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Open AccessArticle

Asbestos-Related Lung Cancer: A Hospital-Based Case-Control Study in Indonesia

1
CIHLMU Center for International Health, University Hospital, LMU Munich, 80539 Munich, Germany
2
Occupational Health and Safety Program, Universitas Binawan, Jakarta 13630, Indonesia
3
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), 80336 Munich, Germany
4
Member, German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), 81377 Munich, Germany
5
Occupational Medicine Specialist, Universitas Indonesia Academic Hospital, Jakarta 16424, Indonesia
6
Department of Radiology, Faculty of Medicine UPN Veteran, Persahabatan Hospital, National Respiratory Referral Hospital, Jakarta 13230, Indonesia
7
Division of Thoracic Oncology Department of Pulmonology Faculty of Medicine, Universitas Indonesia Persahabatan hospital, Jakarta 13230, Indonesia
8
IBE—Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian Universität, 81377 Munich, Germany
9
Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT—Private University for Health Sciences, Medical Informatics and Technology, 6060 Hall in Tirol, Austria
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(2), 591; https://doi.org/10.3390/ijerph17020591
Received: 16 December 2019 / Revised: 7 January 2020 / Accepted: 13 January 2020 / Published: 16 January 2020
(This article belongs to the Special Issue Occupational Respiratory Health)
Indonesia has limited data on asbestos-related diseases despite abundant use. This study investigated the risk of occupational asbestos exposure for lung cancer development, utilizing a hospital-based case-control study. Subjects were patients who received a thoracic CT scan at Persahabatan Hospital, Jakarta. The cases had primary lung cancer confirmed by histology, the controls were negative for lung cancer. The cumulative occupational asbestos exposure was calculated by multiplying the exposure intensity by the years of exposure. The exposure intensity was obtained by adopting the weighted arithmetic mean value of asbestos exposure from a job-exposure matrix developed in Korea. The primary data analysis was based on logistic regression. The study included 696 subjects, with 336 cases and 360 controls. The chance of lung cancer for subjects exposed to asbestos was doubled (OR = 2.04, 95% CI = 1.21–3.42) compared with unexposed, and subjects with a cumulative asbestos exposure of 10 fiber-years or more even showed an OR of 3.08 (95% CI = 1.01–9.46). The OR of the combined effect between smoking and asbestos was 8.7 (95% CI = 1.71–44.39); the interaction was consistent with an additive and multiplicative risk model. Asbestos exposure is associated with a higher chance of lung cancer. Improved policies are needed to protect the population from asbestos hazards. View Full-Text
Keywords: lung cancer; asbestos; Indonesia lung cancer; asbestos; Indonesia
MDPI and ACS Style

Suraya, A.; Nowak, D.; Sulistomo, A.W.; Ghanie Icksan, A.; Syahruddin, E.; Berger, U.; Bose-O’Reilly, S. Asbestos-Related Lung Cancer: A Hospital-Based Case-Control Study in Indonesia. Int. J. Environ. Res. Public Health 2020, 17, 591.

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