Asbestos : selected cancers

SUMMARY 1 1 Introduction 13 Statement of Charge, 13 Current Legislation, 13 Overview of Patterns of Asbestos Use and Recognition of Its Health Consequences, 14 Committee’s Approach to Its Charge, 16 References, 17 2 Committee’s Approach to Its Charge and Methods Used in Evaluation 18 General Approach to Evidence Review, 18 Evidence Considered, 22 Criteria for Evidence Evaluation, 25 Methods Used for Quantitative Meta-Analysis, 36 Integration of Data, 43 References, 45 3 Background Information on Asbestos 49 Introduction, 49 “Fibrous” and “Asbestiform,” 50 Serpentine Asbestos (Chrysotile) Mineralogy, 52 Amphibole Asbestos Mineralogy, 55 Properties of Potentially Hazardous Fibrous Minerals, 57 References, 61 Contents 4 Exposure and Disposition 63 Exposure, 63 Dosimetry, 68 References, 77 5 Biological Aspects of Asbestos-Related Diseases 81 Asbestos-Related Pulmonary Diseases and Their Mechanisms, 81 Information from Animal Studies, 90 Biomarkers, 94 References, 96 6 Description of Epidemiologic Studies Included in Evidentiary Dataset 104 Cohort Studies, 104 Case-Control Studies, 140 Integration of Epidemiologic Evidence with Non-Epidemiologic Evidence, 144 References, 145 7 Pharyngeal Cancer and Asbestos 159 Nature of This Cancer Type, 159 Epidemiologic Evidence Considered, 161 Evidence Integration and Conclusion, 169 References, 170 8 Laryngeal Cancer and Asbestos 173 Nature of This Cancer Type, 173 Epidemiologic Evidence Considered, 175 Evidence Integration and Conclusion, 186 References, 188 9 Esophageal Cancer and Asbestos 193 Nature of This Cancer Type, 193 Epidemiologic Evidence Considered, 195 Evidence Integration and Conclusion, 198 References, 200 10 Stomach Cancer and Asbestos 203 Nature of This Cancer Type, 203 Epidemiologic Evidence Considered, 204 Evidence Integration and Conclusion, 211 References, 212 x CONTENTS 11 Colorectal Cancer and Asbestos 216 Nature of This Cancer Type, 216 Epidemiologic Evidence Considered, 217 Evidence Integration and Conclusion, 224 References, 226 12 Summary and Recommendations 230 Summary, 230 Recommendations, 232 APPENDIXES A Agendas of Public Meetings Held by the Committee on Asbestos: Selected Health Effects 233 B Lineage and Design Properties of Studies on Cohorts Informative for Selected Cancers 237 C Description of Case-Control Studies of All Selected Cancers as Related to Exposure to Asbestos 255 D Cohort Results Tables 271 E Case-Control Results Tables 297 F Initial Analyses of Available Data Concerning Cancers of the Colon and/or Rectum and Asbestos Exposure 309 G Committee on Asbestos: Selected Health Effects 323