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Exposure to fibres and risk of pleural mesothelioma in the Norwegian Offshore Petroleum Workers cohort
  1. Leon Alexander Mclaren Berge1,2,
  2. Nita Kaupang Shala1,2,
  3. Francesco Barone-Adesi3,
  4. H Dean Hosgood4,
  5. Sven Ove Samuelsen5,
  6. Magne Bråtveit6,
  7. Jorunn Kirkeleit7,
  8. Debra Silverman8,
  9. Melissa C Friesen8,
  10. Ronnie Babigumira1,2,
  11. Tom K Grimsrud2,
  12. Marit B Veierød1,
  13. Jo S Stenehjem2
  1. 1 Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
  2. 2 Department of Research, Cancer Registry of Norway, National Institute of Public Health, Oslo, Norway
  3. 3 Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
  4. 4 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
  5. 5 Department of Mathematics, University of Oslo, Oslo, Norway
  6. 6 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  7. 7 Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
  8. 8 Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
  1. Correspondence to Dr Leon Alexander Mclaren Berge, Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, 0317, Norway; l.a.m.berge{at}medisin.uio.no

Abstract

Objectives Pleural mesothelioma is a rare respiratory cancer, mainly caused by inhalation of asbestos fibres. Other inorganic fibres are also suggested risk factors. We aimed to investigate the association between exposure to asbestos or refractory ceramic fibres (RCFs) and pleural mesothelioma among male Norwegian offshore petroleum workers.

Methods Among 25 347 men in the Norwegian Offshore Petroleum Workers (NOPW) cohort (1965–1998), 43 pleural mesothelioma cases were identified through the Cancer Registry of Norway (1999–2022). A case–cohort study was conducted with 2095 randomly drawn non-cases from the cohort. Asbestos and RCF exposures were assessed with expert-made job-exposure matrices (JEMs). Weighted Cox regression was used to estimate HRs and 95% CIs, adjusted for age at baseline and pre-offshore employment with likely asbestos exposure.

Results An increased risk of pleural mesothelioma was indicated for the highest versus lowest tertile of average intensity of asbestos (HR=1.21, 95% CI: 0.57 to 2.54). Pre-offshore asbestos exposure (vs no such exposure) was associated with increased risk of pleural mesothelioma (HR=2.06, 95% CI: 1.11 to 3.81). For offshore workers with no pre-offshore asbestos exposure, an increased risk of pleural mesothelioma was found for the highest tertile of average intensity of asbestos (HR=4.13, 95% CI: 0.93 to 18), versus the lowest tertile. No associations were found between RCF and pleural mesothelioma.

Conclusions Associations between JEM-based offshore asbestos exposure and pleural mesothelioma were confirmed in the NOPW cohort. Pleural mesothelioma risk was also associated with asbestos exposure before work in the offshore petroleum industry.

  • epidemiology
  • occupational health
  • asbestos
  • mineral fibers
  • mesothelioma

Data availability statement

Data may be obtained from a third party and are not publicly available. The data are available as presented in the paper. According to Norwegian legislation, our approvals to use the data for the current study do not allow us to distribute or make the data directly available to other parties.

https://doi.org/10.1136/oemed-2024-109424

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. The data are available as presented in the paper. According to Norwegian legislation, our approvals to use the data for the current study do not allow us to distribute or make the data directly available to other parties.

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    Footnotes

    • X @MaritBVeierod

    • Contributors JSS and TKG conceived of the study. LAMB, NKS, JSS, TKG, MBV and RB contributed to the project design and data acquisition. LAMB conducted all data management. LAMB, NKS, JSS, TKG and MBV designed the analytical strategy. All authors helped interpret the findings. LAMB conducted all statistical analyses and the literature review. LAMB, NKS, JSS, TKG, MBV and RB drafted the Introduction, Methods, Results and Discussion sections. All authors reviewed and critically revised the manuscript, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work. LAMB is the guarantor. MBV and JSS are shared last authors.

    • Funding This work was supported by the Research Council of Norway [grant number 280537].

    • Competing interests The authors declare that they have no financial or other relationships that might lead to a conflict of interest. However, coauthors TKG and JSS have received funding from the Research Council of Norway (governmental agency) in the form of an industry-collaborative grant to the Cancer Registry of Norway (governmental agency) in 2019, to establish an enlarged cohort of offshore petroleum workers. A condition pertaining to such industry-collaborative grants is that 20% (US$175 000) of the grant was provided by the petroleum industry and 80% (US$700 000) from State funding by the Research Council itself with the intention of joining forces for the common interest of occupational health among petroleum workers. The application process was governed by the Research Council alone without any involvement from the petroleum industry. The grant does not cover the salary of the PIs or any of the employees at collaborating institutions.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.