Case-referent survey of young adults with mesothelioma: II. Occupational analyses

Objectives: Our study aimed to identify occupations at increased risk of de veloping mesothelioma in persons aged 50 yr or less, and to relate these oc cupations to lung tissue concentration of asbestos fibres by type. In this age group it was thought that most, but not all, work-related exposures wou ld have been since 1970, when the importation of crocidolite, but not amosi te, was virtually eliminated. Methods: Eligible cases were sought from recent reports by chest physicians to the SWORD occupational disease surveillance scheme. Work histories were obtained for 115 men and 13 women, usually with the help of the chest phys icians or coroners. Jobs were coded by the Office of National Statistics, s o that the observed years spent in each occupation could be compared with e xpected values from census data, 1960-90. Lung tissue samples were obtained at autopsy from 69 male and four female cases, and mineral fibres identifi ed, sized and counted by electron microscopy. Results: Of 37 industrial occupations analysed, odds ratios were significan tly raised in eight: five in the construction industry and the others in sh ipbuilding, the manufacture of cement products and the manufacture of non-m etallic mineral products (including asbestos). The concentrations in lung o f crocidolite and amosite fibres, which together could account for 80-90% o f cases, did not differ between occupational categories; those for amosite were appreciably higher than for crocidolite. Tremolite fibres were rarely found. Conclusion: Mesothelioma in this young age group is dominated by carpenters , plumbers, electricians and insulators in the construction industry, and i s mainly attributable to amphibole exposure. Work in shipbuilding and manuf acture of mineral products was less important than in earlier studies. Cont rary to expectation, however, some 90% of cases were in men who had started work before 1970. (C) 2001 British Occupational Hygiene Society. Published by Elsevier Science Ltd. All rights reserved.