Abstract
Indonesia has limited data on asbestos-related diseases despite abundant use. This study investigated the risk of occupational asbestos exposure for lung cancer development, utilizing a hospital-based case-control study. Subjects were patients who received a thoracic CT scan at Persahabatan Hospital, Jakarta. The cases had primary lung cancer confirmed by histology, the controls were negative for lung cancer. The cumulative occupational asbestos exposure was calculated by multiplying the exposure intensity by the years of exposure. The exposure intensity was obtained by adopting the weighted arithmetic mean value of asbestos exposure from a job-exposure matrix developed in Korea. The primary data analysis was based on logistic regression. The study included 696 subjects, with 336 cases and 360 controls. The chance of lung cancer for subjects exposed to asbestos was doubled (OR = 2.04, 95% CI = 1.21–3.42) compared with unexposed, and subjects with a cumulative asbestos exposure of 10 fiber-years or more even showed an OR of 3.08 (95% CI = 1.01–9.46). The OR of the combined effect between smoking and asbestos was 8.7 (95% CI = 1.71–44.39); the interaction was consistent with an additive and multiplicative risk model. Asbestos exposure is associated with a higher chance of lung cancer. Improved policies are needed to protect the population from asbestos hazards.
Highlights
Lung cancer is the most common cancer in Indonesian men and the third most common in women, causing a total of 26,095 fatalities in 2018 [1]
Two subjects were excluded because of metastatic cancer from other organs to the lung, five subjects were suspected mesothelioma cases, three subjects were suspected asbestosis, and two subjects were suspected of interstitial lung diseases
The present study proves our hypothesis that exposure to asbestos is associated with an increased risk of lung cancer among Indonesian workers
Summary
This study was conducted at the National Respiratory Hospital, a 585 bed public hospital in Jakarta, Indonesia [16]. A case-control study was performed to identify the association between asbestos exposure and the risk of developing lung cancer. Inpatients and outpatients aged 35 years or older who had received a thoracic CT scan at the radiology department between May 2018 and August. The reasons for a thoracic CT scan were lung infection, mediastinal mass, lung nodule or mass, trauma, evaluation of pleural diseases and malignancies and other conditions. The cases had primary lung cancer confirmed by histology regardless of the type of cancer
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