Asbestos Exposure, Smoking, and Neoplasia

TLDR

Asbestos insulation workers have a markedly elevated risk of bronchogenic carcinoma, about seven to eight times the expected rate. The study followed 370 asbestos‑exposed workers from January 1, 1963 to April 30, 1967. Among these workers, smoking increased mortality dramatically—24 of 283 smokers died of bronchogenic carcinoma versus only 3 expected, a 92‑fold excess risk—while no deaths occurred among 87 non‑smokers, showing that asbestos exposure alone does not fully explain the elevated risk and highlighting the need to minimize exposure and stop smoking.

Abstract

Asbestos insulation workers, as a group, have a high risk of dying of bronchogenic carcinoma (about seven or eight times expected). We have observed 370 such workmen from Jan 1, 1963 to April 30, 1967. Our findings indicate that asbestos exposure alone is not the entire explanation. Of 87 noncigarette smokers, none died of bronchogenic carcinoma. Of 283 workmen with a history of regular cigarette smoking, 24 died of bronchogenic carcinoma, although only three were expected to die of this disease. Calculations suggest that asbestos workers who smoke have about 92 times the risk of dying of bronchogenic carcinoma as men who neither work with asbestos nor smoke cigarettes. We conclude that asbestos exposure should be minimized, that asbestos workers who do not smoke should never start, and that those now smoking should stop immediately.