PERITONEAL CANCER AND OCCUPATIONAL EXPOSURE TO ASBESTOS - RESULTS FROM THE APPLICATION OF A JOB-EXPOSURE MATRIX

Background Because of the rarity of peritoneal mesothelioma, occupatio nal risks associated with it have seldom been studied particularly amo ng women. In this respect, death certificates databases may provide nu mbers large enough for analysis, although the international Classifica tion of Diseases, 9th revision (ICD-9) does not single out mesotheliom a from the rest of peritoneal cancers. The aim of this paper is twofol d: to explore occupational risks of peritoneal cancer among men and wo men, and to test the performance of a job-exposure matrix in detecting its association with asbestos exposure using the occupation and indus try reported in the death certificate. Methods From a large database c ontaining information on the 1984-1992 death certificates of 24 U.S. s tates, we identified 657 deaths from peritoneal cancer and 6,570 contr ols who died from non-malignant diseases, 1:10 matched by region, gend er race, and 5-year age group. Results Occupations at risk included in sulators among men, and machine operators among women. Among men, we f ound a significant increase in risk associated with employment in manu facturing industries, such as industrial and miscellaneous chemicals; miscellaneous nan-metallic mineral and stone products; construction an d material handling machines; and electrical machinery equipment, and supplies; as well as in services to dwellings and other buildings. Ind ustries at increased risk among women included elementary and secondar y schools; miscellaneous retail stares; and publishing and printing. O ur job-exposure matrix classified 17 male cases and 3 controls in the high probability category of exposure to asbestos (OR = 61.6). Among m en, risk of peritoneal cancer increased significantly by probability a nd intensity of exposure to asbestos. No such pattern was observed amo ng women. The job-exposure matrix did not classify any female subjects in the high probability or intensity of asbestos exposure. Discussion This study provides evidence that death certificate data and job-expo sure matrices are useful tools to observe well-established association s, such as the one existing between peritoneal cancer and asbestos exp osure among men, in spite of crude information disease misclassificati on, and occupational misclassification. These factors are more likely to preclude meaningful results among women. Am. J. Ind. Med. 35:9-14, 1999. Published 1999 Wiley-Liss, Inc.dagger