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Objectives To examine the association between work-place exposure to asbestos and risk factors for developing asbestos related diseases using the analysis of a cross-sectional cohort of 8582 formerly asbestos exposed workers followed between March 2002 until the end of the year 2009. To assess the value of the three risk categories used for focused health surveillance programmes among formerly asbestos exposed power industry. Methods The work started with a descriptive analysis of three asbestos exposed sub-cohorts of workers from different types of the power industry then assessed the difference between the three sub-cohorts with regard to their corresponding level of risk. Further, we investigated how well the risk categories could predict the risk of asbestos related disease in comparison to applying a single risk factor such as age or asbestos exposure. Results The smokers over 65 age of years and those who had an exposure duration over 10 years were more likely to have lung cancer in this cohort. Hence the results showed that the age of participants (over 65 years, OR=11.47), smoking habits (OR=9.48 (current smoker), were associated significantly with lung cancer. The results showed that the risk of having lung cancer in group A was 1.87 times. Conclusions There was a strong association between both duration of exposure and age, and the risk of developing lung cancer. The use of risk categories based on a combination of risk factors may be an advantage for planning focused health surveillance programmes.

Objectives For the proposed tumour markers mesothelin and osteopontin we determined the influence of gender, age and former asbestos exposure on blood concentrations, assessed the changes over time and investigated characteristics of marker concentrations in prediagnosis samples of patients with malignant pleural mesothelioma (MPM) and lung cancer (LC). Methods We analysed multiple blood samples of 2262 volunteers of three groups: 1894 formerly asbestos exposed power industry workers, 266 mostly asbestos exposed patients suffering from chronic respiratory diseases and 102 not occupationally exposed controls. Marker concentrations were determined using commercial ELISA kits. For statistical analysis we used the t-test and multiple regression models. Results We measured 3273 and 3218 concentrations of mesothelin and osteopontin respectively. Second, third and fourth samples were obtained in 691, 304 and 72 participants. 16 patients suffering from newly developed MPM or LC could be identified, seven of them had multiple prediagnosis samples. While marker concentrations were associated with age (mesothelin p=0.006, osteopontin p Conclusions The concentrations of mesothelin and osteopontin in asbestos exposed healthy individuals are strongly influenced by age. Fixed cut-off values for deciding between clinical work up and continued surveillance appear inadequate. Results would be consistent with an increase of the mesothelin concentration between 6 and 18 months before specific clinical symptoms develop.