followed until 31 December 2000. Among the patients with farmer's lung, 109 (8.6%) were diagnosed with asthma compared with 202 (4.0%) incident cases of asthma among those in the reference population. The crude relative risk of asthma was 2.1. The age- and occupation-adjusted relative risk of asthma among patients with farmer's lung was 2.5 in men and 1.4 in women. The rate of asthma was especially high during the first two years after notification of farmer's lung.
International Archives of Occupational and Environmental Health, Oct. 2002, Vol.75, No.8, p.587-590. Illus. 17 ref.

CIS 02-1822 Koskinen K., Pukkala E., Martikainen R., Reijula K., Karjalainen A.
Different measures of asbestos exposure in estimating risk of lung cancer and mesothelioma among construction workers
To analyse occupation, expert-evaluated cumulative exposure and radiographic abnormalities as indicators of asbestos-related cancer risk, a cohort of 16,696 construction workers was followed in 1990-2000. Standardized incidence ratios (SIR) in comparison to the Finnish population and relative risks (RR) in a multivariate analysis in comparison to the internal low-exposure category of each indicator were calculated. Overall, the risk was increased for mesothelioma (SIR 2.0) but not for lung cancer (SIR 1.1). Radiographic lung fibrosis indicated a two-fold and a high value of the exposure index, and a three-fold RR of lung cancer, while there was no risk among those with pleural plaques. The risk of lung cancer was the highest in insulators (RR 3.7).
Journal of Occupational and Environmental Medicine, Dec. 2002, Vol.44, No.12, p.1190-1196. 20 ref.

CIS 02-1830 Rongo L.M.B., Besselink A., Douwes J., Barten F., Msamanga G.I., Dolmans W.M.V., Demers P.A., Heederik D.
Respiratory symptoms and dust exposure among male workers in small-scale wood industries in Tanzania
Few studies have assessed respiratory symptoms and dust exposure levels in small-scale wood industry workers in Africa. In this study, 546 Tanzanian workers exposed to wood dust and 565 unexposed controls were interviewed using a respiratory health questionnaire. Inhalable dust measurements were collected in the breathing air of 106 workers. The dust exposure was high, and job title-based geometric mean exposure levels ranged from 2.9 to 22.8mg/m3. Prevalence of respiratory symptoms in the previous 12 months was significantly higher in the exposed group compared with the controls. Allergy and sensitivity symptoms were reported regularly in the exposed group with odds ratios varying from 2.4 for low- and 2.7 for high-exposure groups compared with controls. It is concluded that working in the small-scale wood industry in Tanzania is associated with an increased prevalence of respiratory symptoms.
Journal of Occupational and Environmental Medicine, Dec. 2002, Vol.44, No.12, p.1153-1160. 25 ref.

CIS 02-1581
Health and Safety Executive
Respiratory sensitisers and COSHH - Breathe freely
The Control of Substances Hazardous to Health Regulations 1999 (COSHH, see CIS 00-620) requires employers to carry out an assessment of the risks to workers' health resulting from exposures to hazardous substances. This leaflet summarizes the duties of employers under COSHH applicable to respiratory sensitizers. Contents: description of respirators sensitizers; symptoms of respiratory sensitization; effects of continued exposure; legal aspects; hazard evaluation; preventing or controlling exposure; health surveillance; what to do with respect to sensitized employees; what employees need to know.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 6FS, United Kingdom, July 2002. 6p. 8 ref. [in English]

CIS 02-1669 Kleinerman R.A., Wang Z., Wang L., Metayer C., Zhang S.Z., Brenner A.V., Zhang S.R., Xia Y., Shang B., Lubin J.H.
Lung cancer and indoor exposure to coal and biomass in rural China
Incomplete combustion of coal in homes has been linked with lung cancer in China. This article reports on a lung cancer case-control study in a rural area of China, where many residents live in underground dwellings and burn coal and unprocessed biomass (crop residues, wood, sticks and twigs) for heating and cooking. 846 patients with lung cancer (626 men and 220 women, aged 30 to 75) diagnosed between 1994 and 1998, and 1740 population-based controls were interviewed. The odds ratio for lung cancer associated with coal use compared with that for biomass in the house of longest residence was 1.29, adjusted for smoking and socioeconomic status. The risk for lung cancer increased relative to the percentage of time that coal was used over the past 30 years. The findings suggest that coal may contribute to the risk of lung cancer in this rural area of China.
Journal of Occupational and Environmental Medicine, Apr. 2002, Vol.44, No.4, p.338-344. 28 ref.

CIS 02-1714 Hoyle J., Cherry N., Pickering C.A.C., Burgess G., Smedley J., Dippnall M., Niven R.M.
Health and Safety Executive
Occupational lung disease in ferrous foundry workers
In a study of workers in ten ferrous foundries, it was found that the 509 men exposed to chemical binders were more likely (16.1%) to complain of chest tightness than the 402 non-exposed men (7.7%), an odds ratio of 2.32 after allowing for confounders. Of the 170 exposed men complaining of at least one chest symptom, 144 underwent histamine challenge testing. 20 were positive in the exposed group, while in the non-exposed group, only eight were positive. No difference was seen between exposure groups in the small number of cases diagnosed as occupational asthma. No evidence of major differences in health were found between exposed and non-exposed ex-employees. The most notable finding was the low reactivity in the histamine challenge test of workers with symptoms from both the exposed and non-exposed cohorts. Although there was only weak evidence of respiratory ill health associated with foundry work in this study, the potential exists where exposures to chemicals binders are high.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2002. iv, 26p. 4 ref. Price: GBP 10.00. [in English]

CIS 02-1667 Liu Y.H., Du C.L., Lin C.T., Chan C.C., Chen C.J., Wang J.D.
Increased morbidity from nasopharyngeal carcinoma and chronic pharyngitis or sinusitis among workers at a newspaper printing company
To determine the association between printing work and nasopharyngeal carcinoma as well as other diseases, demographic and hospital admission data were obtained for all workers at a newspaper who had worked since its establishment in 1950. Of the 1564 workers identified, 579 were admitted to hospital at least once. Of these, five out of 144 printing workers were diagnosed with nasopharyngeal carcinoma compared with none of the 435 non-printing workers. The morbidity odds ratios (OR) among printing workers was 57.0 for nasopharyngeal carcinoma, 28.0 for benign skin tumours and 29.4 for chronic pharyngitis or sinusitis. In conclusion, printing work is associated with an increased risk of nasopharyngeal carcinoma, benign skin tumours, chronic pharyngitis or sinusitis, chronic liver diseases and mechanical injuries.
Occupational and Environmental Medicine, Jan. 2002, Vol.59, No.1, p.18-22. 30 ref.

CIS 02-1978 Schleifer L.M., Ley R., Spalding T.W.
A hyperventilation theory of job stress and musculoskeletal disorders
This article presents a hyperventilation theory of job stress and work-related musculoskeletal disorders based on established principles of breathing and job stress. Hyperventilation refers to a drop in arterial CO2 caused by ventilation that exceeds metabolic demands for O2. Excessive loss of CO2 that results from hyperventilation produces a rise in blood pH which triggers a chain of systemic physiological reactions that have adverse implications for musculoskeletal health, including increased muscle tension, muscle spasm, amplified response to catecholamines, and muscle ischaemia and hypoxia. Hyperventilation is also often characterized by a shift from a diaphragmatic to a thoracic breathing pattern, which imposes biomechanical stress on the neck and shoulder region. The theory provides an innovative framework for understanding how job stress contributes to increasing the risk of musculoskeletal disorders, enabling effective work organization interventions and individual stress-management methods.
American Journal of Industrial Medicine, May 2002, Vol.41, No.5, p.420-432. Illus. 59 ref.

CIS 02-1737 Rosenberg N.
Respiratory allergies in bakers
Allergie respiratoire du boulanger [in French]
Wheat flour contains numerous allergens, and bakers' asthma remains the most common occupational asthma in France. In this occupation, one also encounters cases of allergic rhinitis and rhinoconjunctivitis. Contents of this article on bakers' allergic respiratory diseases: physiopathology; incidence and frequency; diagnosis in occupational settings; confirmation of diagnosis in specialized establishments; evolution; prevention; compensation.
Documents pour le médecin du travail, 2nd Quarter 2002, No.90, p.189-196. 71 ref.

CIS 02-1688 Breton C.
Prevention of occupational respiratory allergies in bakeries and confectionaries
Prévention des allergies respiratoires professionnelles en boulangerie-pâtisserie [in French]
Flour is the prime source of respiratory allergies in France. The average incidence rate of occupational asthma in bakery workers in approximately 25 times that of all workers. Contents of this review article on the prevention of occupational of allergic respiratory diseases in bakery workers: epidemiological data; recognition of baker's asthma as an occupational disease; collaboration between government, employers' and employees' representatives in defining a prevention approach; role of medical centres and physicians; risk factors for diseases due to exposure to flour; pluridisciplinary approach to prevention; preventive measures (choice of flour, choice of additives, length of the filling hose, use of a protective lid during kneading); role of the occupational physician.
Documents pour le médecin du travail, 2nd Quarter 2002, No.90, p.111-129. Illus. 47 ref.

CIS 02-1815 Morfeld P., Lampert K., Emmerich M., Reischig H.L., Klinkner H.G., Bauer H.D., Stegmaier C., Ziegler H., Dhom G., Piekarski C.
Dust exposure, pneumoconiosis and lung cancer: An epidemiological study in the Saarland hard coal mining industry
Staubexposition, Pneumokoniose und Lungenkrebs: Eine epidemiologische Studie aus dem Saarländischen Steinkohlenbergbau [in German]
This study examines the relationship between exposure to dust and lung cancer mortality among coal miners in the German State (Land) of Saarland. The follow-up of the mortality of a cohort of 4581 miners was carried out between 1980 and 1998. The standardized mortality ratio was 0.80 overall, 0.80 for cancer and 0.79 for lung cancer. Exposures to coal and quartz dusts were evaluated by various techniques. Average concentrations of 2.79mg/m3 and 0.23mg/m3 were found for coal and quartz dusts, respectively. 95,455 chest radiographs were re-evaluated according to ILO classification criteria. There was a 23.5% risk of coal miners' pneumoconiosis after 40 years of working underground. It was not possible to prove a direct causal relationship between pulmonary fibrosis and the risk of lung cancer. However, coal miners' pneumoconiosis could represent a biological marker of lung susceptibility to lung cancer. Interactions between dust exposures, pneumoconiosis and cancer risk need to be studied further.
Zentralblatt für Arbeitsmedizin, Arbeitsschutz und Ergonomie, Oct. 2002, Vol.52, No.10, p.382-397. Illus. 36 ref.

CIS 02-1686 Zanoni G., Martini S., Zedde A., Pagani M., Guarnieri A., Tridente G., Romeo L.
Specific immune response to occupational antigens in asymptomatic egg processing workers
Hen's egg proteins are known sensitizers and may cause occupational respiratory diseases in exposed workers. This study was conducted in order to determine the prevalence of sensitization to work-related antigens in asymptomatic egg processing factory workers. Clinical history, respiratory function, atopy and the presence of specific antibodies to environmental and occupational antigens were evaluated in 77 workers. A total of 116 unexposed controls were also studied. The antigen concentration of the factory environment was measured. Specific IgE and precipitin positivity to egg components was more frequently present in workers than among controls. The egg white protein concentration was higher in the egg breaking area. The avian proteins inhaled induced immune responses to occupational antigens in asymptomatic, professionally exposed subjects. Measures to decrease environmental antigen concentrations and thorough monitoring of sensitized workers are advocated.
American Journal of Industrial Medicine, June 2002, Vol.41, No.6, p.490-497. 24 ref.

CIS 02-1665 Ortega H.G., Kreiss K., Schill D.P., Weissman D.N.
Fatal asthma from powdering shark cartilage and review of fatal occupational asthma literature
Work-related asthma is the most common occupational respiratory disease in developed countries. This article reports a case of fatal occupational asthma due to exposure to shark cartilage dust. A 38-year-old male operator worked for eight years in a facility which primarily granulated and powdered various plastics. Sixteen months prior to his death, the plant also began grinding shark cartilage. After ten months of exposure, he reported chest symptoms at work in association with exposure to shark cartilage dust and a physician diagnosed asthma. Six months later, he complained of shortness of breath at work and died from autopsy-confirmed asthma. The latency from onset of exposure to symptoms, and from the appearance of symptoms to death was shorter than for ten occupational asthma fatalities reported in literature. Recognition of occupational causes and triggers of asthma and removal of affected individuals from these exposures can prevent progression to irreversible or fatal asthma.
American Journal of Industrial Medicine, July 2002, Vol.42, No.1, p.50-54. 31 ref.

CIS 02-1664 Schabath M.B., Spitz M.R., Delclos G.L., Gunn G.B., Whitehead L.W., Wu X.
Association between asbestos exposure, cigarette smoking, myeloperoxidase (MPO) genotypes, and lung cancer risk
The objective of the study was to determine whether genetic factors such as polymorphic metabolic/oxidative enzyme myeloperoxidase (MPO) could modulate individual susceptibility to asbestos-associated carcinogenesis. Restricted fragment length polymorphism-polymerase chain reaction analysis identified the MPO genotypes in 375 lung cancer cases and 378 matched controls. Detailed information regarding smoking, occupational history and exposures were obtained through interviews. Asbestos exposure was associated with a significantly elevated risk (odds ratio (OR) 1.45). However, G/G carriers who were exposed to asbestos had an OR of 1.72 while that of A-allele carriers (G/A+A/A) was 0.89. All three risk factors (MPO genotypes, asbestos exposure and smoking) were analysed for combined effects. Heavy smokers with the G/G genotype and a history of asbestos exposure demonstrated a significant elevated risk estimate (OR 2.19, while the A-allele carriers with the same exposure profile were at a lower risk for lung cancer (OR 1.18). The A-allele genotypes demonstrated similar protective effects for all exposure profiles.
American Journal of Industrial Medicine, July 2002, Vol.42, No.1, p.29-37. 37 ref.

CIS 02-1689 Schlünssen V., Schaumburg I., Taudorf E., Mikkelsen A.B., Sigsgaard T.
Respiratory symptoms and lung function among Danish woodworkers
A cross-sectional study including 54 furniture factories and three control factories was conducted in order to analyse lung function and the prevalence of respiratory symptoms among woodworkers. Spirometry was performed on 2423 persons. Questionnaires regarding respiratory symptoms and wood dust exposure were completed by 2033 woodworkers and 474 controls. Personal passive dust measurements were performed on 1579 persons. It was found that inhalable dust levels were relatively low (1.19±0.86mg/m3). Woodworkers had increased frequency of coughing. A dose-response relationship was observed between dust exposure and asthma symptoms, and a positive interaction for asthma was seen between female gender and dust exposure. Increased frequency of wheezing and a cross-shift decrease in one-second forced expiratory volume among workers using pinewood was seen. In conclusion, wood dust exposure may cause respiratory symptoms, even at relatively low exposure levels.
Journal of Occupational and Environmental Medicine, Jan. 2002, Vol.44, No.1, p.82-98. 56 ref.

CIS 02-1662 Fink G., Moshe S., Goshen J., Klainman E., Lebzelter J., Spitzer S., Kramer M.R.
Functional evaluation in patients with chronic obstructive pulmonary disease: Pulmonary function tests versus cardiopulmonary exercise test
216 ambulatory patients with chronic obstructive pulmonary disease were administered the pulmonary function test (PFT) and a cardiopulmonary exercise test, and the results were analysed by categorical statistical comparison, based on standard medical impairment classifications. 65 patients (30.1%) were similarly classified by the two methods. Of the remaining patients, 132 (61.1%) were found to be less impaired according to the cardiopulmonary exercise test than according to the PFT, and 19 (8.8%) were more impaired according to the PFT. The results favour the use of the cardiopulmonary exercise test for the routine evaluation of respiratory impairment in patients with chronic obstructive pulmonary disease, particularly for patients with mild or moderate impairment revealed by the PFT. However, given the large discrepancy between the two methods, complementary tests are recommended for some groups of patients.
Journal of Occupational and Environmental Medicine, Jan. 2002, Vol.44, No.1, p.54-58. 29 ref.

CIS 02-1799 Sjögren S.B., Gunnare S., Sandler H.
Inhalation of decomposed chlorodifluoromethane (freon-22) and myocardial infarction
After exposure to decomposed chlorodifluoromethane, a 65-year-old man developed respiratory symptoms such as cough, blood-stained sputum and increasing dyspnoea. Three weeks later, his family doctor diagnosed infectious bronchitis. Another week later he died due to myocardial infarction. The discussion focuses on an inflammatory process caused by the inhalation of decomposed chlorodifluoromethane and its possible association with myocardial infarction.
Scandinavian Journal of Work, Environment and Health, June 2002, Vol.28, No.3, p.205-207.13 ref.

CIS 02-1785 Teschke K., Chow Y., Brauer M., Chessor E., Hirtle B., Kennedy S.M., Yeung M.C., Ward H.D.
Exposures and their determinants in radiographic film processing
Radiographers process X-ray films using solutions that contain chemicals known to cause asthma. In this study, it was found that radiographers' average full-shift personal exposures to glutaraldehyde, acetic acid and sulfur dioxide were 0.0009mg/m3, 0.09mg/m3 and 0.08mg/m3, respectively, all more than one order of magnitude lower than current occupational exposure limits. Local exhaust ventilation of the processing machines and use of silver recovery units further lowered exposures, whereas the number of films processed per machine and the time spent near the machines increased exposures. Developments in digital imaging technology are making available options that do not involve wet-processing of photographic film and therefore could eliminate the use of developer and fixer chemicals altogether.
AIHA Journal, Jan.-Feb. 2002, Vol.63, No.1, p.11-21. 25 ref.

CIS 02-1691 Akpinar-Elci M., Cimrin A.H., Elci O.M.
Prevalence and risk factors of occupational asthma among hairdressers in Turkey
This study was designed to evaluate the prevalence and possible risk factors of occupational asthma among hairdressers in Turkey. Occupational history and respiratory, ocular, dermal, and nasal symptoms were investigated using a standardized questionnaire, worksite pulmonary function tests were conducted and allergen skin tests were performed. Asthma risk factors were then determined using age- and sex-adjusted logistic regression models. The prevalence of occupational asthma in hairdressers was 14.6%. The odds ratio for hairdressers in a high work intensity group was 3.6 with a significant dose-response trend. The odds ratio for occupational asthma among workers with atopy was 4.5. An excess risk of occupational asthma with allergic rhinitis and conjunctivitis was also observed.
Journal of Occupational and Environmental Medicine, June 2002, Vol.44, No.6, p.585-590. 35 ref.

CIS 02-1797 Carel R., Boffetta P., Kauppinen T., Teschke K., Andersen A., Jäppinen P., Pearce N., Andreassen Rix B., Bergeret A., Coggon D., Persson B., Szadkowska-Stanczyk I., Kielkowski D., Henneberger P., Kishi R., Facchini L.A., Sala M., Colin D., Kogevinas M.
Exposure to asbestos and lung and pleural cancer mortality among pulp and paper industry workers
The mortality from lung and pleural cancers in a cohort of 62,937 male workers employed for at least one year in the pulp and paper industry was studied in 13 countries from 1945 to 1996. Departments were classified according to probability and level of exposure to asbestos on the basis of available dust measurements and company-specific information on exposure circumstances. 36% of workers were classified as ever exposed to asbestos. Standardized mortality ratios of lung cancer were 0.99 among unexposed and 1.00 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 cumulative exposure to asbestos. 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.
Journal of Occupational and Environmental Medicine, June 2002, Vol.44, No.6, p.579-584. 33 ref.

CIS 02-1683 Watkins D.K., Chiazze L., Fryar C.D., Fayerweather W.
A case-control study of lung cancer and non-malignant respiratory disease among employees in asphalt roofing manufacturing and asphalt production
Two case control studies involving workers engaged in asphalt roofing manufacturing and asphalt production were carried out, one for lung cancer and one for nonmalignant respiratory disease excluding influenza and pneumonia, in order to determine whether there was an increased risk associated with exposure to asphalt fumes or respirable crystalline silica in these industries. Historical exposure scenarios were constructed to estimate historic exposures to asphalt fumes and respirable crystalline silica. It was found that the only statistically significant odds ratios were for cigarette smoking in both the lung cancer and the non-malignant disease analyses.
Journal of Occupational and Environmental Medicine, June 2002, Vol.44, No.6, p.551-558. 25 ref.

CIS 02-1239 Martins L.C., do Rosário Dias de Oliveira Latorre M., do Nascimento Saldiva P.H., Ferreira Braga A.L.
Air pollution and emergency room visits due to chronic lower respiratory diseases in the elderly: An ecological time-series study in São Paulo, Brazil
The objective of this study was to investigate the effect of daily air pollution levels (carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide and particulate matter with an aerodynamic profile <10µm) on morbidity by using the daily number of emergency room visits due to chronic lower respiratory disease (CLRD) in people older than 64 years of age in the city of São Paulo, Brazil, from 1996 to 1998. Generalized additive Poisson regression models were adopted, adjusted for long-time trends and weather, day of the week, and daily number of non-respiratory admissions. Ozone and sulfur dioxide were the pollutants statistically associated with CLRD visits. Increases in the 6-day moving average of sulfur dioxide (17.82µg/m3) and in the 4-day moving average of ozone (35.87µg/m3) increased CLRD emergency room visits in 18% and 14%, respectively. These results reinforce the idea that air pollution may promote adverse health effects in the elderly.
Journal of Occupational and Environmental Medicine, July 2002, Vol.44, No.7, p.622-627. Illus. 29 ref.

CIS 02-825 Hauptmann M., Pohlabeln H., Lubin J.H., Jöckel K.H., Ahrens W., Brüske-Hohlfeld I., Wichmann H.E.
The exposure-time-response relationship between occupational asbestos exposure and lung cancer in two German case-control studies
Numerous studies have been carried out to evaluate the association between lung cancer and occupational asbestos exposure. However, data are lacking on the effects of timing of the exposure. Two German case-control studies with data on occupational asbestos exposure histories were pooled. Duration of work in jobs with potential exposure to asbestos, derived exposure measures and the time lapsed since the last exposure were analyzed. The odds ratios (OR) were 1.8 and 2.4 for subjects having worked for 3 to 7 years and 8 or more years, respectively, in a job with potential asbestos exposure compared to those never exposed. Based on an evaluation of time since last exposure, the OR decreased significantly to about one half after more than 20 years since the exposure ceased. In contrast to previous indications, this study indicates that the risk of lung cancer increases soon after asbestos exposure, with its maximum effect from 10 to 15 years after the exposure was initiated.
American Journal of Industrial Medicine, Feb. 2002, Vol.41, No.2, p.89-97. Illus. 19 ref.

CIS 02-677 Boojar M.M.A., Goodarzi F.
A longitudinal follow-up of pulmonary function and respiratory symptoms in workers exposed to manganese
To study the effects on the respiratory system in mine workers with long-term exposure to manganese (Mn) in the workplace, a follow-up of pulmonary function and respiratory symptoms was carried out among 145 workers employed in a large manganese mine and 65 matched controls. Lung function was measured by recording spirometric parameters. The Mn-exposed workers reported more respiratory symptoms and a significantly higher prevalence of all grades of pulmonary function impairment. All predicted symptoms except for asthma increased significantly in the current smoking group compared with the non-smoking group. There was a significant decrease in FEV1, FVC, and FEV1% values in exposed workers at stages 2 and 3, with an additive effect of the smoking habit. The Mn concentrations in blood, urine, and hair were significantly higher in the exposed workers. The level of cumulative exposure index of workplace Mn was notable and did not change significantly over this study.
Journal of Occupational and Environmental Medicine, Mar. 2002, Vol.44, No.3, p.282-290. 42 ref.

CIS 02-733 Wouters I.M., Hilhorst S.K.M., Kleppe P., Doekes G., Douwes J., Peretz C., Heederik D.
Upper airway inflammation and respiratory symptoms in domestic waste collectors
In a cross sectional study among 47 waste collectors and 15 controls, questionnaire data on respiratory symptoms were collected. Nasal lavage (NAL) was performed before and after a work shift at the beginning and at the end of the working week. In NAL fluid, cells were counted and differentiated and concentrations of interleukin 6 and 8 (IL6, IL8), tumour necrosis factor-α (TNFα), and IL1β were measured. In collectors, inhalable dust samples were collected in which bacterial endotoxin and mould β(1⇒3)-glucan were assessed. Waste collectors show signs of increased upper airway inflammation and respiratory symptoms compared with controls. Geometric mean exposure concentrations were 0.58mg/m3 for dust, 39EU/m3 for endotoxin, and 1.3µg/m3 for β(1⇒3)-glucan. At the end of the week collectors had higher concentrations of total cells and IL8 in NAL before and after a shift than controls. However, concentrations of IL6, TNFα, and IL1β were not associated with symptoms or exposure.
Occupational and Environmental Medicine, Feb. 2002, Vol.59, No.2, p.106-112. Illus. 38 ref.

CIS 02-806 Wild P., Leodolter K., Réfrégier M., Schmidt H., Zidek T., Haidinger G.
A cohort mortality study and nested case-control study of French and Austrian talc workers
The mortality of two historical cohorts comprised of male subjects who had worked for at least one year in talc producing companies in France and Austria was compared with local death rates. Case-control studies focusing on respiratory diseases were set up to estimate possible dose-response relations with estimated cumulative exposure to talc dust. Mortality from lung cancer was in small excess in both cohorts (France, standardized mortality ratio (SMR) 1.23, 21 cases observed, Austria SMR 1.06, seven cases observed). The case-control study of non-malignant respiratory disease showed an increased mortality in the highest exposure groups (odds ratio (OR) 2.5 for a cumulative exposure ≥800 with a significant trend (OR/100 1.08) with cumulative exposure to talc. However, no increasing trend could be found in the case-control study of lung cancer. Adjustment for smoking and exposure to quartz had no significant influence on the results.
Occupational and Environmental Medicine, Feb. 2002, Vol.59, No.2, p.98-105. 29 ref.


CIS 03-1173 Huuskonen O., Kivisaari L., Zitting A., Taskinen K., Tossavainen A., Vehmas T.
High-resolution computed tomography classification of lung fibrosis for patients with asbestos-related disease
This study tested a new high-resolution computed tomography (HRCT) scoring method for asbestos-induced parenchymal changes in the lung. HRCT scans of 602 asbestos-exposed workers and 49 referents were reviewed by three radiologists. The HRCT fibrosis score (from 0 to V) was compared with the radiographic classification of the ILO. All the specified computed tomography findings explained 86% of the variance in the HRCT fibrosis score. Age and occupational group were significant predictors of fibrosis. The sensitivity (70%) and specificity (91%) of the HRCT fibrosis score (classes I/II-V representing asbestosis) were better than those of the ILO classification. The examined HRCT scoring method proved to be a simple, reliable, and reproducible method for classifying lung fibrosis and diagnosing asbestosis also in large populations with occupational disease, and it would be possible to use it as a part of an international classification.
Scandinavian Journal of Work, Environment and Health, Apr. 2001, Vol.27, No.2, p.106-112. Illus. 29 ref.

CIS 03-725 McDonald J.C., Edwards C.W., Gibbs A.R., Lloyd H.M., Pooley F.D., Ross D.J., Rudd R.M.
Case-referent survey of young adults with mesothelioma: II. Occupational analyses
This study was aimed at the identification of occupations with an increased risk of developing mesothelioma in persons aged 50 years or less, and at the matching up of these occupations with lung tissue concentration of asbestos fibres by type. Eligible cases were sought from recent reports by chest physicians to the SWORD occupational disease surveillance scheme. Work histories were obtained for 115 men and 13 women. Lung tissue samples were obtained at autopsy from 69 male and four female cases, and mineral fibres identified, sized and counted by electron microscopy. Of 37 industrial occupations analysed, odds ratios were significantly raised in eight: five in the construction industry and the others in shipbuilding, the manufacture of cement products and the manufacture of non-metallic mineral products (including asbestos). Mesothelioma in this young age group is concentrated among carpenters, plumbers, electricians and insulators in the construction industry, and is mainly attributable to amphibole exposure. Work in shipbuilding and manufacture of mineral products was less important than in earlier studies. See also CIS 03-724.
Annals of Occupational Hygiene, Oct. 2001, Vol.45, No.7, p.519-523. 6 ref.

CIS 03-724 McDonald J.C., Armstrong B.G., Edwards C.W., Gibbs A.R., Lloyd H.M., Pooley F.D., Ross D.J., Rudd R.M.
Case-referent survey of young adults with mesothelioma: I. Lung fibre analyses
The study was aimed at the determination of lung tissue concentration of asbestos and other mineral fibres by type and length in persons with mesothelioma aged 50 years or less at time of diagnosis, compared with controls of similar age and geographical region. In this age group, it was thought that most work-related exposures would have been since 1970, when the importation of crocidolite, but not amosite, into the United Kingdom was virtually eliminated. Eligible cases were sought from recent reports by chest physicians to the SWORD occupational disease surveillance scheme. Lung tissue samples were obtained at autopsy from 69 male and four female cases, and mineral fibres identified, sized and counted by electron microscopy. Unadjusted and adjusted odds ratios increased steadily with concentration of crocidolite, amosite, tremolite and all amphiboles combined. In this young age group, amosite and crocidolite fibres could account for about 80% of cases of mesothelioma, and tremolite for some 7%. Contrary to expectation, however, some 90% of cases were in men who had started work before 1970; this was so whether or not amosite or crocidolite was found in lung tissue. See also CIS 03-725.
Annals of Occupational Hygiene, Oct. 2001, Vol.45, No.7, p.513-518. 15 ref.

CIS 03-648 Elci O.C., Dosemeci M., Blair A.
Occupation and the risk of laryngeal cancer in Turkey
Among 7631 cancer cases seen at an oncology treatment centre between 1979 and 1984, 958 laryngeal cancer cases were identified among men. Occupational history, tobacco and alcohol use, as well as demographic data were obtained from patients with a standardized questionnaire. Excess odds ratios (ORs) of laryngeal cancer occurred among guards (OR 1.5), production supervisors (OR 1.8), textile workers (OR 1.9), drivers (OR 1.7), construction workers (OR 1.7), workers in grain mills (OR 3.1), trade unions (OR 3.6) and local government services (OR 4.7). Supraglottic laryngeal cancer was excessive among the textile workers, construction workers, and local government labourers, all with potential dust exposure.
Scandinavian Journal of Work, Environment and Health, Aug. 2001, Vol.27, No.4, p.233-239. Illus. 43 ref.

CIS 02-1681 Farruggia E., Bellia M.
Occupational allergic asthma in greenhouse cultivation: Description of a clinical case
Asma occupazionale allergica in colture protette. Descrizione di un caso clinico [in Italian]
Case of occupational allergic asthma observed in a greenhouse worker. Colonies of Aspergillus niger were identified on the plants cultivated in the greenhouse, and the mould proved to be the aetiologic agent responsible of the asthma. Allergy tests were conducted for the diagnostic procedure.
Medicina del lavoro, May-June 2001, Vol.92, No.3, p.203-205. 11 ref.

CIS 02-1649 Merler E., Gioffrè F., Rozio L., Bizzotto R., Mion M., Sarto F.
Pleural mesothelioma among women in the Veneto region with past work as rag sorters for textile recycling and paper production
Mesoteliomi pleurici insorti in donne, residenti in Veneto, addette alla cernita di stracci presso "robe vecchie" e cartiere [in Italian]
A report of 9 cases of mesothelioma diagnosed among Italian women, whose only activity that could have involved exposure to asbestos had been as rag sorters. They had worked in textile recycling (8 cases) and in a paper mill (1 case) where cotton was used for paper production.
Medicina del lavoro, May-June 2001, Vol.92, No.3, p.181-186. 24 ref.

CIS 02-1931 Belisario A., Cipolla C., Nucci C., Auletti G., Nobile M., Raffi G.B.
Four-year follow-up of a group of workers with allergic sensitization employed in breeding of insects for biological pest control
Follow-up di 4 anni in un gruppo di lavoratori con sensibilizzazione allergica addetti alla produzione di insetti per la lotta biologica [in Italian]
As a follow-up to preventive measures (semi-closed cycles, gloves, masks, overalls and sunglasses) implemented after previous reports of sensitization, workers employed in insect breeding were monitored through allergy and respiratory function tests. A decrease in skin sensitization for insects and a decrease in allergic conditions (rhinoconjunctivitis and asthma) were found. The application of preventive measures is vindicated.
Medicina del lavoro, Mar.-Apr. 2001, Vol.92, No.2, p.125-129. Illus. 20 ref.

CIS 02-1889 Becker K.
How much protection against radon do we need?
It has been long established that exposure to radon contributed to lung cancer risk among miners in the past. However, based on recent epidemiological data that the author considers controversial, regulators currently favour linear extrapolation from the very high exposures encountered in mining to low residential radon exposures. Direct and indirect evidence are reviewed and it is argued that this approach may be misleading due to various perturbing factors, in particular the retrospective determination of smoking habits.
Central European Journal of Occupational and Environmental Medicine, 2001, Vol.7, No.3-4, p.168-177. Illus. 19 ref.

CIS 02-1248 Fishwick D., Allan L.J., Wright A., Barber C.M., Curran A.D.
Respiratory symptoms, lung function and cell surface markers in a group of hemp fiber processors
Lung function and immunological changes associated with hemp dust exposure were studied in 11 male hemp processors with a mean age of 43 years. All workers were subjected to a questionnaire, lung function testing including FEV1 and blood analyses. In total, seven workers (64%) complained of at least one respiratory symptom (one with byssinosis). The mean percentage predicted FEV1 was 91.5, FVC 97.7, PEF 92.1, and FEF25-75 79.5. Serial FEV1 measurements in the two workers with work-related respiratory symptoms revealed a mean change in FEV1 on the first working day of -12.9%. This contrasted with +6.25% on the last working day. Respective values for two workers without work-related symptoms were -1.4 and +3.2 %. Lung function changes and abnormalities in a profile of cell surface activation markers and antibodies related to the presence of work-related respiratory symptoms were not seen in the control group.
American Journal of Industrial Medicine, Apr. 2001, Vol.39, No.4, p.419-425. Illus. 17 ref.

CIS 02-1319 Borak J., Diller W.F.
Phosgene exposure: Mechanisms of injury and treatment strategies
The study summarizes recent findings on the mechanisms of phosgene-induced pulmonary oedema and provides an approach to the treatment of phosgene exposure victims.
Journal of Occupational and Environmental Medicine, Feb. 2001, Vol.43, No.2, p.110-119. Illus. 82 ref.

CIS 02-1228 Burton W.N., Connerty C.M., Schultz A.B., Chen C.Y., Edington D.W.
Bank One's worksite-based asthma disease management program
Although the value of patient education in the management of asthma is well demonstrated, management programmes generally have not been offered at the workplace. Employees with asthma were identified in a US bank and 76 participated in a worksite asthma disease programme. As outcome, significantly more employees reported using controller medications (to prevent an attack) than reliever medications (to respond to an attack). Similar programmes for asthma should reduce medical care costs, absenteeism and improve worker productivity.
Journal of Occupational and Environmental Medicine, Feb. 2001, Vol.43, No.2, p.75-82. Illus. 23 ref.

CIS 02-1227 Korhola O., Hiltunen A., Karjalainen A., Martikainen R., Riihimäki H.
Association between pleural plaques and coronary heart disease
Chest X-rays from 148 patients referred for coronary angiography and from 100 consecutive lung cancer patients were analysed for the presence of calcified pleural plaques according to the classification of the International Labour Office. The prevalence of pleural plaques was 35% for the coronary patients and 19% for the lung cancer patients. The plaques were more common among men than women and the risk increased with age. Further studies on past exposure to asbestos and other potential risk factors are warranted to confirm these observations concerning the association between coronary heart disease and calcified pleural plaques.
Scandinavian Journal of Work, Environment and Health, Apr. 2001, Vol.27, No.2, p.154-155. 6 ref.

CIS 02-1245 Kimbell-Dunn M.R., Fishwick R.D., Bradshaw L., Erkinjuntti-Pekkanen R., Pearce N.
Work-related respiratory symptoms in New Zealand farmers
A questionnaire survey of respiratory diseases was addressed at 2,203 New Zealand farmers. Breathing problems at work were reported by 17.6% of the responders, in particular by those working with oat. Dyspnoea was more common in female farmers, chronic bronchitis in males. Organic Dust Toxic Syndrome/Farmer's Lung was reported by 7% of workers. Risk factors for all respiratory symptoms were the presence of hay fever, eczema and smoking.
American Journal of Industrial Medicine, Mar. 2001, Vol.39, No.3, p.292-300. 44 ref.

CIS 02-1367 Vanhanen M., Tuomi T., Tiikkainen U., Tupasela O., Tuomainen A., Luukkonen R., Nordman H.
Sensitization to enzymes in the animal feed industry
To assess the prevalence of enzyme sensitization in the animal feed industry in Finland, a cross-sectional study was conducted in four animal feed factories, where several enzymes had been used in powder form for 7-9 years. 218 workers were tested, including 140 employed in various manufacturing tasks where exposure to various organic dusts and to enzymes was possible, together with 78 non-exposed office workers. The workers were interviewed for work-related respiratory and skin symptoms. Enzyme concentrations in the air varied from less than 0.8ng/m3 up to 16ng/m3 for xylanase, from less than 20ng/m3 up to 200 ng/m3 for α-amylase, and from less than 0.4ng/m3 up to 2900ng/m3 for protease. Ten workers were sensitized to enzymes in the exposed group of 140, whereas none were sensitized in the non-exposed group. Six of the sensitized workers had respiratory symptoms at work, of which two especially in connection with exposure to enzymes.
Occupational and Environmental Medicine, Feb. 2001, Vol.58, No.2, p.119-123. 16 ref.

CIS 02-1453 Eduard W., Douwes J., Mehl R., Heederik D., Melbostad E.
Short term exposure to airborne microbial agents during farm work: Exposure-response relations with eye and respiratory symptoms
Airborne exposure to microbial agents of 106 Norwegian farmers and their spouses was measured while carrying out specific tasks. Fungal spores, bacteria, endotoxins, β(1-3)-glucans, fungal antigens specific for Penicillium and Aspergillus species, and mites were measured by methods not based on microbial cultures. Also silica, inorganic and organic dust, ammonia, hydrogen sulfide and nitrogen dioxide were measured. Respiratory, nose and eye symptoms experienced during measurements were recorded by a short questionnaire. Prevalences of work related symptoms were: wheezing 3%; chest tightness 7%; cough 14%; eye symptoms 18%; nose symptoms 22%. Prevalence ratios for nose and eye symptoms were 4-8 after exposure to 20-500x103 fungal spores/m3 and higher, and a prevalence ratio for cough was 4 after exposure to 500-17,000x103 fungal spores/m3. Nose symptoms were also associated with exposure to silica with prevalence ratios of 4-6 after exposure to 0.015-0.075mg/m3 and higher.
Occupational and Environmental Medicine, Feb. 2001, Vol.58, No.2, p.113-118. 29 ref.

CIS 02-828 Iwatsubo Y., Pairon J.C., Boutin C., Menard O., Massin N., Caillaud D., Orlowski E., Galateau-Salle F., Bignon J., Brochard P.
Dose-response relationship between low levels of asbestos and pleural mesothelioma - Population-based case-control study in France
Relation dose-effet entre faibles niveaux d'exposition à l'amiante et mésothéliome pleural - Etude cas-témoins en population générale française [in French]
The relationship between prior occupational exposure to asbestos and pleural mesothelioma was studied in 405 cases and 387 controls among hospital patients between 1987 and 1993. Exposure to asbestos fibres was evaluated by a group of experts in terms of the probability, intensity and frequency of exposure. Among men, the odds ratio (OR) increased with probability of exposure from 1.2 for possible exposure to 3.6 for cases where exposure was certain. A dose-effect relationship was observed with the cumulative exposure index: the OR increased from 1.2 for the least-exposed category to 8.7 for the most-exposed category. Among women, the OR was 18.8 for cases where exposure was possible or certain. This study enabled the highlighting of a clear relationship between cumulative exposure to asbestos and pleural mesothelioma. A significant excess of mesothelioma was observed for exposure levels that were probably far below the limits adopted by most industrialized countries during the 1980s.
Cahiers de notes documentaires - Hygiène et sécurité du travail, 4th Quarter 2001, No.185, p.7-16. 52 ref.

CIS 02-672 Daly L., Nouaigui H., Hammadi M., Rammeh H., Ben Laïba M.
Occupational asthma
L'asthme professionnel [in French]
Contents of this review article on occupational asthma: definitions; epidemiology; pathophysiological and pathogenic mechanisms (with and without latency period); aetiology; diagnosis; evolution and prognosis; prevention; compensation. Tables include lists of the most important allergens of plant, animal and synthetic origin, incidence rates by occupation, classification system for asthma according to severity and compensation of occupational asthma by allergen under Tunisian legislation.
SST - Santé et Sécurité au Travail, Oct. 2001, No.19, p.2-20. Illus. 10 ref.

CIS 02-704 Ascoli V., Calisti R., Carnovale-Scalzo C., Nardi F.
Malignant pleural mesothelioma in bakers and pastry cooks
The occurrence of malignant pleural mesothelioma (MPM) among bakers and pastry cooks has never been documented. This article describes eight cases of MPM in bakers, pastry cooks, and biscuit cooks engaged in making, baking/cooking and selling pastry/bread in two hospital-based series in Italy totaling 222 cases during the period from 1990 to 1997. Field investigations revealed asbestos-containing material in ovens for baking bread manufactured prior to the 1980s. It is suggested that there is a possible new association between the occupations of baker/pastry cook and malignant pleural mesothelioma. The presumptive sources of asbestos are the asbestos-insulated ovens.
American Journal of Industrial Medicine, Oct. 2001, Vol.40, No.4, p.371-373. 12 ref.

CIS 02-823 Liss G.M., Tarlo S.M.
Natural rubber latex-related occupational asthma: Association with interventions and glove changes over time
Until 1999, there were 60 compensated claims for occupational asthma following exposure to latex in the Canadian province of Ontario. Of these, 49 were among health care workers (HCWs). The number of claims among HCWs varied between zero and two per year up to 1990, increased to between seven and eleven per year from 1991 to 1994 and declined to three per year in 1995-1996 and to between one and two per year in 1997-1999. In eight of the ten institutions having two or more occupational asthma latex claims, all claims occurred in 1996 or earlier. At the largest hospital, there were five accepted claims between 1993 and 1995. These findings suggest that despite the effect of increasing recognition of latex-related occupational asthma, the introduction of gloves with reduced powder or protein, and other interventions have resulted in actual declines the number of cases.
American Journal of Industrial Medicine, Oct. 2001, Vol.40, No.4, p.347-353. Illus. 24 ref.

CIS 02-737 Austin C.C., Dussault G., Ecobichon D.J.
Municipal firefighter exposure groups, time spent at fires and use of self-contained-breathing-apparatus
The objective of this study was to develop better estimates of firefighter exposures for use in future epidemiological studies. The study population consisted of the 1883 firefighters of the fire department of the city of Montreal. The storage and distribution of self-contained-breathing-apparatus (SCBAs) were tracked for 12 months. Time spent at fires and use of SCBAs were calculated. Eight firefighter exposure groups were identified (based on job title, assignment to a fire district and time spent at fires), ranging from no exposures to 3,244min/year/firefighter. SCBAs appear to have been used for approximately 50% of the time at structural fires but for only 6% of the time at all fires. Failure of previous studies to identify homogeneous exposure groups may have resulted in misclassification and underestimates of health risks. The approach used in this study should facilitate the highlighting of exposure/response relationships in future epidemiological studies.
American Journal of Industrial Medicine, Dec. 2001, Vol.40, No.6, p.683-692. Illus. 37 ref.

CIS 02-846 Cocco P., Rice C.H., Chen J.Q., McCawley M.A., McLaughlin J.K., Dosemeci M.
Lung cancer risk, silica exposure, and silicosis in Chinese mines and pottery factories: The modifying role of other workplace lung carcinogens
To explore whether exposure to other lung carcinogens, or clinical features of silicosis, modify or confound the association between silica and lung cancer, data from a nested case-control study conducted in the late 1980s in 29 Chinese mines and potteries were used. The were 316 lung cancer cases and 1,356 controls, matched by decade of birth and facility type. Pooling the 29 work sites, the study showed a moderate association between lung cancer risk and silica exposure. Risk did not vary after excluding subjects with silicosis or adjusting the risk estimates by radiological staging of silicosis. The results suggest that numerous occupational and non-occupational risk factors interact in a complex fashion to modify lung cancer risk.
American Journal of Industrial Medicine, Dec. 2001, Vol.40, No.6, p.674-682. 32 ref.

CIS 02-771 Debbabi F., Mrizek N., Tabka Z., Choudat D., Zebidi A., Conso F.
Rhinitis and respiratory disorders due to cotton dust in a textile mill in Monastir (Tunisia)
Pathologie nasale et respiratoire liée à la poussière de coton dans une entreprise textile à Monastir (Tunisie) [in French]
A transversal epidemiological study was conducted in a textile mill to determine the prevalence of nasal and broncho-pulmonar symptoms, and to establish the relationship with exposure to dust. The study population consisted of 183 workers, of whom 52% were employed in cotton and acrylic fibre spinning, 25% in weaving, 8% in garment manufacturing, 5.5% in dyeing and 9.5% in administration. The investigations included a standardized questionnaire, environmental assessments with dust measurement in the different units of the factory, pulmonary function tests and rhinomanometry. It was found that dust levels were high throughout the mill, and particularly so in the spinning area. A decrease in spirometric values was observed in 21.5% of the workers. The prevalence of nasal obstruction determined by rhinomanometry was high (68.8%), but in 53.5% of the cases the workers had no clinical symptoms of rhinitis.
Archives des maladies professionnelles et de médecine du travail, Dec. 2001, Vol.62, No.8, p.621-625. 17 ref.

CIS 02-817 Bianchi C., Brollo A., Ramani L., Bianchi T., Giarelli L.
Asbestos exposure in malignant mesothelioma of the pleura: A survey of 557 cases
A series of 557 cases of malignant pleural mesothelioma diagnosed in the Trieste-Monfalcone area, Italy, in the period 1968-2000 was reviewed. The cases included 492 men and 65 women, aged between 32 and 93 years. Necropsy findings were available in 456 cases (82%). Occupational histories were obtained from the patients or their relatives. Routine lung sections were examined for asbestos bodies in 442 cases. In 109 cases isolation and counting of asbestos bodies were performed. A majority of people had histories of working in shipyards. Asbestos bodies were observed in lung sections in 67% of the cases. Latency periods (time intervals between first exposure to asbestos and death) ranged between 14 and 75 years. Latency periods among insulators and dock workers were shorter than among the other categories. High asbestos consumption occurred in many countries in the 1960s and in the 1970s. The data on latency periods obtained in the present study suggest that a world mesothelioma epidemic is to be expected in the coming decades.
Industrial Health, Apr. 2001, Vol.39, No.2, p.161-167. 32 ref.

CIS 02-816 Morinaga K., Kishimoto T., Sakatani M., Akira M., Yokoyama K., Sera Y.
Asbestos-related lung cancer and mesothelioma in Japan
In Japan, crocidolite used to be used for asbestos cement pipes, and amosite was used for building boards; both types were used in spraying applications. The use of these two types of asbestos was discontinued in Japan in the late 1970s. A strong increase in asbestos imports was observed between 1960 (77,000 tons) and 1974 (352,316 tons). This rise in imports correlates well with the recent rapid increase in mortality from malignant pleural mesothelioma. Between 1995 and 1999, the estimated mean annual deaths from pleural mesothelioma was about 500. The annual number of compensated occupational respiratory cancers due to asbestos exposure has also been increasing. Up to the end of March 2000, 162 cases with malignant mesothelioma and 197 cases with lung cancer were compensated. The smoking rate among males in Japan is still over 50%, so lung cancer deaths caused by the interaction between smoking and asbestos exposure are likely to continue.
Industrial Health, Apr. 2001, Vol.39, No.2, p.65-74. Illus. 63 ref.

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