Document 93MOrG85JQv5x23kjK261MG16

ASBESTOS EXPOSURE-SELIKOFF ET AL 107 293 men had first been ex posed between the be Table 1.--Subjects Classified by Age as of Jan 1. 1963. and by Years From First Occupational Exposure to Asbestos Dust up to Jan 1. 1963 ginning of 1923 and the end of 1942. All of these men were successfully traced through Dec 31, 1962, and 262 of them were found to have died Age, Yr 35-39 40-44 45-49 50-54 55 59 Total No. of Subfects 2 13 32 109 60 20-24 2 12 17 No. of Years Since First Exposure to Asbestos 25-29 2 30-34 13 80 16 35-39 28 34 40-44 .. 8 4549 ... ... so+ _No. of 52 Mo' 1 2 18 11 up to that time. Of the 262 deaths, seven oc curred prior to the 20th anniversary of the man's 60-64 65-69 70-74 75-79 BO-84 42 49 38 21 4 3 11 19 8 16 1 10 18 18 2 17 3 . . ... ... 12 1 1 6 17 18 5 15 8 1 23 first exposure to asbestos Total 370 31 6 113 86 59 39 36 94 dust and 255 occurred after the 20th anniver sary. Thus, of the 632 men, 370 were still living on Jan 1, 1963. These 370 men were Table 2.--Subjects Classified by Age and by Smoking Habits on or about Jan 1, 1963 Age. Yr 35-39 Tout No. 2 Never Smoked Regularly 1 Cigar Only ... cigarette Smokers* 1 Current Cigarette Smokers* 1-9 a Day 10-19 a Day 20-39 a Oay 40+ a Day the subjects of the pres 40-44 4549 13 32 2 2 ent investigation. Table 1 50-54 109 12 2 15 6 26 3 54 12 12 5 33 24 shows their age distribu 55-59 60 6 5 16 3 20 10 tion as of Jan 1, 1963, 60-64 65-69 42 7 49 6 4 15 8 17 1 11 49 4 S and the lapsed time from 70-74 38 7 7 12 1 4 4 3 first exposure up to that 75-79 21 3 7 6 date. All of them have 80-84 42 1 1 13 1 ... been traced, and 94 of Total 370 48 39 101 5 17 97 63 them were found to have Includes cigarette smokers who also smoked pipes or cigars. died during the four-year and four-month interval from Jan 1, 1963, to April 101 were excigarette smokers, five currently smoked 30, 1967. one to nine cigarettes a day, 17 smoked 10 to 19 Beginning in October 1962, we made arrange cigarettes a day, 97 smoked 20 to 39 cigarettes a ments to examine these men periodically, once day, and 63 smoked 40 or more cigarettes a day. every six to twelve months; the interval depended The smoking habits of the 370 subjects were upon age and physical condition. The examinations compared with the smoking habits of a large num include chest x-ray films as well as physical ex ber of men selected from the general population/ amination and cover past and present smoking There were proportionally more cigarette smokers habits, occupational history, medical history, and among the 370 subjects than were found in the current physical complaints. Altogether, we have general population sample; age was taken into examined 338 (91.4) of the men at least once consideration. and have repeatedly examined most of those who Causes of Death.--A copy of the death certificate are still living. was obtained for each of the 94 deaths. In addi Information on smoking habits was obtained by tion, we examined hospital records, postmortem personal interview with the 338 men who were ex findings (41 cases), as well as the surgical and amined. Of the 32 men who were not examined, pathologic reports when surgery was performed (39 six told us their smoking habits by telephone and cases). We also reexamined histologic specimens. five gave us the information by mail. The local It was found that the death certificate was inac union secretaries (who personally knew these men curate in 14 instances. However, this did not alter well) ascertained the smoking habits of 18 men, the picture as much as might have been expected and family members supplied the information on since there were several compensating errors. For the remaining three men. This accounts for all of example, in one instance the death certificate in the 370 men. Table 2 shows their smoking habits dicated bronchogenic carcinoma as the cause of on or about Jan 1, 1963, the men being classified death while a review of the histologic specimen by their ages on that date, even though some showed that death was due to pleural mesothe changed their smoking habits between 1963 and lioma; but in another instance exactly the reverse 1967. was found. Likewise, review in one instance, re Of the 370 men, 48 never smoked regularly, 39 sulted in changing the reported cause of death smoked or had smoked pipes or cigars but never from bronchogenic carcinoma to cancer of the smoked cigarettes regularly, and 283 had smoked stomach with metastasis to the lungs while review cigarettes regularly. Some of those with history of in another instance resulted in exactly the oposite cigarette smoking also smoked pipes or cigars. Of change. The 9^ deaths were ascribed to the follow the 283 with a history of regular cigarette smoking, ing causes: bronchogenic carcinoma, "24; pleural JAMA, April 8. 1968 Vol 204. No 2 p 105 FOS 0009339