{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:57:57Z","timestamp":1770512277273,"version":"3.49.0"},"reference-count":36,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,3,20]]},"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate cause-specific mortality among asbestos workers and potentially exposed workers in Belgium and evaluate potential excess in mortality due to established and suspected asbestos-related diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This cohort study is based on an individual record linkage between the 1991 Belgian census and cause-specific mortality information for Flanders and Brussels (2001\u20132009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Belgium (Flanders and Brussels region).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study population consists of 1\u2005397\u2005699 male workers (18\u201365\u2005years) with 72\u2005074 deaths between 1 October 2001 and 31 December 2009. Using a classification of high-risk industries, mortality patterns between 2056 asbestos workers, 385\u2005046 potentially exposed workers and the working population have been compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Standardised mortality ratios (SMRs) and 95% CIs are calculated for manual and non-manual workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our findings show clear excess in asbestos-related mortality in the asbestos industry with SMRs for mesothelioma of 4071 (CI 2327 to 6611) among manual workers and of 4489 (CI 1458 to 10\u2005476) among non-manual workers. Excess risks in asbestos-related mortality are also found in the chemical industry, the construction industry, the electrical generation and distribution industry, the basic metals manufacturing industry, the metal products manufacturing industry, the railroad industry, and the shipping industry. Oral cancer mortality is significantly higher for asbestos workers (SMR 383; CI 124 to 894), railroad workers (SMR 192; CI 112 to 308), shipping workers (SMR 172; CI 102 to 271) and construction workers (SMR 125; CI 100 to 153), indicating a possible association with occupational asbestos exposure. Workers in all four industries have elevated mortality rates for cancer of the mouth. Only construction workers experience significantly higher pharyngeal cancer mortality (SMR 151; CI 104 to 212).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study identifies vulnerable groups of Belgian asbestos workers, demonstrating the current-day health repercussions of historical asbestos use. Results support the hypothesis of a possible association between the development of oral cancer and occupational asbestos exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-007384","type":"journal-article","created":{"date-parts":[[2015,6,24]],"date-time":"2015-06-24T21:26:00Z","timestamp":1435181160000},"page":"e007384","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Enduring health effects of asbestos use in Belgian industries: a record-linked cohort study of cause-specific mortality (2001\u20132009)"],"prefix":"10.1136","volume":"5","author":[{"given":"Laura","family":"Van den Borre","sequence":"first","affiliation":[{"name":"Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Deboosere","sequence":"additional","affiliation":[{"name":"Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,6,24]]},"reference":[{"key":"2025120520344106000_5.6.e007384.1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1179\/2049396714Y.0000000058","article-title":"Asbestos in Belgium: an underestimated health risk. The evolution of mesothelioma mortality rates (1969\u20132009)","volume":"20","author":"Van den Borre","year":"2014","journal-title":"Int J Occup Environ Health"},{"key":"2025120520344106000_5.6.e007384.2","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2003.010165"},{"key":"2025120520344106000_5.6.e007384.3","doi-asserted-by":"crossref","unstructured":"Virta RL . Worldwide asbestos supply and consumption trends from 1900 through 2003 . Reston, VA: U.S. Department of the Interior; 2006, U.S. Geological Survey Report No.: Circular 1298.","DOI":"10.3133\/cir1298"},{"key":"2025120520344106000_5.6.e007384.4","first-page":"304","article-title":"Bilan de l'indemnisation de l'asbestose","volume":"64","author":"Vande Weyer","year":"1973","journal-title":"Acta Tuberc Pneumol Belg"},{"key":"2025120520344106000_5.6.e007384.5","unstructured":"Lacquet LM , van der Linden L , Lepoutre J . Roentgenographic lung changes, asbestosis and mortality in a Belgian asbestos-cement factory. In: Wagner JC, ed. Biological effects of mineral fibres IARC Scientific Publication 30. Lyon, France: International Agency for Research on Cancer, 1980:783\u201395."},{"key":"2025120520344106000_5.6.e007384.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60776-4"},{"key":"2025120520344106000_5.6.e007384.7","unstructured":"De Kezel E . Asbest, gezondheid en veiligheid. Ontwikkelingen in het aansprakelijkheidsrecht. Antwerpen: Intersentia, 2013."},{"key":"2025120520344106000_5.6.e007384.8","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1179\/oeh.2003.9.3.287","article-title":"Asbestos in Belgium: use and abuse","volume":"9","author":"Nay","year":"2003","journal-title":"Int J Occup Environ Health"},{"key":"2025120520344106000_5.6.e007384.9","first-page":"924","article-title":"Doodsoorzaken bij de bevolking woonachtig rond en bij de arbeiders werkzaam in een asbestverwerkende nijverheid in het noorden van Brabant","volume":"58","author":"Van De Voorde","year":"1967","journal-title":"Acta Tuberc Pneumol Belg"},{"key":"2025120520344106000_5.6.e007384.10","first-page":"69","article-title":"Pathologie respiratoire de l'amiante en Belgique","volume":"2","author":"Vande Weyer","year":"1981","journal-title":"Rev M\u00e9d Brux"},{"key":"2025120520344106000_5.6.e007384.11","unstructured":"International Agency for Research on Cancer. Asbestos (chrysotile, amosite, crocidolite, tremolite, actinolite, and anthophyllite). A review of human carcinogens Part C: Arsenic, metals, fibres, and dusts\/IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Vol. 100. Lyon, France: International Agency for Research on Cancer, 2012:219\u2013309."},{"key":"2025120520344106000_5.6.e007384.12","unstructured":"Scientific Institute of Public Health, Public Health and Surveillance. Standardized procedures for mortality analysis. Brussels, 2015. http s:\/\/www.wiv-isp.be\/epidemio\/spma"},{"key":"2025120520344106000_5.6.e007384.13","doi-asserted-by":"publisher","DOI":"10.1136\/oem.56.8.505"},{"key":"2025120520344106000_5.6.e007384.14","unstructured":"Rothman KJ , Boice JD . Epidemiological analysis with a programmable calculator. Washington DC: US Government Printing Office, 1979."},{"key":"2025120520344106000_5.6.e007384.15","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jea.7500450"},{"key":"2025120520344106000_5.6.e007384.16","doi-asserted-by":"publisher","DOI":"10.1093\/annhyg\/men036"},{"key":"2025120520344106000_5.6.e007384.17","doi-asserted-by":"publisher","DOI":"10.1093\/annhyg\/mer066"},{"key":"2025120520344106000_5.6.e007384.18","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1097\/JTO.0b013e3182519a60","article-title":"Cause-specific mortality in relation to chrysotile-asbestos exposure in a Chinese cohort","volume":"7","author":"Lin","year":"2012","journal-title":"J Thorac Oncol"},{"key":"2025120520344106000_5.6.e007384.19","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1038\/sj.bjc.6603998","article-title":"First and subsequent asbestos exposures in relation to mesothelioma and lung cancer mortality","volume":"97","author":"Pira","year":"2007","journal-title":"Br J Cancer"},{"key":"2025120520344106000_5.6.e007384.20","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2006.031005"},{"key":"2025120520344106000_5.6.e007384.21","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1038\/bjc.1996.167","article-title":"Cancer in electrical workers: an analysis of cancer registrations in England, 1981\u201387","volume":"73","author":"Fear","year":"1996","journal-title":"Br J Cancer"},{"key":"2025120520344106000_5.6.e007384.22","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0347"},{"key":"2025120520344106000_5.6.e007384.23","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-011-0683-y"},{"key":"2025120520344106000_5.6.e007384.24","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1002\/ajim.20725","article-title":"Mortality among sheet metal workers participating in a medical screening program","volume":"52","author":"Dement","year":"2009","journal-title":"Am J Ind Med"},{"key":"2025120520344106000_5.6.e007384.25","doi-asserted-by":"crossref","first-page":"411","DOI":"10.5271\/sjweh.693","article-title":"Cancer incidence among workers in the asbestos-cement producing industry in Norway","volume":"28","author":"Ulvestad","year":"2002","journal-title":"Scand J Work Environ Health"},{"key":"2025120520344106000_5.6.e007384.26","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2013-101528"},{"key":"2025120520344106000_5.6.e007384.27","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5271\/sjweh.706","article-title":"Incidence of cancer among the participants of the Finnish Asbestos Screening Campaign","volume":"29","author":"Koskinen","year":"2003","journal-title":"Scand J Work Environ Health"},{"key":"2025120520344106000_5.6.e007384.28","first-page":"90","article-title":"Incidence of cancer and mortality among employees in the asbestos cement industry in Denmark","volume":"46","author":"Raffn","year":"1989","journal-title":"Br J Ind Med"},{"key":"2025120520344106000_5.6.e007384.29","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2006.029652"},{"key":"2025120520344106000_5.6.e007384.30","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/155.11.1016"},{"key":"2025120520344106000_5.6.e007384.31","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1164\/rccm.201302-0257OC","article-title":"Asbestos, asbestosis, smoking, and lung cancer. New findings from the North American insulator cohort","volume":"188","author":"Markowitz","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"key":"2025120520344106000_5.6.e007384.32","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.099390"},{"key":"2025120520344106000_5.6.e007384.33","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/bgm034"},{"key":"2025120520344106000_5.6.e007384.34","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2009.047019"},{"key":"2025120520344106000_5.6.e007384.35","unstructured":"Starr P . Social categories and claims in the liberal state. In: Douglas M , Hull D, eds. How classification works. Edinburgh University Press, 1992:154\u201379."},{"key":"2025120520344106000_5.6.e007384.36","unstructured":"Pichault F , Xhauflair V , Deflandre D , et al . Flexibiliteit en Aantrekkelijkheid: Sociaal overleg in een context van projectmanagement. Report Federatie van Algemene Bouwondernemers-F\u00e9d\u00e9ration des Entrepreneurs G\u00e9n\u00e9raux de la Construction, 2005:103."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-007384","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:34:51Z","timestamp":1764995691000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-007384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2015,6,24]]},"published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1136\/bmjopen-2014-007384"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-007384","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6]]}}}