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Synergy between Asbestos and Smoking on Lung Cancer Risks
Thomas C. Erren, Michael Jacobsen and Claus Piekarski
Vol. 10, No. 4 (Jul., 1999), pp. 405-411
Published by: Lippincott Williams & Wilkins
Stable URL: http://www.jstor.org/stable/3703560
Page Count: 7
You can always find the topics here!Topics: Asbestos, Lung neoplasms, Tobacco smoking, Disease risks, Smoking cessation, Mortality, Cigar smoking, Cigarette smoking, Biological synergy, Anti smoking movements
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We have examined data from 12 epidemiologic studies for quantitative evidence of biologic synergy between asbestos and smoking on lung cancer risks. Estimates of the effect associated with joint exposure to the two agents exceeded the sum of their separate effects in each study. We explored the variations in the strength of the synergistic effect across the studies using three indices: the ratio of the combined effects to the sum of the separate effects of smoking and asbestos (S), the relative excess risk due to interaction (RERI), and the attributable proportion of risk due to interaction (AP). The weighted average of S across all studies was 1.64 (95% confidence interval = 1.33-2.03). The attributable proportion associated with this average S was estimated as 33%, that suggests that one-third of cancer cases among smokers who were exposed to asbestos can be attributed to the synergistic behavior of the two carcinogens, as distinct from their separate effects and those attributable to other ("background") factors.
Epidemiology © 1999 Lippincott Williams & Wilkins