Cancer Attributable to Asbestos Exposure in Shipbreaking Workers: A Matched-Cohort Study

PLoS One. 2015 Jul 20;10(7):e0133128. doi: 10.1371/journal.pone.0133128. eCollection 2015.


Purpose: Long-term follow-up studies of asbestos-related cancer in shipbreaking workers are lacking. This study examines the relationship between cancer incidence and asbestos exposure among former Taiwan shipbreaking workers.

Methods: A total of 4,427 shipbreaking workers and 22,135 population-based matched controls were successfully followed in this study. The study cohort was linked to the Taiwan Cancer Registry for new cancer cases. The adjusted hazard ratio (aHR) for cancer was calculated for the shipbreaking workers with Total Exposure Potential Scores (TEP) for asbestos.

Results: Follow-up generated 109,932 person-years, with 940 deaths and 436 cancer cases, among 4,427 shipbreaking workers from 1985 to 2008. The high asbestos exposure group also had a statistically significant increase in the risk of overall cancer (aHR= 1.71; 95% CI: 1.42-2.05), esophagus cancer (aHR= 2.31; 95% CI: 1.00-5.41), liver and intrahepatic bile duct cancer (aHR= 1.60; 95% CI: 1.08-2.36), and trachea, bronchus, and lung cancer (aHR= 3.08; 95% CI: 1.80-5.25). Mesothelioma cases were found in the high asbestos exposure group. Moreover, overall cancer, esophagus cancer, and trachea, bronchus, and lung cancer were seen in a dose-dependent relationship with asbestos exposure.

Conclusions: This study presented the elevated trend of asbestos exposure with cancer incidence for overall cancer, esophagus cancer, and trachea, bronchus, and lung cancer among shipbreaking workers. Those workers previously exposed to asbestos should receive persistent monitoring in order to early detect adverse health outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asbestos / toxicity*
  • Cohort Studies
  • Esophageal Neoplasms / epidemiology
  • Esophageal Neoplasms / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / etiology
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / etiology*
  • Occupational Diseases / etiology*
  • Occupational Exposure*
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Taiwan / epidemiology


  • Asbestos

Grant support

This study was partly supported by National Health Research Institutes (EO-101-PP-07) and Institute of Occupational Safety and Health (IOSH 98-M-507), Taiwan, ROC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.