Update of Potency Factors for Asbestos-Related Lung Cancer and Mesothelioma

Figures & data

FIG. 1 Observed and predicted lung cancer relative risk vs. cumulative exposure (Wittenoom Cohort).

FIG. 2 Observed and predicted lung cancer relative risk vs. cumulative exposure (South Carolina Cohort).

FIG. 3 Observed and predicted lung cancer relative risk vs. cumulative exposure (Patterson, New Jersey Cohort).

FIG. 4 Observed and predicted lung cancer relative risk vs. years after exposure ends (Wittenoom Cohort).

FIG. 5 Observed and predicted lung cancer relative risk vs. years after exposure ends (South Carolina Cohort).

FIG. 6 Observed and predicted lung cancer relative risk vs. years after beginning of exposure (New Jersey Cohort).

TABLE 1 Results of tests of hypotheses that mesothelioma mortality varies linearly with exposure intensity (test of K = 1 in Eq. 7), or with the square of time since exposure lagged 10 Years (test of z = 2 in Eq. 8)

				K (non-	P-value for
Tests of non-linearity				linearity	test of K = 1
parameter, K		KM × 10^8	90% CI	parameter)	(linearity)
Wittenoom	(K = 1)	12	(11, 15)	1.0
(222 mesotheliomas)	(K estimated)			followup ends	<0.00001
Quebec
Mines and mills at Asbestos	(K = 1)	0.012	(0.0065, 0.021)	1.0
(8 mesotheliomas)	(K estimated)	0.35		0.21	0.02
Mines and mills at Thedford Mines	(K = 1)	0.021	(0.014, 0.029)	1.0
(22 mesotheliomas)	(K estimated)	0.99		0.15	<0.00001
Factory workers	(K = 1)	0.095	(0.041, 0.18)	1.0
(5 mesotheliomas)	(K estimated)	0.63		0.51	0.15
All locations	(K = 1)	0.020	(0.015, 0.026)	1.0
(35 mesotheliomas)	(K estimated)	0.72		0.19	<0.00001
South Carolina	(K = 1)	0.15	(0.047, 0.33)	1.00
(3 mesotheliomas)	(K estimated)	0.42		0.44	0.43
Test of power of time, z				z (power on time)	P-value for test of z=2
Wittenoom		21		1.83	0.29
Quebec, all locations		0.013		2.12	0.79
South Carolina		2.5		1.21	0.56

FIG. 7 Observed and predicted mesothelioma deaths per 100,000 person-years vs. exposure intensity (Wittenoom Cohort).

FIG. 8 Observed and predicted mesothelioma deaths per 100,000 person-years vs. years since last exposure (Wittenoom Cohort).

FIG. 9 Observed and predicted mesothelioma deaths per 100,000 person-years vs. years since last exposure (Quebec Cohort).

FIG. 10 Observed and predicted mesothelioma deaths per 100,000 person-years vs. years since first exposure (New Jersey Cohort).

TABLE 2 Uncertainty Factors Used to Develop Uncertainty Intervals for Exposure-Response Coefficients (K_L's and K_M's)

		Uncertainty Factors for Estimating Exposure^a			Special Uncertainty Factors^b		Combined Uncertainty Factor, F
Operation	Cohort	F1	F2	F3	F4L	F4M	Lung Cancer	Mesothelioma	Reference
Chrysotile
Mining and milling	Quebec	2	1.5				2.2	2.2	Liddell et al. (1997)
	Asbestos, Quebec	2	1.5				ND	2.2	Liddell et al. (1997)
	Thedford Mines	2	1.5				ND	2.2	Liddell et al. (1997)
	Italian mine and Mill	2					2.0	ND	Piolatto et al. (1990)
Friction products	Connecticut plant	2	3			3	3.7	5.5	McDonald et al. (1984)
Cement manufacture	New Orleans plant	2	1.5			5	2.2	6.0	Hughes et al. (1987)
Textiles	South Carolina plant	1.5					1.5	1.5	Hein et al. (2007)
		2				3	2.0	3.7	McDonald et al. (1983a)
Crocidolite
Mining and milling	Wittenoom	2.5	3	1.5			4.4	4.4	Berry et al. (2004)
Amosite
Insulation manufacture	Patterson, NJ factory	3.5					3.5	3.5	Seidman et al. (1986)
	Tyler, TX factory	3					3.0	ND	Levin et al. (1998)
Winchite-richterite
Vermiculite mines and mills	Libby, MT	2	1.5				2.2	ND	Sulluvan (2007)
		2	1.5				2.2	ND	McDonald et al. (2004)
Mixed
Friction products	British factory	2			1.5		2.2	ND	Berry & Newhouse (1983)
Cement Manufacture	Ontario factory	4	3			2	5.9	6.7	Finkelstein (1984)
	New Orleans plant	2	1.5			2.5	2.2	3.4	Hughes et al. (1987)
	Swedish plant	4					4.0	ND	Albin et al. (1990)
	Belgian factory	4					4.0	ND	Laquet et al. (1980)
Factory workers	U.S. retirees	2	3				3.7	ND	Enterline et al. (1986)
	Asbestos, Quebec	2	1.5				ND	2.2^c	Liddell et al. (1997)
Insulation Application	U.S. insulation workers	4		2	2		5.5	4.7	Seilkoff & Seidman (1991)
Textiles	Pennsylvania plant	2	3			2	3.7	4.4	McDonald et al. (1983b)
	Rochdale plant	2	2				2.7	2.7	Peto et al. (1985)

^aUncertainty factor definitions are: F1, estimating exposure concentration; F2, converting to PCM; F3, assigning job histories.

^bSpecial uncertainty factor definitions are: F4L, lung cancer limitations; F4M, mesothelioma limitations.

NOTES: values for uncertainty factors not listed in the table are assumed to be equal to 1.0.

A description of the manner in which each of the values presented in this table was assigned is presented under the individual study descriptions.

ND means not determined.

TABLE 3 Lung cancer dose-response coefficients (K_L) derived from various epidemiological studies.

			EPA (1986)
					This Update	90% Confidence	Uncertainty
Fiber Type	Operation	Cohort	K*L 100	Ref.	K*L100	Interval	Interval^a	Ref.
Chrysotile	Mining and Milling	Quebec mines and mills	0.06	1	0.029	(0.019, 0.051)	(0.0085, 0.11)	16
			0.17	2
		Italian mine and mill	0.081	3	0.051	(0, 0.57)	(0, 1.1)	17
	Friction Products	Connecticut plant	0.01	4	0	(0, 0.61)	(0, 2.2)	4
	Cement Manufacture	New Orleans plants			0.25	(0, 0.70)	(0, 1.6)	18
	Textiles	South Carolina plant	2.8	5	1.8	(1.1, 3.7)	(0.75, 5.6)	19
			2.5	6	1	(0.44, 2.5)	(0.22, 4.9)	6
Crocidolite	Mining and Milling	Wittenoom			1.1	(0.75, 5.3)	(0.17, 23)	20
Amosite	Insulation	Patterson, NJ factory	4.3	7	2.4	(1.8, 7.6)	(0.52, 27)	21
	Manufacture	Tyler, Texas factory			0.28	(0, 2.2)	(0, 6.6)	22
Tremolite	Vermiculite Mines	Libby, Montana			0.26	(0, 1.3)	(0, 3.0)	23
	and Mills				0.36	(0.03, 3.6)	(0.013, 8.0)	24
Mixed	Friction Products	British factory	0.058	8	0.058	(0, 0.8)	(0, 1.8)	25
	Cement Manufacture	Ontario factory	4.8	9	1.9	(1.2, 6.8)	(0.20, 40)	26
		New Orleans plants	0.53	10,11	0.25	(0, 0.70)	(0, 1.6)	18
		Swedish plant			0.067	(0, 6.4)	(0, 26)	27
		Belgium factory			0.0068	(0, 0.21)	(0, 0.84)	28
	Factory workers	U.S. retirees	0.49	12	0.11	(0.041, 0.28)	(0.011, 1)	29
	Insulation Application	U.S. insulation workers	0.75	13	0.28	(0.25, 0.93)	(0.045, 5.1)	30
	Textiles	Pennsylvania plant	1.4	14	1.8	(0.27, 4.5)	(0.073, 16)	14
		Rochdale plant	1.1	15	0.41	(0.12, 0.87)	(0.046, 2.3)	31

^aUncertainty Interval formed by combining 90% confidence interval with uncertainty factors in Table A-3.

References: ¹McDonald et al. (1980); ²Nicholson et al. (1979); ³Piolatto et al. (1990); ⁴McDonald et al. (1984); ⁵Dement et al. (1983); ⁶McDonald et al. (1983a); ⁷Seidman (1984); ⁸Berry and Newhouse (1983); ⁹Finkelstein (1983); ¹⁰Weill et al. (1979); ¹¹Weill (1984); ¹²Henderson and Enterline (1979); ¹³Selikoff et al. (1979); ¹⁴McDonald et al. (1983b); ¹⁵Peto (1980); ¹⁶Liddell et al. (1997); ¹⁷Piolatto et al. (1990); ¹⁸Hughes et al. (1987); ¹⁹Hein et al. (2007); ²⁰Berry et al. (2004), raw data from de Klerk; ²¹Seidman (1986); ²²Levin et al. (1998); ²³Sullivan (2007); ²⁴McDonald et al. (2004); ²⁵Berry & Newhouse (1983); ²⁶Finkelstein (1984); ²⁷Albin et al. (1990); ²⁸Laquet et al. (1980); ²⁹Enterline et al. (1986); ³⁰Selikoff & Seidman (1991); ³¹Peto (1985).

TABLE 4 Mesothelioma dose-response coefficients (K_M) derived from various epidemiological studies.

			EPA (1986)
					This Update	90 % Confidence	Uncertainty
Fiber Type	Operation	Cohort	KM* 10^8	Reference	KM* 10^8	Interval	Interval^a	Reference
Chrysotile	Mining and Milling	Asbestos, Quebec			0.012	(0.0065, 0.021)	(0.0029, 0.047)	6
		Thetford MInes			0.021	(0.014, 0.029)	(0.0065, 0.065)	6
	Friction Products	Connecticut plant			0	(0, 0.12)	(0, 0.65)	7
	Cement manufacture	New Orleans plants			0.2	(0.065, 0.45)	(0.011, 2.7)	8
	Textiles	South Carolina plant			0.15	(0.047, 0.33)	(0.031, 0.5)	9
					0.088	(0.0093, 0.32)	(0.0025, 1.2)	10
Crocidolite	Mining and Milling	Wittenoom			12	(11, 14)	(2.5, 60)	11
Amosite	Insulation manufacturing	Patterson, NJ factory	3.2	1	3.9	(2.6, 5.7)	(0.74, 20)	12
Mixed	Cement manufacture	Ontario factory	12	2	18	(13, 24)	(2, 160)	13
		New Orleans plants			0.3	(0.097, 0.68)	(0.029, 2.3)	8
	Factory workers	Asbestos, Quebec			0.095	(0.04, 0.18)	(0.018, 0.41)	6
	Insulation application	U.S. insulation workers	1.5	3	1.3	(1.2, 1.4)	(0.25, 6.5)	14
	Textiles	Pennsylvania plant			1.4	(1.0, 1.8)	(0.23, 8)	15
		Rochdale plant	1	4,5	1.3	(0.74, 2.1)	(0.28, 5.6)	16

^aUncertainty Interval formed by combining 90% confidence interval with uncertainty factors in Table A-3.

Rererences: ¹Seidman (1984); ²Finkelstein (1983); ³Selikoff et al. (1979); ⁴Peto (1980); ⁵Peto et al. (1982); ⁶Liddell et al. (1997), raw data from Liddell; ⁷McDonald et al. (1984); ⁸Hughes et al. (1987); ⁹Hein et al. (2007), raw data and supplemental information from Hein; ¹⁰McDonald et al. (1983a); ¹¹Berry et al. (2004), raw data from de Klerk; ¹²Seidman (1986); ¹³Finkelstein (1984); ¹⁴Selikoff and Seidman (1991); ¹⁵McDonald et al. (1983b); ¹⁶Peto (1985)

FIG. 11 Plot of estimated K_L values and associated uncertainty intervals by study environment (from Table 3).

FIG. 12 Plot of estimated K_M values and associated uncertainty intervals by study environment (from Table 4).

TABLE B1 Cancer of lung, trachea, or bronchus by cumulative exposure level among workers in quebec chrysotile mines and mills Liddell et al. (1997)

mpcf-yr						Predicted
		(f-yr)/ml
Range	Mean	Mean	SMR	Expected	Observed	α=1	α=1.15
0–3	1.5	4.71	1.12	67.0	75	67.1	76.9
3–10	6.5	20.41	1.27	50.4	64	50.8	58.2
10–30	20	62.8	1.03	59.2	61	60.8	69.2
30–60	45	141.3	1.32	45.5	60	48.1	54.3
60–100	80	251.2	1.45	42.1	61	46.4	51.8
100–200	150	471	1.27	52.8	67	63.0	68.8
200–300	250	785	1.1	31.8	35	42.1	44.8
300–400	350	1099	1.46	19.9	29	28.8	30.1
400–1000	700	2198	1.84	47.8	88	91.1	89.9
>1000	1500	4710	2.97	15.8	47	46.5	43.0
Totals				432.2	587	544.7	587.0
			α=1(fixed)		α=1.15(MLE)
KL× 100			0.041		0.029
(90% Confidence Interval)			(0.032, 0.051)		(0.019, 0.041)
Goodness of Fit		P-value	0.18		0.58
Test of H0: α= 1		P-value	0.01

TABLE B2 Lung cancer mortality among chrysotile asbestos miners in balangero, Northern Italy Piolatto et al. (1990)

f-y/ml				Predicted
Range	Mean	Observed	Expected	α=1	α=0.937
<100	50	4	5.1	5.2	4.9
100–400	250	8	6.1	6.6	6.4
>400	600	10	8.7	10.5	10.7
Totals		22	19.9	22.3	22.0
			α=1(fixed)		α=0.937(MLE)
KL× 100			0.035		0.051
(90% Confidence Interval)			(0, 0.15)		(0, 0.57)
Goodness of Fit		P-value	0.75		0.45
Test of H0: α= 1		P-value	0.88

TABLE B3 Lung cancer mortality among workers in a chrysotile asbestos friction products plant in connecticut McDonald et al. (1984)

mpcf-yr						Predicted
		(f-yr)/ml
Range	Mean	Mean	SMR	Expected	Observed	α=1	α=1.49
<10	5	15	167.4	32.9	55	33.8	49.0
10–20	15	45	101.7	5.9	6	6.4	8.8
20–40	30	90	105.4	4.7	5	5.5	7.1
40–80	60	180	162.8	3.7	6	4.9	5.5
>80	110	330	55.22	1.8	1	2.9	2.7
Totals				49.0	73	53.6	73.0
			α=1(fixed)		α=1.49(MLE)
KL× 100			0.19		0
(90% Confidence Interval)			(0, 0.61)		(0, 0.17)
Goodness of Fit		P-value	0.01		0.28
Test of H0: α= 1		P-value	0.001

Table

	Number	Number of
Age	entering	deaths in	Person-years
(years)	interval	interval	in interval
45–50	x	0.032x	4.9x
50–55	x(1 – .00638)^5= 0.97x	0.052x	4.7x
55–60	0.97x(1 – 0.01072)^5= 0.92x	0.076x	4.4x
60–65	0.92x(1 – 0.01718)^5= 0.84x	0.11x	3.9x
65+	0.84x(1 – 0.02681)^5= 0.73x
Totals		0.27x	18.0x

TABLE B4 Mesothelioma mortality among connecticut friction product plant workers McDonald et al. (1984)

Years after first exposure
		Duration of		Person
Range	Mean	Exposure	f/ml	Years	Observed	Predicted
14–34	22	8.04	5.52	37742	0	0.0
>34	39	8.04	5.52	9420	0	0.0
Totals				47162	0	0.0
KM× 10^8			0
(90% Confidence Interval)			(0, 0.12)
Goodness of Fit P-Value			1.00

TABLE B5 Lung cancer mortality among workers employed in two asbestos cement manufacturing plants in New Orleans, Louisiana Hughes et al. (1987)

mpcf-yr					Predicted
		(f-yr)/ml
Range	Mean	Mean	Observed	Expected	α=1	α=1.14
Plant 1 Employees
<6	4	5.6	3	2.9	3.0	3.4
6–25	13	18.2	9	8	8.6	9.6
25–50	35	49	2	3.7	4.4	4.8
50–100	74	103.6	3	3.8	5.4	5.5
>100	183	256.2	5	4.1	8.3	7.7
Plant 2 Employees
<6	3	4.2	20	18.9	19.2	21.8
6–25	12	16.8	19	14.5	15.5	17.3
25–50	36	50.4	12	6	7.2	7.7
50–100	71	99.4	10	5.5	7.7	7.9
>100	164	229.6	12	5.2	9.9	9.4
Totals			95	72.6	89.0	95.0
			α=1 (fixed)		α=1.14 (MLE)
KL× 100			0.4		0.25
(90% Confidence Interval)			(0.15, 0.7)		(0, 0.66)
Goodness of Fit		P-value	0.44		0.42
Test of H0: α= 1		P-value	0.18

TABLE B6 Lung cancer mortality among chrysotile asbestos textile workers in Charleston, South Carolina Hein et al. (2007)

f-y/ml				Predicted
Range	Mean	Observed	Expected	α=1	α=1.35
<1.5	0.4	34	22.1	22.3	30.1
1.5–5	2.9	34	25.3	27.4	35.9
5–15	8.8	33	21.7	27.1	33.7
15–60	31.3	35	18.4	34.6	38.1
60–120	84.3	32	9.4	31.7	30.9
>120	185.1	31	5.4	33.6	30.2
Totals		199	102.3	176.7	199.0
			α=1(fixed)		α=1.35(MLE)
KL× 100			3.0		1.8
(90% Confidence Interval)			(2.3,3.73)		(1.12,2.67)
Goodness of Fit		P-value	0.09		0.64
Test of H0: α= 1		P-value	0.008

TABLE B7 Lung cancer mortality among workers in a chrysotile asbestos textiles plant in South Carolina McDonald et al. (1983a)

mpcf-yr						Predicted
		(f-yr)/ml
Range	Mean	Mean	SMR	Expected	Observed	α=1	α=1.07
<10	5	30	143.1	21.7	31	29.2	30.4
10–20	15	90	182.7	2.7	5	5.6	5.7
20–40	30	180	304.2	2.6	8	8.1	8.0
40–80	60	360	419.5	1.7	7	8.6	8.4
>80	110	660	1031.9	0.8	8	6.7	6.5
Totals				29.5	59	58.1	59.0
			α=1(fixed)		α=1.07(MLE)
KL× 100			1.2		1
(90% Confidence Interval)			(0.75, 1.6)		(0.44, 2.5)
Goodness of Fit		P-value	0.95		0.88
Test of H0: α= 1		P-value	0.80

TABLE B8 Mesothelioma mortality among South Carolina textile plant workers McDonald et al. (1983a)

Years after first exposure
				Person
Range	Mean	Duration	f/ml	Years	Observed	Predicted
19–39	28	10	5.4	26280	0	0.7
>39	44	10	5.4	2787	1	0.3
Totals				29067	1	1.0
KM× 10^8			0.088
(90% Confidence Interval)			(0.0093, 0.32)
Goodness of Fit P-Value			0.14

TABLE B9 Lung cancer mortality among asbestos workers in Wittenoom, Australia, Berry et al. (2004), based on raw data from de Klerk

(f-yr)/ml				Predicted
Range	Average	Expected	Observed	α=1	α=2.81	α=2
0–1	0.11	19.1	50	19.4	53.7	38.4
1–5	2.65	24.5	65	27.3	69.5	50.4
5–10	7.03	14.7	53	19.1	42.4	31.6
10–30	17.7	18.8	57	33.2	56.8	45.0
30–60	42.8	9.5	25	27.0	31.5	28.0
60–120	84.3	6.1	29	28.2	23.1	23.5
> 120	219.9	4.7	23	47.4	25.0	31.3
Totals		97.4	302	201.5	302.0	248.1
			α=1(fixed)		α=2.81(MLE)	α=2(fixed)
KL× 100			4.3		0.42	1.1
(90% Confidence Interval)			(3.4, 5.3)		(0.16, 0.76)	(0.74, 1.5)
Goodness of Fit		P-value	<0.0001		0.31
Test of H0: α= 1		P-value	<0.0001

Note: These estimates were derived from data cross-categorized by cumulative exposure lagged 10 years and time since last exposure.

TABLE B10 Lung Cancer Mortality by Cumulative Exposure among Amosite Asbestos Factory Workers in Paterson, New Jersey Seidman et al. (1986)

(f-yr)/ml					Predicted
Range	Average	SMR	Expected	Observed	α=1	α=3.32	α=2
<6	3	2.8	5.3	15	6.3	18.2	11.4
6–12	9	4.2	2.9	12	4.5	10.5	7.0
12–25	18.5	4.4	3.4	15	7.3	13.5	9.8
25–50	37.5	4.7	2.8	13	9.3	13.0	10.6
50–100	75	7.1	2.4	17	13.5	14.3	13.4
100–150	125	6.0	1.5	9	13.1	11.7	12.0
150–250	200	11.4	1.3	15	17.7	13.9	15.4
250+	375	16.0	0.9	15	22.9	15.8	19.0
Totals			20.5	111	94.5	111.0	98.7
			α=1(fixed)		α=3.32(MLE)		α=2(fixed)
KL× 100			6.2		1.1		2.4
(90% Confidence Interval)			(5, 7.6)		(0.58, 1.9)		(1.8, 3.1)
Goodness of Fit		P-value	<0.001		0.90
Test of H0: α= 1		P-value	<0.001

TABLE B11 Mesothelioma Mortality among Amosite Insulation Workers in New Jersey Seidman et al. (1986)

Years after first exposure
Range	Mean	Duration	f/ml	Person Years	Observed	Predicted
5–10	7.5	1.5	46.9	3952	0	0
10–15	12.5	1.5	48.3	3628	0	0.1
15–19	17.5	1.5	44.1	3198	0	1.1
20–25	22.5	1.5	43.2	2656	2	2.8
25–30	27.5	1.5	40.3	2094	5	4.2
30–35	32.5	1.5	33.5	1576	8	4.4
35–40	37.5	1.5	31.1	1086	2	4.3
Totals				18190	17	17.0
KM× 10^8			3.9
(90% Confidence Interval)			(2.6, 5.7)
Goodness of Fit P-value			0.35

TABLE B12 Lung cancer deaths among asbestos workers in Tyler, Texas Levin et al. (1998)

Duration						Predicted
Range	Mean	f/ml	f-y/ml	Expected	Observed	α=1	α=2.48	α=2
<0.5	0.25	45	11.25	8.9	23	10.2	22.4	18.4
0.5–1	0.75	45	33.75	1.1	3	1.6	2.9	2.4
1–5	3	45	135	1.8	4	4.8	5.3	5.0
>5	7.5	45	337.5	1.5	6	7.8	5.4	5.9
Totals				13.3	36	24.4	36.0	31.6
			α=1(fixed)		α=2.48(MLE)		α=2
KL× 100			1.3		0.13		0.28
(90% Confidence Interval)			(0.55, 2.2)		(0, 0.60)		(0, 0.69)
Goodness of Fit		P-value	0.004		0.81
Test of H0: α= 1		P-value	< 0.001

TABLE B13 Lung cancer mortality by cumulative exposure among vermiculite miners near Libby, Montana Sullivan (2007)

(f-yr)/ml					Predicted
Range	Average	SMR	Expected^1	Observed^1	α=1	α=1.50
0–4.5	2.25	1.39	14.35	20	21.6	20.3
4.5–23	12	1.66	14.46	24	22.3	23.2
23.0–100	55	1.71	13.44	23	22.9	22.1
>=100.0	150	2.06	12.64	26	26.2	23.5
Totals			54.9	93.0	93.0	89.0
			α=1(fixed)		α=1.50(MLE)
KL× 100			0.88		0.26
(90% Confidence Interval)			(0.48, 1.3)		(0, 0.76)
Goodness of Fit		P-value	0.11		0.97
Test of H0: α= 1		P-value	0.02

¹Observed and expected values are based on cumulative exposure lagged ten years (P. Sullivan, 2008, personal communication).

TABLE B14 Lung cancer mortality by cumulative exposure among ontario asbestos cement plant workers Finkelstein (1984)

(f-yr)/ml						Predicted
Range	Average	SMR	Expected	Observed	Mortality Rate	α=1	α=4.26	α=2
<=30	15	2.31	1.3	3	3	2.3	5.8	3.3
30–75	52.5	6.15	1.0	6	8	3.5	4.8	3.9
75–105	90	12.08	0.4	5	15.7	2.3	2.2	2.2
105–150	127.5	9.00	0.6	5	11.7	4.1	3.2	3.8
>150	200	2.69	0.7	2	3.5	8.2	5.0	7.1
Totals			4.0	21		20.4	21.0	20.3
			α=1(fixed)		α=4.26(MLE)		α=2 (fixed)
KL× 100			5.0		0.29		1.9
(90% Confidence Interval)			(3.5, 6.8)		(0, 0.68)		(1.2, 2.8)
Goodness of Fit		P–value	0.03		0.05		0.03
Test of H0: α= 1		P-value	0.07

TABLE B15 Mesothelioma mortality among employees of an Ontario Asbestos cement factory Finkelstein (1984)

Years After First Exposure
Range	Mean	Duration	f/ml	Years	Observed	Predicted
10–15	12	6.7	9	2500	1	0.03
15–20	17	6.7	9	2500	1	1.4
20–25	22	6.7	9	2963	8	7.6
25–30	27	6.7	9	2063	13	12.8
30–35	32	6.7	9	625	6	7.2
Totals				10651	29	29.0
KM× 10^8			18
(90% Confidence Interval)			(13, 24)
Goodness of Fit P-value			0.26

TABLE B16 Lung cancer mortality among Asbestos cement workers in Sweden Albin et al. (1990)

					Predicted
(f-yr)/ml	RR	Lower Bound	Upper Bound	St. Dev.	α=1	α=1.82
Relative Risk (RR) of Dying of Lung Cancer
3.1	1.8	0.8	3.9	0.39	1.1	1.8
25.6	1.9	0.7	5.3	0.52	1.5	1.8
88.2	1.9	0.5	7.1	0.67	2.7	1.9
Totals					5.2	5.6
			α=1(fixed)		α=1.82(MLE)
KL× 100			1.9		0.067
(90% Confidence Interval)			(0, 6.5)		(0, 3.6)
Goodness of Fit		P-value	0.32		0.95
Test of H0: α= 1		P-value	0.13

TABLE B17 Lung cancer mortality among belgian Asbestos-cement factory workers Laquet et al. (1980)

(f-yr)/ml				Predicted
Range	Average	Expected	Observed	α=1	α=0.924
0–49	25	5.2	6	5.2	4.8
50–100	75	2.4	3	2.4	2.3
100–200	150	4.6	5	4.6	4.3
200–400	300	7.5	4	7.4	7.0
400–800	600	2.0	1	1.9	1.9
800–1600	1200	0.6	2	0.5	0.6
1600–3200	2400	0.2	0	0.2	0.2
Totals		22.4	21	22.1	21.0
			α=1(fixed)		α=0.924(MLE)
KL× 100			0		0.0068
(90% Confidence Interval)			(0, 0.1)		(0, 0.21)
Goodness of Fit		P-value	0.51		0.39
Test of H0: α= 1		P-value	0.77

TABLE B18 Lung cancer mortality among retirees from a US Asbestos Company Enterline et al. (1986)

mppcf-y						Predicted
Range	Mean	f-y/ml Mean	SMR	Observed	Expected	α=1	α=1.43
<125	62	186	182.3	23	12.6	17.5	21.8
125–250	182	546	203.1	14	6.9	14.7	15.9
250–500	352	1056	322	24	7.5	23.7	23.4
500–750	606	1818	405	10	2.5	11.7	10.8
>=750	976	2928	698.7	8	1.1	8.1	7.1
Totals				79	30.6	75.6	79.0
				α=1(fixed)		α=1.43(MLE)
KL× 100				0.21		0.11
(90% Confidence Interval)				(0.15, 0.27)		(0.041, 0.28)
Goodness of Fit		P-value		0.75		0.92
Test of H0: α= 1		P-value		0.24

TABLE B19 Lung cancer deaths among insulation workers in the United States and Canada Selikoff and Seidman (1991)

Years After 1st Exp.							Predicted
Range	Mean	Duration	Person Years	f-y/ml	OBS	EXP	α=1	α=2.39	α=2
<15	12.5	2.5	61655.4	37.5	7	3.9	5.1	9.9	8.5
15–20	17.5	7.5	52709.5	112.5	34	11.6	23.0	33.4	30.5
20–25	22.5	12.5	57595.4	187.5	85	27.5	72.4	88.2	83.7
25–30	27.5	17.5	50518.6	262.5	172	46.6	153.1	164.8	161.3
30–35	32.5	22.5	37165.8	337.5	252	57.5	226.5	222.3	223.1
35–40	35	25	20340	375	193	46.7	These categories
40–45	35	25	10200.5	375	129	30.9	combined into the
45–50	35	25	5256.5	375	66	18.8		Over 35 Years
50+	35	25	6151	375	71	25.4	category
35+	35	25	41948	375	459	121.8	519.0	490.4	497.5
Totals					1009	390.6	999.1	1009.0	1004.6
Exposure Concentration is 15 f/ml
				α=1(fixed)		α=2.39(MLE)			α=2 (fixed)
KL× 100				0.87		0.18		0.28
(90% Confidence Interval)				(0.81, 0.93)		(0.065, 0.38)		(0.25, 0.31)
Goodness of Fit		P-value		0.002		0.12
Test of H0: α= 1		P-value		<0.001

TABLE B20 Mesothelioma deaths among Asbestos Insulation workers Selikoff and Seidman (1991)

Years after first exposure			Observed
Range	Mean	Person Years	Pleural	Peritoneal	Total	Predicted
<15	12.5	61655	0	0	0	0.2
15–20	17.5	52710	2	3	5	4.6
20–25	22.5	57595	10	8	18	23.4
25–30	27.5	50519	33	40	73	56.3
30–35	32.5	37166	40	65	105	88.0
35–40	37.5	20340	33	58	91	87.9
40–45	42.5	10201	17	42	59	71.9
45–50	47.5	5257	27	31	58	55.5
50+	55	6151	11	38	49	106.3
Totals		301593	173	285	458	494.1
Duration = 25 Years and Exposure Concentration = 15 f/ml
KM× 10^8			1.3
(90% Confidence Interval)			(1.2, 1.4)
Goodness of Fit P-value			< 0.001

TABLE B21 Lung Cancer Mortality among Workers in a Pennsylvania Textile Factory McDonald et al. (1983b)

mppcf-y						Predicted
Range	Mean	f-y/ml	SMR	Observed	Expected	α=1	α=0.519
<10	5	15	66.9	21	31.4	34.1	20.7
10–20	15	45	83.6	5	6.0	7.5	5.6
20–40	30	90	156	10	6.4	9.7	8.8
40–80	60	180	160	6	3.8	7.6	8.3
>=80	110	330	416.1	11	2.6	7.6	9.6
Totals				53	50.2	66.4	53.0
				α=1(fixed)		α=0.519(MLE)
KL× 100				0.57		1.8
(90% Confidence Interval)				(0.27, 0.94)		(0.75, 4.5)
Goodness of Fit		P-value		0.08		0.76
Test of H0: α= 1		P-value		0.01

TABLE B22 Mesothelioma mortality among Pennsylvania textile plant workers McDonald et al. (1983b)

Years after first exposure	Duration	f/ml	Person Years	Observed	Predicted
15.5	9.18	6.96	17179	6	0.3
24	9.18	6.96	40868	10	10.4
41	9.18	6.96	9840	7	18.4
Totals			67887	29	29.0
KM× 10^8			1.4
(90% Confidence Interval)			(1.0, 1.8)
Goodness of Fit P-value			< 0.001

TABLE B23 Lung Cancer Mortality among Rochdale Asbestos Textile Factory Peto et al. (1985)

particle-yr/ml					Predicted
Range	Mean	f-y/ml	Observed	Expected	α=1	α=1.10
<1000	209	5.92	34	29.5	30.4	33.2
1000–2000	1409	39.92	8	7.7	9.2	9.8
2000–3000	2511	71.13	11	6.6	9.0	9.4
3000–4000	3474	98.41	6	5.7	8.5	8.8
4000–5000	4551	128.92	10	4.3	7.2	7.2
>=5000	9057	256.57	24	10.8	25.2	24.6
Totals			93	64.6	89.6	93.0
				α=1(fixed)		α=1.10(MLE)
KL× 100				0.52		0.41
(90% Confidence Interval)				(0.28, 0.79)		(0.12, 0.87)
Goodness of Fit		P-value		0.72		0.63
Test of H0: α= 1		P-value		0.57

TABLE B24 Mesothelioma mortality among rochdale asbestos textile factory Peto et al. (1985)

Years after first exposure
Range	Mean	Duration	f/ml	Person Years	Observed	Predicted
0–20	11.5	0.5	9.12	28015	0	0.01
20–25	22.5	0.5	9.12	4668	0	0.2
25–30	27.5	0.5	9.12	3470	0	0.3
30–35	32.5	0.5	9.12	2041	0	0.3
35–40	37.5	0.5	9.12	840	0	0.2
>=40	42	0.5	9.12	402	0	0.1
0–20	11.5	3	9.12	4786	0	0.003
20–25	22.5	3	9.12	877	0	0.2
25–30	27.5	3	9.12	632	0	0.3
30–35	32.5	3	9.12	421	0	0.3
35–40	37.5	3	9.12	238	0	0.3
>=40	42	3	9.12	148	1	0.2
0–20	11.5	7.5	9.12	8521	0	0.01
20–25	22.5	7.5	9.12	1417	0	0.5
25–30	27.5	7.5	9.12	1104	0	0.9
30–35	32.5	7.5	9.12	707	0	1.1
35–40	37.5	7.5	9.12	383	0	0.9
>=40	42	7.5	9.12	249	0	0.9
0–20	11.5	15	9.12	4814	0	0.003
20–25	22.5	15	9.12	1423	0	0.5
25–30	27.5	15	9.12	870	0	0.9
30–35	32.5	15	9.12	470	3	1.0
35–40	37.5	15	9.12	204	0	0.7
>=40	42	15	9.12	102	1	0.5
20–25	22.5	25	9.12	848	1	0.3
25–30	27.5	25	9.12	935	1	1.0
30–35	32.5	25	9.12	600	2	1.3
35–40	37.5	25	9.12	257	1	1.0
>=40	42	25	9.12	122	0	0.8
30–35	32.5	35	9.12	86	0	0.2
35–40	37.5	35	9.12	107	0	0.4
>=40	42	35	9.12	103	0	0.7
Totals				69861	10	16.1
KM× 10^8			1.3
(90% Confidence Interval)			(0.74, 2.1)
Goodness of Fit P-value			0.80