Environmental exposure to tremolite and respiratory cancer in New Caledonia: a case-control Study
Résumé
Acase-control study on respiratory cancers was conducted ni New Caledonia (South Pacific), wherea high incidence of malignant pleural mesothelioma had been observed. The disease pattern suggested an environmental exposureto asbestos.The first results showed that, insome areas, tremolite asbestosderived from local outcroppings was used as whitewash (locally named "pö"). Al cases diagnosed between 1993 and 1995 (including 15 pleural mesotheliomas, 228 lung cancers, and23 laryngeal cancers) and 305 controls were included inthe study. Detailed information on past orpresent use of the whitewash, residential history, smoking, diet, and occupation was collected.The risk of mesothelioma was strongly associated with the use of the whitewash (odds ratio (OR) =40.9; 95% confidence interval (CI):5.15, 325).Al Melanesian cases had been exposed. AmongMelanesian women, exposure tothe whitewash was associated with an increasedrisk oflung cancer (OR =4.89; 95% Cl: 1.13, 21.2), and smokers exposed topö had an approximatelyninefold risk (OR = 9.26; 95% Cl: 1.72, 49.7) compared with women who never smoked and had never used the whitewash. In contrast, no association was noted between exposure to po and lung cancer risk among Melanesian men, probably because of lower exposure levels. Among non-Melanesians, the numbers ofexposedsubjects were 100smalltoassesstheeffectofexposuretopo.Therewasnoindicationofelevatedrisksfortheothercancel sites.
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