For definition of Groups, see Preamble Evaluation.
Supplement 7: (1987) (p. 106)
A. Evidence for carcinogenicity to humans (sufficient)
Numerous reports from several countries have described cases or series of pleural and peritoneal mesotheliomas in relation to occupational exposure to various types and mixtures of asbestos (including talc containing asbestos), although occupational exposures have not been identified in all cases [ref: 1-21]. Mesotheliomas of the tunica vaginalis testis and of the pericardium have been reported in persons occupationally exposed to asbestos [ref: 22-24].
Environmental exposure either in the houses of asbestos workers or in the neighbourhood of asbestos mines or factories has been noted in some of the cases [ref: 1,2,4-6,9,11,25,26]. It has been estimated that a third of the mesotheliomas occurring in the USA may be due to nonoccupational exposure [ref: 27]. In a study from Israel, the incidence of mesothelioma was found to be higher among those born in the USA or in Europe relative to those born in Israel [ref: 9].
In some of these case reports and in other studies, asbestos fibres have been identified in the lung [ref: 5,6,11,28-32]. Amphibole fibres have usually predominated, but in a few cases mainly or only chrysotile fibres were found [ref: 6,28].
The long latency required for mesothelioma to develop after asbestos exposure has been documented in a number of publications [ref: 11,13,26,28,33-37]. An increasing proportion of cases has been seen with increasing duration of exposure [ref: 36].
A number of epidemiological studies of respiratory cancer and mesothelioma have been reported in relation to exposure to unspecified or complex mixtures of asbestos in shipyard work [ref: 38-45]. The risk ratio for lung cancer has usually been moderately increased, both in these studies and in studies on various other occupational groups with similarly job-related but unspecified or complex asbestos exposures [ref: 35,46-54]. Risk ratios of about 2-5 have been reported in some studies, but the ratio was considerably higher in one rather small study [ref: 55] and did not exceed unity in another [ref: 42]. In one study, individuals suffering from asbestosis had a considerably greater risk for lung cancer, with a risk ratio of 9.0 [ref: 56]. In some of the studies referred to, a number of mesotheliomas were also observed [ref: 41,42,44,47,51,53,55]. Abdominal mesotheliomas have sometimes been mistaken for pancreatic cancer [ref: 57]. Mesothelioma cases have been observed to have a relatively lower fibre content in the lungs than lung cancer cases [ref: 32].
Laryngeal cancer has been considered in two case-control studies, resulting in risk ratios of 2.4 and 2.3 that relate to shipyard work and unspecified exposure, respectively [ref: 40,58] A cohort study of insulation workers showed a relative risk of 1.9, based on nine cases [ref: 57]. A case series indicated a high frequency of exposure to asbestos, especially in low-grade smokers [ref: 59]. A risk ratio of 3.2 for laryngeal cancer was reported among chrysotile miners in an area with generally high incidence [ref: 60], but no increased risk was seen in a cohort of workers with exposure to crocidolite [ref: 61]. Two correlation studies have also indicated a relationship between laryngeal cancer and exposure to asbestos [ref: 39,62].
Mesotheliomas related to shipyard work and other exposures, including household contact with asbestos workers, have also been subject to epidemiological studies [ref: 36,63-67], resulting in risk ratios of about 3-15 in comparison with background rates not clearly referable to asbestos exposure.
Some studies have specifically considered environmental exposures with reference to mesotheliomas [ref: 66,67]. Three correlation studies and one case-control study considering exposure to piped drinking-water [ref: 68-71] did not show consistently increased risks for any type of cancer, whereas another study [ref: 72] considering chrysotile contamination mainly from natural sources gave some indication of an increase in the incidence of peritoneal and stomach cancers in persons of each sex, although no other cancer site was consistent in this respect.
Exposure to crocidolite has been studied with regard to risk of lung cancer [ref: 61,73-76], and risk ratios of about 2-3 have been reported. Three lung cancers and two mesotheliomas occurred in 20 individuals after one year of high exposure to crocidolite; at least 17 of the cases had asbestos-induced lung changes on X-ray films [ref: 77].
One study [ref: 78] of histological types of lung cancers showed that among persons exposed to crocidolite 45.7% of cases were squamous-cell carcinomas, as compared to 35.2% among unexposed persons. In the context of unspecified and complex exposures, small-cell carcinoma was found to be relatively more prevalent than other forms [ref: 50].
Exposure to chrysotile was found in some studies to result in virtually no increase in risk ratio [ref: 60,79-81], or a slightly elevated relative risk of lung cancer [ref: 82-86]. Somewhat higher risk ratios, up to 2.5, 3.5 and 2, respectively, were obtained in one study of chrysotile miners [ref: 87] and in two independent studies from one asbestos [chrysotile] textile plant [ref: 88,89], the latter being the more comprehensive. With regard to mesotheliomas, one study suggested a particularly high risk of combined exposure to chrysotile and amphiboles (risk ratio, 61), thus almost multiplying the risk ratios (6 and 12, respectively) of exposures to chrysotile and amphiboles alone [ref: 90]. Another study showed no mesothelioma among a large worker population with exposure to chrysotile only [ref: 91].
A slight excess of lung cancer and some mesotheliomas appeared in some groups with mixed exposures involving amosite, chrysotile and crocidolite [ref: 92-94]. Exposure predominantly to amosite, but also to chrysotile, was reported to be the probable cause of at least four of five mesotheliomas (one peritoneal) observed in a UK insulation-board factory [ref: 95]. One cohort with exposure to cummingtonite-grunerite, which is closely related to amosite, had no clear excess of lung cancer, although one case of mesothelioma was observed [ref: 96].
Exposure to tremolite and actinolite has been the subject of a few studies in investigations of vermiculite mining and milling [ref: 97,98] and environmental exposure [ref: 99]. The studies of miners indicated a risk ratio for lung cancer of up to approximately six fold. Deaths from mesothelioma were found in the occupational studies, whereas the study of environmental exposure showed no increased risk, although pleural plaques were reported. Publication of one case report of a mesothelioma after environmental exposure suggests that tremolite was of etiological importance [ref: 31].
Cancers other than of the lung or mesothelioma have been considered in many studies [ref : 1, 17, 35, 39, 41-44, 48, 51, 55, 60-62, 68-70, 72-74, 76, 83, 87, 89, 92, 93, 96, 97, 99-108]. Some indicated an approximately two-fold risk with regard to gastrointestinal cancer in connection with shipyard work [ref: 41,43], and some increased risk was also seen in association with exposure to both chrysotile and crocidolite [ref: 103], to crocidolite [ref: 61,74] or to chrysotile [ref: 87]. Cancer of the colon and rectum was associated with asbestos exposure during chrysotile production, with an approximately two-fold risk [ref: 87]; a similar excess was found for unspecified asbestos exposure [ref: 104]. Some excess of ovary cancer has been reported in two studies [ref: 73,76] but not in another [ref: 92]; exposure to crocidolite was probably more predominant in the studies that showed excesses. Bile-duct cancer appeared in excess in one study based on record-linking [ref: 105], and large-cell lymphomas of the gastrointestinal tract and oral cavity appeared to be strongly related to asbestos exposure in one small study covering 28 cases and 28 controls, giving a risk ratio of 8; however, ten cases and one control also had a history of malaria [ref: 106]. An excess of lymphopoietic and haematopoietic malignancies has been reported in plumbers, pipe-fitters, sheet-metal workers and others with asbestos exposure [ref: 17,54,107,108].
The relationship between asbestos exposure and smoking indicates a synergistic effect of smoking with regard to lung cancer [ref: 1]. Further evaluations indicate that this synergistic effect is close to a multiplicative model [ref: 52,109]. As noted previously [ref: 1], the risk of mesothelioma appears to be independent of smoking [ref: 47,66], and a significantly decreasing trend in risk was observed with the amount smoked in one study [ref: 65].
The studies of the carcinogenic effect of asbestos exposure, including evidence reviewed earlier [ref: 1], show that occupational exposure to chrysotile, amosite and anthophyllite asbestos and to mixtures containing crocidolite results in an increased risk of lung cancer, as does exposure to minerals containing tremolite and actinolite and to tremolitic material mixed with anthophyllite and small amounts of chrysotile. Mesotheliomas have been observed after occupational exposure to crocidolite, amosite, tremolitic material and chrysotile asbestos. Gastrointestinal cancers occurred at an increased incidence in groups occupationally exposed to crocidolite, amosite, chrysotile or mixed fibres containing crocidolite, although not all studies are consistent in this respect. An excess of laryngeal cancer has also been observed in some groups of exposed workers. No clear excess of cancer has been associated with the presence of asbestos fibres in drinking-water. Mesotheliomas have occurred in individuals living in the neighbourhood of asbestos factories and mines and in people living with asbestos workers.
B. Evidence for carcinogenicity to animals (sufficient)
Asbestos has been tested for carcinogenicity by inhalation in rats, by intrapleural administration in rats and hamsters, by intraperitoneal injection in mice, rats and hamsters and by oral administration in rats and hamsters. Chrysotile, crocidolite, amosite, anthophyllite and tremolite produced mesotheliomas and lung carcinomas in rats after inhalation exposure [ref: 1,110,111] and mesotheliomas following intrapleural administration [ref: 1,112]. Chrysotile, crocidolite, amosite and anthophyllite induced mesotheliomas in hamsters following intrapleural administration [ref: 1]. Intraperitoneal administration of chrysotile, crocidolite and amosite induced peritoneal tumours, including mesotheliomas, in mice [ref: 1,113] and rats [ref: 1,111,114]. Given by the same route, crocidolite produced abdominal tumours in hamsters [ref: 115], and tremolite and actinolite produced abdominal tumours in rats [ref: 110,116-118]. A statistically significant increase in the incidence of malignant tumours was observed in rats given filter material containing chrysotile orally [ref: 1]. In more recent studies, tumour incidence was not increased by oral administration of amosite or tremolite in rats [ref: 119], of amosite in hamsters [ref: 120,121] or of chrysotile in hamsters [ref: 121]. In two studies in rats, oral administration of chrysotile produced a low incidence of benign adenomatous polyps of the large intestine in males (9/250 versus 3/524 pooled controls) [ref: 122] and of mesenteric haemangiomas (4/22 versus 0/47 controls) [ref: 123]. Synergistic effects were observed following intratracheal administration of chrysotile and benzo[a]pyrene to rats and hamsters [ref: 1] and of intratracheal administration of chrysotile and subcutaneous or oral administration of N-nitrosodiethylamine to hamsters [ref: 124].
C. Other relevant data
Insulation workers exposed to asbestos 'displayed a marginal increase' in the incidence of sister chromatid exchanges in lymphocytes in one study [ref: 125].
Chrysotile did not induce micronuclei in bone-marrow cells of mice or chromosomal aberrations in bone-marrow cells of rhesus monkeys treated in vivo. In cultured human cells, conflicting results were reported for the induction of chromosomal aberrations and negative results for the induction of sister chromatid exchanges by chrysotile and crocidolite; amosite and crocidolite did not induce DNA strand breaks, and crocidolite was not mutagenic. Amosite, anthophyllite, chrysotile and crocidolite induced transformation of Syrian hamster embryo cells, chrysotile and crocidolite transformed BALB/c3T3 mouse cells, and chrysotile transformed rat mesothelial cells. Neither amosite nor crocidolite transformed CH3 10T1/2 cells. In cultured rodent cells, amosite, anthophyllite, chrysotile and crocidolite induced chromosomal aberrations, and amosite, chrysotile and crocidolite induced sister chromatid exchanges; chrysotile and crocidolite induced aneuploidy and micronuclei. Chrysotile did not induce unscheduled DNA synthesis in rat hepatocytes. Amosite, chrysotile and crocidolite were inactive or weakly active in inducing mutation in rodent cells in vitro; none were mutagenic to bacteria [ref: 125].
For definition of the italicized terms, see Preamble Evaluation.
Also see previous evaluations: Vol. 2 (1973); Vol. 14 (1977)
1. IARC Monographs, 14, 1977
2. Armstrong, B.K., Musk, A.W., Baker, J.E., Hunt, J.M., Newall, C.C., Henzell, H.R., Blunsdon, B.S., Clarke-Hundley, M.D., Woodward, S.D. & Hobbs, M.S.T. (1984) Epidemiology of malignant mesothelioma in Western Australia. Med. J. Aust., 141, 86-88
3. Beck, B. & Irmscher, G. (1979) Extrathoracic mesotheliomas after inhalation of asbestos dust (Ger.). Z. Erkrank. Atm.-Org., 152, 282-293
4. Biava, P.M., Fiorito, A., Canciani, L. & Bovenzi, M. (1983) Epidemiology of mesothelioma of the pleura in the province of Trieste: role of occupational exposure to asbestos (Ital.). Med. Lav., 74, 260-265
5. Edge, J.R. & Choudhury, S.L. (1978) Malignant mesothelioma of the pleura in Barrow-in-Furness. Thorax, 33, 26-30
6. Emonot, A., Marquet, M., Baril, A., Berardj & Braillon (1979) Epidemiology of asbestos mesotheliomas in the region of St Etienne (Fr.). Ann. Med. intern., 130, 71-74
7. Griffiths, M.H., Riddell, R.J. & Xipell, J.M. (1980) Malignant mesothelioma: a review of 35 cases with diagnosis and prognosis. Pathology, 12, 591-603
8. Kovarik, J.L. (1976) Primary pleural mesothelioma. Cancer, 38, 1816-1825
9. Lemesch, C., Steinitz, R. & Wassermann, M. (1976) Epidemiology of mesothelioma in Israel. Environ. Res., 12, 255-261
10. McDonald, A.D. (1980) Malignant mesothelioma in Quebec. In: Wagner, J.C., ed., Biological Effects of Mineral Fibres (IARC Scientific Publications No. 30), Lyon, International Agency for Research on Cancer, pp. 673-680
11. Mowe, G. & Gylseth, B. (1986) Occupational exposure and regional variation of malignant mesothelioma in Norway, 1970-79. Am. J. ind. Med., 9, 323-332
12. Paur, R., Woitowitz, H.-J., Rödelsperger, K. & Jahn, H. (1985) Pleural mesothelioma after asbestos exposure in brake repair work in automobile repair workshop: case observations (Ger.). Prax. klin. Pneumol., 39, 362-366
13. Sheers, G. & Coles, R.M. (1980) Mesothelioma risks in a naval dockyard. Arch. environ. Health, 35, 276-282
14. Vande Weyer, R., Groetenbriel, C., Lauwers, D. & Yernault, J.C. (1982) Evolution of deaths by bronchial carcinoma and pleural mesothelioma among two groups of Belgian workers who died between 1973 and 1981: the role of asbestosis and coalworkers' pneumoconiosis (Abstract No. 5). Eur. J. respir. Dis., 63 (Suppl. 125), 10
15. Xu, Z., Armstrong, B.K., Blundson, B.J., Rogers, J.M., Musk, A.W. & Shilkin, K.B. (1985) Trends in mortality from malignant mesothelioma of the pleura, and production and use of asbestos in Australia. Med. J. Aust., 143, 185-187
16. Ben-Dror, G., Suprun, H. & Shkolnik, T. (1985) Peritoneal mesotheliomas and exposure to asbestos (Arabic). Harefuah, 108, 435-437
17. Cantor, K.P., Sontag, J.M. & Heid, M.F. (1986) Patterns of mortality among plumbers and pipefitters. Am. J. ind. Med., 10, 73-89
18. Gardner, M.J., Jones, R.D., Pippard, E.C. & Saitoh, N. (1985) Mesothelioma of the peritoneum during 1967-82 in England and Wales. Br. J. Cancer, 51, 121-126
19. Mancuso, T.F. (1983) Mesothelioma among machinists in railroad and other industries. Am. J. ind. Med., 4, 501-513
20. Newhouse, M.L., Oakes, D. & Woolley, A.J. (1985) Mortality of welders and other craftsmen at a shipyard in NE England. Br. J. ind. Med., 42, 406-410
21. Sera, Y. & Kang, K.-Y. (1981) Asbestos and cancer in the Sennan district of Osaka. Tohoku J. exp. Med., 133, 313-320
22. Fligiel, Z. & Kaneko, M. (1976) Malignant mesothelioma of the tunica vaginalis propria testis in a patient with asbestos exposure. Cancer, 37, 1478-1484
23. Beck, B., Konetzke, G., Ludwig, V., Röthig, W. & Sturm, W. (1982) Malignant pericardial mesotheliomas and asbestos exposure: a case report. Am. J. ind. Med., 3, 149-159
24. Kahn, E.I., Rohl, A., Barrett, E.W. & Suzuki, Y. (1980) Primary pericardial mesothelioma following exposure to asbestos. Environ. Res., 23, 270-281
25. Arul, K.J. & Holt, P.F. (1977) Mesothelioma possibly due to environmental exposure to asbestos in childhood. Int. Arch. occup. environ. Health, 40, 141-143
26. Bignon, J., Sebastien, P., di Menza, L., Nebut, M. & Payan, H. (1979) French registry of mesotheliomas 1965-1978 (Fr.). Rev. fr. Mal. respir., 7, 223-242
27. Enterline, P.E. (1983) Cancer produced by nonoccupational asbestos exposure in the United States. J. Air Pollut. Control Assoc., 33, 318-322
28. Greenberg, M. & Davies, T.A.L. (1974) Mesothelioma register 1967-68. Br. J. ind. Med., 31, 91-104
29. Chen, W.-J. & Mottet, N.K. (1978) Malignant mesothelioma with minimal asbestos exposure. Hum. Pathol., 9, 253-258
30. Gylseth, B., Mowé, G. & Wannag, A. (1983) Fibre type and concentration in the lungs of workers in an asbestos cement factory. Br. J. ind. Med., 40, 375-379
31. Magee, F., Wright, J.L., Chan, N., Lawson, L. & Churg, A. (1986) Malignant mesothelioma caused by childhood exposure to long-fiber low aspect ratio tremolite. Am. J. ind. Med., 9, 529-533
32. Wagner, J.C., Moncrieff, C.B., Coles, R., Griffiths, D.M. & Munday, D.E. (1986) Correlation between fibre content of the lungs and disease in naval dockyard workers. Br. J. ind. Med., 43, 391-395
33. Browne, K. (1983) Asbestos-related mesothelioma: epidemiological evidence for asbestos as a promoter. Arch. environ. Health, 38, 261-266
34. Churg, A., Warnock, M.L. & Bensch, K.G. (1978) Malignant mesothelioma arising after direct application of asbestos and fiber glass to the pericardium. Am. Rev. respir. Dis., 118, 419-424
35. Beck, E.G. & Schmidt, P. (1985) Epidemiological investigations of deceased employees of the asbestos cement industry in the Federal Republic of Germany. Zbl. Bakt. Hyg., I. Abt. Orig. B, 181, 207-215
36. Hughes, J.M., Hammad, Y.Y. & Weill, H. (1986) Mesothelioma risk in relation to duration and type of asbestos fiber exposure (Abstract). Am. Rev. respir. Dis., 133 (Suppl. 4), A33
37. Selikoff, I.J., Hammond, E.C. & Seidman, H. (1980) Latency of asbestos disease among insulation workers in the United States and Canada. Cancer, 46, 2736-2740
38. Blot, W.J., Harrington, J.M., Toledo, A., Hoover, R., Heath, C.W., Jr & Fraumeni, J.F., Jr (1978) Lung cancer after employment in shipyards during World War II. New Engl. J. Med., 299, 620-624
39. Blot, W.J., Stone, B.J., Fraumeni, J.F., Jr & Morris, L.E. (1979) Cancer mortality in US counties with shipyard industries during World War II. Environ. Res., 18, 281-290
40. Blot, W.J., Morris, L.E., Stroube, R., Tagnon, I. & Fraumeni, J.F., Jr (1980) Lung and laryngeal cancers in relation to shipyard employment in coastal Virginia. J. natl Cancer Inst., 65, 571-575
41. Kolonel, L.N., Yoshizawa, C.N., Hirohata, T. & Myers, B.C. (1985) Cancer occurrence in shipyard workers exposed to asbestos in Hawaii. Cancer Res., 45, 3924-3928
42. Rossiter, C.E. & Coles, R.M. (1980) HM Dockyard, Devonport: 1947 mortality study. In: Wagner, J.C., ed., Biological Effects of Mineral Fibres (IARC Scientific Publications No. 30), Lyon, International Agency for Research on Cancer, pp. 713-721
43. Sandén, A., Näslund, P.-E. & Järvholm, B. (1985) Mortality in lung and gastrointestinal cancer among shipyard workers. Int. Arch. occup. environ. Health, 55, 277-283
44. Lumley, K.P.S. (1976) A proportional study of cancer registrations of dockyard workers. Br. J. ind. Med., 33, 108-114
45. Nicholson, W.J., Lilis, R., Frank, A.L. & Selikoff, I.J. (1980) Lung cancer prevalence among shipyard workers. Am. J. ind. Med., 1, 191-203
46. Alies-Patin, A.M. & Valleron, A.J. (1985) Mortality of workers in a French asbestos cement factory 1940-82. Br. J. ind. Med., 42, 219-225
47. Berry, G., Newhouse, M.L. & Antonis, P. (1985) Combined effect of asbestos and smoking on mortality from lung cancer and mesothelioma in factory workers. Br. J. ind. Med., 42, 12-18
48. Hodgson, J.T. & Jones, R.D. (1986) Mortality of asbestos workers in England and Wales. Br. J. ind. Med., 43, 158-164
49. Coggon, D., Pannett, B. & Acheson, E.D. (1984) Use of job-exposure matrix in an occupational analysis of lung and bladder cancers on the basis of death certificates. J. natl Cancer Inst., 72, 61-65
50. Kjuus, H., Skjaerven, R., Langard, S., Lien, J.T. & Aamodt, T. (1986) A case-referent study of lung cancer, occupational exposures and smoking. II. Role of asbestos exposure. Scand. J. Work Environ. Health, 12, 203-209
51. Newhouse, M.L., Berry, G. & Wagner, J.C. (1985) Mortality of factory workers in East London 1933-80. Br. J. ind. Med., 42, 4-11
52. Hilt, B., Langard, S., Andersen, A. & Rosenberg, J. (1985) Asbestos exposure, smoking habits, and cancer incidence among production and maintenance workers in an electrochemical plant. Am. J. ind. Med., 8, 565-577
53. Woitowitz, H.-J., Lange, H.-J., Beierl, L., Rathgeb, M., Schmidt, K., Ulm, K., Giesen, T., Woitowitz, R.H., Pache, L. & Rödelsperger, K. (1986) Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust. Int. Arch. occup. environ. Health, 57, 161-171
54. Zoloth, S. & Michaels, D. (1985) Asbestos disease in sheet metal workers: the results of a proportional mortality analysis. Am. J. ind. Med., 7, 315-321
55. Elmes, P.C. & Simpson, M.J.C. (1977) Insulation workers in Belfast. A further study of mortality due to asbestos exposure (1940-75). Br. J. ind. Med., 34, 174-180
56. Huuskonen, M.S. (1980) Asbestos and cancer in Finland. J. Toxicol. environ. Health, 6, 1261-1265
57. Selikoff, I.J. & Seidman, H. (1981) Cancer of the pancreas among asbestos insulation workers. Cancer, 47 (Suppl.), 1469-1473
58. Burch, J.D., Howe, G.R., Miller, A.B. & Semenciw, R. (1981) Tobacco, alcohol, asbestos, and nickel in the etiology of cancer of the larynx: a case-control study. J. natl Cancer Inst., 67, 1219-1224
59. von Bittersohl, G. (1977) On the problem of asbestos-induced carcinoma of the larynx (Ger.). Z. ges. Hyg., 23, 27-30
60. Rubino, G.F., Piolatto, G., Newhouse, M.L., Scansetti, G., Aresini, G.A. & Murray, R. (1979) Mortality of chrysotile asbestos workers at the Balangero mine, Northern Italy. Br. J. ind. Med., 36, 187-194
61. Musk, A.W., de Klerk, N., Hobbs, M.S.T. & Armstrong, B.K. (1986) Mortality in crocidolite miners and millers from Wittenoom, Western Australia (Abstract). Am. Rev. respir. Dis., 133 (Suppl. 4), A34
62. Graham, S., Blanchet, M. & Rohrer, T. (1977) Cancer in asbestos-mining and other areas of Quebec. J. natl Cancer Inst., 59, 1139-1145
63. Chiappino, G., Riboldi, L., Todaro, A. & Schulz, L. (1985) Survey of mesotheliomas in Lombardy in the period 1978-1982 (Ital.). Med. Lav., 76, 454-465
64. Mowé, G., Gylseth, G., Hartveit, F. & Skaug, V. (1984) Occupational asbestos exposure, lung-fiber concentration and latency time in malignant mesothelioma. Scand. J. Work Environ. Health, 10, 293-298
65. Tagnon, I., Blot, W.J., Stroube, R.B., Day, N.E., Morris, L.E., Peace, B.B. & Fraumeni, J.F., Jr (1980) Mesothelioma associated with the shipbuilding industry in coastal Virginia. Cancer Res., 40, 3875-3879
66. Thériault, G.P. & Grand-Bois, L. (1978) Mesothelioma and asbestos in the province of Québec, 1969-1972. Arch. environ. Health, 33, 15-19
67. Vianna, N.J. & Polan, A.K. (1978) Non-occupational exposure to asbestos and malignant mesothelioma in females. Lancet, i, 1061-1063
68. Meigs, J.W., Walter, S.D., Heston, J.F., Millette, J.R., Craun, G.F., Woodhull, R.S. & Flannery, J.T. (1980) Asbestos cement pipe and cancer in Connecticut 1955-1974. J. environ. Health, 42, 187-191
69. Wigle, D.T. (1977) Cancer mortality in relation to asbestos in municipal water supplies. Arch. environ. Health, 32, 185-190
70. Harrington, J.M., Craun, G.F., Meigs, J.W., Landrigan, P.J., Flannery, J.T. & Woodhull, R.S. (1978) An investigation of the use of asbestos cement pipe for public water supply and the incidence of gastrointestinal cancer in Connecticut, 1935-1973. Am. J. Epidemiol., 107, 96-103
71. Polissar, L., Severson, R.K. & Boatman, E.S. (1984) A case-control study of asbestos in drinking water and cancer risk. Am. J. Epidemiol., 119, 456-471
72. Kanarek, M.S., Conforti, P.M., Jackson, L.A., Copper, R.C. & Murchio, J.C. (1980) Asbestos in drinking water and cancer incidence in the San Francisco Bay area. Am. J. Epidemiol., 112, 54-72
73. Acheson, E.D., Gardner, M.J., Pippard, E.C. & Grime, L.P. (1982) Mortality of two groups of women who manufactured gas masks from chrysotile and crocidolite asbestos: a 40-year follow-up. Br. J. ind. Med., 39, 344-348
74. Botha, J.L., Irwig, L.M. & Strebel, P.M. (1986) Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa. Am. J. Epidemiol., 123, 30-40
75. Hobbs, M.S.T., Woodward, S.D., Murphy, B., Musk, A.W. & Elder, J.E. (1980) The incidence of pneumoconiosis, mesothelioma and other respiratory cancer in men engaged in mining and milling crocidolite in Western Australia. In: Wagner, J.C., ed., Biological Effects of Mineral Fibres (IARC Scientific Publications No. 30), Lyon, International Agency for Research on Cancer, pp. 615-625
76. Wignall, B.K. & Fos, A.J. (1982) Mortality of female gas mask assemblers. Br. J. ind. Med., 39, 34-38
77. Hilt, B., Rosenberg, J. & Langard, S. (1981) Occurrence of cancer in a small cohort of asbestos-exposed workers. Scand. J. Work Environ. Health, 7, 185-189
78. Baker, J.E., Reutens, D.C., Graham, D.F., Sterrett, G.F., Musk, A.W., Hobbs, M.S.T., Armstrong, B.K. & de Klerk, N.H. (1986) Morphology of bronchogenic carcinoma in workers formerly exposed to crocidolite at Wittenoom Gorge in Western Australia. Int. J. Cancer, 37, 547-550
79. Berry, G. & Newhouse, M.L. (1983) Mortality of workers manufacturing friction materials using asbestos. Br. J. ind. Med., 40, 1-7
80. Gardner, M.J., Winter, P.D., Pannett, B. & Powell, C.A. (1986) Follow up study of workers manufacturing chrysotile asbestos cement products. Br. J. ind. Med., 43, 726-732
81. Weiss, W. (1977) Mortality of a cohort exposed to chrysotile asbestos. J. occup. Med., 19, 737-740
82. Haider, M. & Neuberger, M. (1980) Comparison of lung cancer risks for dust workers, asbestos-cement workers and control groups. In: Wagner, J.C., ed., Biological Effects of Mineral Fibres (IARC Scientific Publications No. 30), Lyon, International Agency for Research on Cancer, pp. 973-977
83. McDonald, A.D., Fry, J.S., Woolley, A.J. & McDonald, J.C. (1984) Dust exposure and mortality in an American chrysotile asbestos friction products plant. Br. J. ind. Med., 41, 151-157
84. Peto, J. (1980) Lung cancer mortality in relation to measured dust levels in an asbestos textile factory. In: Wagner, J.C., ed., Biological Effects of Mineral Fibres (IARC Scientific Publications No. 30), Lyon, International Agency for Research on Cancer, pp. 829-836
85. Peto, J., Doll, R., Howard, S.V., Kinlen, L.J. & Lewinsohn, H.C. (1977) A mortality study among workers in an English asbestos factory. Br. J. ind. Med., 34, 169-173
86. Peto, J., Doll, R., Hermon, C., Binns, W., Clayton, R. & Goffe, T. (1985) Relationship of mortality to measures of environmental asbestos pollution in an asbestos textile factory. Ann. occup. Hyg., 29, 305-355
87. Liddell, F.D.K., Thomas, D.C., Gibbs, G.W. & McDonald, J.C. (1984) Fibre exposure and mortality from pneumoconiosis, respiratory and abdominal malignancies in chrysotile production in Quebec, 1926-75. Ann. Acad. Med., 13, 340-344
88. Dement, J.M., Harris, R.L., Jr, Symons, M.J. & Shy, C. (1982) Estimates of dose-response for respiratory cancer among chrysotile asbestos textile workers. Ann. occup. Hyg., 26, 869-887
89. McDonald, A.D., Fry, J.S., Woolley, A.J. & McDonald, J. (1983) Dust exposure and mortality in an American chrysotile textile plant. Br. J. ind. Med., 40, 361-367
90. Acheson, E.D. & Gardner, M.J. (1979) Mesothelioma and exposure to mixtures of chrysotile and amphibole asbestos. Arch. environ. Health, 34, 240-242
91. Browne, K. & Smither, W.J. (1983) Asbestos-related mesothelioma: factors discriminating between pleural and peritoneal sites. Br. J. ind. Med., 40, 145-152
92. Newhouse, M.L., Berry, G. & Skidmore, J.W. (1982) A mortality study of workers manufacturing friction materials with chrysotile asbestos. Ann. occup. Hyg., 26, 899-909
93. Ohlson, C.-G., Klaesson, B. & Hogstedt, C. (1984) Mortality among asbestos-exposed workers in a railroad workshop. Scand. J. Work Environ. Health, 10, 283-291
94. McDonald, A.D. & Fry, J.S. (1982) Mesothelioma and fiber type in three American asbestos factories - preliminary report. Scand. J. Work Environ. Health, 8 (Suppl. 1), 53-58
95. Acheson, E.D., Gardner, M.J., Bennett, C. & Winter, P.D. (1981) Mesothelioma in a factory using amosite and chrysotile asbestos. Lancet, ii, 1403-1405
96. McDonald, J.C., Gibbs, G.W., Liddell, F.D.K. & McDonald, A.D. (1978) Mortality after long exposure to cummingtonite-grunerite. Am. Rev. respir. Dis., 118, 271-277
97. McDonald, J.C., McDonald, A.D., Armstrong, B. & Sébastien, P. (1986) Cohort study of mortality in vermiculite miners exposed to tremolite. Br. J. ind. Med., 43, 436-444
98. Amandus, H.E. & Wheeler, R. (1987) The morbidity and mortality of vermiculite miners and millers exposed to tremolite-actinolite: Part II. Mortality. Am. J. ind. Med., 11, 15-26
99. Neuberger, M., Kundi, M. & Friedl, H.P. (1984) Environmental asbestos exposure and cancer mortality. Arch. environ. Health, 39, 261-265
100. Ohlson, C.-G. & Hogstedt, C. (1985) Lung cancer among asbestos cement workers. A Swedish cohort study and a review. Br. J. ind. Med., 42, 397-402
101. Thomas, H.F., Benjamin, I.T., Elwood, P.C. & Sweetnam, P.M. (1982) Further follow-up study of workers from an asbestos cement factory. Br. J. ind. Med., 39, 273-276
102. Weill, H., Hughes, J. & Waggenspack, C. (1979) Influence of dose and fiber type on respiratory malignancy risk in asbestos cement manufacturing. Am. Rev. respir. Dis., 120, 345-354
103. Finkelstein, M.M. (1984) Mortality among employees of an Ontario asbestos-cement factory. Am. Rev. respir. Dis., 129, 754-761
104. Hardell, L. (1981) Relation of soft-tissue sarcoma, malignant lymphoma and colon cancer to phenoxy acids, chlorophenols and other agents. Scand. J. Work Environ. Health, 7, 119-130
105. Malker, H.S.R., McLaughlin, J.K., Malker, B.K., Stone, B.J., Weiner, J.A., Ericsson, J.L.E. & Blot, W.J. (1986) Biliary tract cancer and occupation in Sweden. Br. J. ind. Med., 43, 257-262
106. Ross, R., Nichols, P., Wright, W., Lukes, R., Dworsky, R., Paganini-Hill, A., Koss, M. & Henderson, B. (1982) Asbestos exposure and lymphomas of the gastrointestinal tract and oral cavity. Lancet, ii, 1118-1120
107. Waxweiler, R.J. & Robinson, C. (1983) Asbestos and non-Hodgkin's lymphoma. Lancet, i, 189-190
108. Spanedda, R., Barbieri, D. & La Corte, R. (1983) Asbestos and non-Hodgkin's lymphoma. Lancet, i, 190
109. Saracci, R. (1977) Asbestos and lung cancer: an analysis of the epidemiological evidence on the asbestos-smoking interaction. Int. J. Cancer, 20, 323-331
110. Davis, J.M.G., Addison, J., Bolton, R.E., Donaldson, K., Jones, A.D. & Miller, B.G. (1985) Inhalation studies on the effects of tremolite and brucite dust in rats. Carcinogenesis, 6, 667-674
111. Davis, J.M.G., Addison, J., Bolton, R.E., Donaldson, K. & Jones, A.D. (1986) Inhalation and injection studies in rats using dust samples from chrysotile asbestos prepared by a wet dispersion process. Br. J. exp. Pathol., 67, 113-129
112. Stanton, M.F., Layard, M., Tegeris, A., Miller, E., May, M., Morgan, E. & Smith, A. (1981) Relation of particle dimension to carcinogenicity in amphibole asbestoses and other fibrous minerals. J. natl Cancer Inst., 67, 965-975
113. Suzuki, Y, & Kohyama, N. (1984) Malignant mesothelioma induced by asbestos and zeolite in the mouse peritoneal cavity. Environ. Res., 35, 277-292
114. Bolton, R.E., Davis, J.M.G., Donaldson, K. & Wright, A. (1982) Variations in the carcinogenicity of mineral fibres. Ann. occup. Hyg., 26, 569-582
115. Pott, F., Huth, F. & Spurny, K. (1980) Tumour induction after intraperitoneal injection of fibrous dusts. In: Wagner, J.C., ed., Biological Effects of Mineral Fibres (IARC Scientific Publications No. 30), Lyon, International Agency for Research on Cancer, pp. 337-342
116. Spurny, K., Pott, F., Huth, F., Weiss, G. & Opiela, H. (1979) Identification and carcinogenic action of fibrous actinolite from a diabase rock (Ger.). Staub-Reinhalt. Luft, 39, 386-389
117. Pott, F., Schlipköter, H.W., Ziem, U., Spurny, K. & Huth, F. (1982) New results from implantation experiments with mineral fibres. In: Biological Effects of Man-made Fibres, Vol. 2, Copenhagen, WHO Regional Office for Europe, pp. 286-302
118. Pott, F., Matscheck, A., Ziem, U., Muhle, H. & Huth, F. (1987) Animal experiments with chemically treated fibres. Ann. occup. Hyg. (in press)
119. McConnell, E.E., Rutter, H.A., Ulland, B.M. & Moore, J.A. (1983) Chronic effects of dietary exposure to amosite asbestos and tremolite in F344 rats. Environ. Health Perspect., 53, 27-44
120. National Toxicology Program (1983) Lifetime Carcinogenesis Studies of Amosite Asbestos (CAS No. 121-72-73-5) in Syrian Golden Hamsters (Feed Studies) (NIH Publ. No. 84-2505; NTP TR 249), Research Triangle Park, NC
121. McConnell, E.E., Shefner, A.M., Rust, J.H. & Moore, J.A. (1983) Chronic effects of dietary exposure to amosite and chrysotile asbestos in Syrian golden hamsters. Environ. Health Perspect., 53, 11-25
122. National Toxicology Program (1985) Toxicology and Carcinogenesis
Studies of Chrysotile Asbestos (CAS No.
123. Bolton, R.E., Davis, J.M.G. & Lamb, D. (1982) The pathological effects of prolonged asbestos ingestion in rats. Environ. Res., 29, 134-150
124. Küng-Vösamäe, A. & Vinkmann, F. (1980) Combined carcinogenic action of chrysotile asbestos dust and N-nitrosodiethylamine on the respiratory tract of Syrian golden hamsters. In: Wagner, J.C., ed., Biological Effects of Mineral Fibres (IARC Scientific Publications No. 30), Lyon, International Agency for Research on Cancer, pp. 305-310
125. IARC Monographs, Suppl. 6, 77-80, 1987
Asbestos is carcinogenic to humans (Group 1).
Synonym for Asbestos fibre:
See Also: Toxicological Abbreviations Asbestos (WHO Food Additives Series 13) ASBESTOS (JECFA Evaluation) Asbestos (IARC Summary & Evaluation, Volume 2, 1973) Asbestos (IARC Summary & Evaluation, Volume 14, 1977)