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.