Occupation and risk of malignant pleural mesothelioma: A case-control study in Spain

Background The association of mesothelioma and asbestos exposure is well kn own, but some data suggest that probably many people are still being expose d to asbestos without knowing it. Methods Between 1993 and 1996 132 cases (77% males) of histologically confi rmed malignant pleural mesothelioma and 257 controls, residents in two prov inces of Spain (Barcelona and Cadiz), were interviewed. They were classifie d according to their probability and intensity of occupational asbestos exp osure by a panel of industrial hygienists, based on a detailed occupational history Results Age and sex-adjusted odds ratio (OR)for the highest probability of exposure to asbestos was 13.2 (95% confidence interval 6.4-27.3), and 27.1 (9.28-79.3)for high intensity. A dose-response trend was observed for both, probability and intensity Overall, 61 % of cases and 42 % of controls had ever worked in an occupation with risk of asbestos exposure, with an OR of 2.59 (1.60-4.22). In our population 62% of cases could be attributed to occ upational asbestos exposure. Conclusion A high risk of pleural mesothelioma due to occupational asbestos exposure is confirmed, but there is still a sizeable proportion for which no evidence of occupational exposure was found. Most of these cases could b e due to other sources of asbestos exposure, mainly domestic or environment al. (C) 2000 Wiley-Liss, Inc.