Dennis Nowak, Tobias Weinmann, Katja Radon, Matthias Möhner*

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Presentation transcript:

Ovarian cancer due to asbestos as a new occupational disease in germany Dennis Nowak, Tobias Weinmann, Katja Radon, Matthias Möhner* *Federal Institute for Occupational Safety and Health

Occupational Asbestos Cancer in Germany: History (1) 1884 Occupational Accidents Statutory Insurance 1925 Occupational Diseases Statutory Insurance 1943 „Lung cancer with asbestosis“ 1976 „Asbestos-induced mesothelioma“ 1988* „Lung cancer with asbestosis or asbestos-induced pleural disease“ 1992* „…or with cumulative exposure to 25 fiber-years“ 1997* „Laryngeal cancer or lung cancer…“ *CR fellow H-J Woitowitz

Occupational Asbestos Cancer in Germany: History (2) 1993 Asbestos prohibition in Germany (CR fellow Woitowitz) 2005 Asbestos prohibition in EU

IARC 2009: Monography 100 C: Sufficient evidence Summary: Straif K, Benbrahim-Tallaa L, Baan R, Grosse Y, Secretan B, El Ghissassi F, et al. 2009. A review of human carcinogens—part C: metals, arsenic, dusts, and fibres. Lancet Oncology 10:453–454.

Environ Health Perspect 119 (2011) 1211-1217

Environ Health Perspect 119 (2011) 1211-1217

Meta-analysis Ovarian cancer due to Asbestos Camargo MC et al, Environ Health Perspect 119 (2011) 1211-1217

Meta-analysis Ovarian cancer due to Asbestos Camargo MC et al, Environ Health Perspect 119 (2011) 1211-1217

Minor differences between reviews IARC included environmental exposures IARC mentioned one additional case control study Reid et al (2011)* found lower effect estimate when including Rosenblatt‘s (1992) case control study with 90 % asbestos exposure in cases and controls Bounin et al (2014)** included more case control studies Two more papers 2014-17, one more update * Reid A et al, Cancer Epidemiol Biomarkers Prev 20 (2011) 1287-1295 **Bounin A et al, Bull Cancer 101 (2014) 1098-1108

Möhner M, Nowak D, Meta analysis for German Ministry of Work and Social Affairs (2017)

Meta-Analysis Ovarian cancer due to Asbestos Studies without histological verification: Pooled effect estimate 1.89 (95 % CI 1.40-2.55) Studies with histological verification: Pooled effect estimate 1.98 (95 CI 1.32-2.97)

Occupational Asbestos Cancer in Germany: History (3) „Lung cancer or laryngeal cancer or ovarian cancer - with asbestosis - or with asbestos-induced pleural disease - or with cumulative exposure to 25 fiber-years“ 8 yrs gap between IARC and German legislation Hopefully, we are not too late with compensation No evidence based screening yet available One more argument for world-wide ban of asbestos

Retrospective cohort study about to start 16.000 formerly asbestos-exposed females are listed in a statutory accident insurance surveillance system These women are at risk for ovarian cancer Feasability study was funded with 5 % (800 of 16.000) females 5 (2-11) ovarian cancers expected Participation rate? X rays / CT scans available? Histology available? Starting 10/2017 (Dr. Weinmann, LMU Munich)

Thank you d.nowak@lmu.de