Occupational asbestos exposure and lung cancer: A systematic review of the lliterature
A partir d'une revue systématique de la littérature (21 études), cette étude fait le point sur une exposition professionnelle à l'amiante et le risque de cancer du poumon
Objectives: To evaluate the scientific literature concerning asbestos and lung cancer emphasizing low-level exposure. Methods: A literature search in PubMed and Embase resulted in 5,864 citations. Information from included studies was extracted using SIGN. Twenty one statements were evidence graded. Results: Histology and location are not helpful in differentiating asbestos-related lung cancer. Pleural plaques, asbestos bodies or asbestos fibers are useful as markers of asbestos exposure. The interaction between asbestos and smoking regarding lung cancer risk is between additive and multiplicative. Conclusions: The association between asbestos exposure and lung cancer risk is basically linear, but may level off at very high exposures. The relative risk for lung cancer increases between 1 and 4% per f-y/ml, corresponding to a doubling of risk at 25?100 f-y/ml. However, one high-quality case-control study showed a doubling at 4 f-y/ml.