Occupational exposure to asbestos is associated with increased mortality in men recruited for a population-based study in Germany

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. Conclusions 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.