{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T23:59:07Z","timestamp":1781308747240,"version":"3.54.1"},"reference-count":49,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T00:00:00Z","timestamp":1640563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objectives: To examine the asbestos-associated cancer incidence and the risk of multiple cancers in former school children exposed to environmental asbestos in childhood. Methods: A cohort of 12,111 former school children, born 1940\u20131970, was established using 7th grade school records from four schools located at a distance of 100\u2013750 m in the prevailing wind direction from a large asbestos-cement plant that operated from 1928 to 1984 in Aalborg, Denmark. Using the unique Danish personal identification number, we linked information on employments, relatives\u2019 employments, date of cancer diagnosis, and type of cancer and vital status to data on cohortees extracted from the Supplementary Pension Fund Register (employment history), the Danish Cancer Registry, and the Danish Civil Registration System. We calculated standardized incidence rates (SIRs) for asbestos-associated cancers, all cancers, and multiple cancers using rates for a gender and five-year frequency-matched reference cohort. Results: The overall incidence of cancer was modestly increased for the school cohort (SIR 1.07, 95% confidence interval (CI) 1.02\u20131.12) compared with the reference cohort. This excess was driven primarily by a significantly increased SIR for malignant mesothelioma (SIR 8.77, 95% CI 6.38\u201312.05). Former school children who had combined childhood environmental and subsequent occupational exposure to asbestos had a significantly increased risk of lung cancer. Within this group, those with additional household exposure by a relative had a significantly increased SIR for cancer of the pharynx (SIR 4.24, 95% CI 1.59\u201311.29). We found no significant difference in the number of subjects diagnosed with multiple cancers between the two cohorts. Conclusions: Our study confirms the strong association between environmental asbestos exposure and malignant mesothelioma and suggests that environmental asbestos exposure in childhood may increase the overall cancer risk later in life.<\/jats:p>","DOI":"10.3390\/ijerph19010268","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T01:18:15Z","timestamp":1640654295000},"page":"268","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cancer Incidence and Risk of Multiple Cancers after Environmental Asbestos Exposure in Childhood\u2014A Long-Term Register-Based Cohort Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Sofie B\u00fcnemann","family":"Dalsgaard","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark"},{"name":"Danish Ramazzini Centre, Department of Occupational and Environmental Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark"},{"name":"Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Goedstrup Hospital, 7400 Herning, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Else Toft","family":"W\u00fcrtz","sequence":"additional","affiliation":[{"name":"Danish Ramazzini Centre, Department of Occupational and Environmental Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark"},{"name":"Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-2725","authenticated-orcid":false,"given":"Johnni","family":"Hansen","sequence":"additional","affiliation":[{"name":"Danish Cancer Society Research Center, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4870-5822","authenticated-orcid":false,"given":"Oluf Dimitri","family":"R\u00f8e","sequence":"additional","affiliation":[{"name":"Department of Oncology, Aalborg University Hospital, 9000 Aalborg, Denmark"},{"name":"Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway"},{"name":"Department of Oncology, Levanger Hospital, Nord-Tr\u00f8ndelag Hospital Trust, 7600 Levanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8yvind","family":"Omland","sequence":"additional","affiliation":[{"name":"Danish Ramazzini Centre, Department of Occupational and Environmental Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1183\/09059180.00007014","article-title":"Malignant pleural mesothelioma: History, controversy and future of a manmade epidemic","volume":"24","author":"Roe","year":"2015","journal-title":"Eur. 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