Document 2Jbbm14VXwYeXByjD2zM7xdb

j06 Asbestos Exposure, Smoking, and Neoplasia In'hig ] Sclikoll, MD; . Citylei Hammond, ScD: and Jacob Churg, MD Asbestos insulation workers, as a group, have a high due to chance, the number of such deaths being risk of dying of bronchogenic carcinoma (about seven or small. During the latter part of the study, we ob eight times expected). We have observed 370 such work tained information on the smoking habits of most men from Jan 1, 1963 to April 30, 1967. Our findings of the survivors, but we could not obtain reliable indicate that asbestos exposure alone is not the entire information on the smoking habits of those who explanation. Of 87 noncigarette smokers, none died of had died at an earlier date. Therefore, we could bronchogenic carcinoma. Of 283 workmen with a history not at that time investigate death rates in rela of regular cigarette smoking, 24 died of bronchogenic tion to smoking habits and exposure to asbestos carcinoma, although only three were expected to die of dust which were considered both separately and this disease. Calculations suggest that asbestos workers jointly. who smoke have about 92 times the risk of dying of There is abundant evidence that cigarette smok bronchogenic carcinoma as men who neither work with ing leads to a high rate of death from lung cancer asbestos nor smoke cigarettes. We conclude that asbestos in the absence of occupational exposure to asbestos exposure should be minimized, that asbestos workers who dust.*' Our findings outlined above suggested (but do not smoke should never start, and that those now did not prove) that exposure to asbestos dust may smoking should stop immediately. lead to a high rate of death from lung cancer in the absence of cigarette smoking. If the latter be n 1964, we reported on deaths occurring between so, then the combined effect of both types of ex I Jan 1, 1943, and Dec 31, 1962, among 632 posure might or might not be equal to or greater members of the International Association of Heat than the sum of the two effects. On the other hand, and Frost Insulators and Asbestos Workers.* All it was possible that exposure to asbestos dust in of these men had been occupationally exposed to creases the risk of lung cancer among cigarette asbestos dust for many years. Their death rate smokers but does not lead to lung cancer among from lung cancer was found to be 6.8 times as high nonsmokers. as that reported for the general white male popu The present study was undertaken primarily lation of the United States during the same years, to investigate these possibilities. In addition, we with age taken into consideration. Three of the men died of diffuse pleural mesothelioma and one wished to obtain more information on the occur rence of mesothelioma and gastrointestinal cancer died of a neoplasm histologically suggestive of peri among asbestos workers. - toneal mesothelioma. This was of interest since mesothelioma is a very rare disease in the general Material population but is reported to be associated with From records of New York Local 12 and Newark, exposure to asbestos dust." In addition, their death NJ, Local 32 of the International Association of rate from cancer of the stomach, colon, and rectum Heat and Frost Insulators and Asbestos Workers, was higher than expected; but this may have been a list was made of every man who was a member From (he Deportment 0( Community Medicine. Mount Sinai School of Medicine iDrs. SelikoS anri'Churg). and the Depart of either one of these locals on Dec 31, 1942, or who joined between that date and Dec 31, 1962. ment of Epidemiology and Slatistics. American Cancer Socielv I Dr. Hammond), New York. Read before a joint meeting of the Section on Diseases of the Chest with the Section on Preventive Medicine and the American No one was omitted regardless of his subsequent work history. Personnel data from union records indicated that College of Chest Physicians at the 116lh annual convention of the American Medical Association. Atlantic City. NJ, June 19 1967 Reprint requests to Mount Sinai School of Medicine.' 100th of the 632 on the union rolls on Jan 1, 1943, 339 of the men had first been occupationally exposed Street and Filth Avenue. New York 10029 tDr. Selikofl). to asbestos dutft prior to 1922, and an- additional 104 P AMA. April 8. 1968 Vol 204. No 2 FOS 0009337 SCF-FA-6090 I