Objectives: The feasibility of a European epidemiologic study of cancer risk among asphalt workers was examined in Western Europe. The study was motivated by occupational and public health concern about possible health risk from exposure to bitumen fumes.
Methods: Information on the accessibility and quality of epidemiologic resources, retrospective worker records, mortality and cancer incidence records, and exposures was requested from research institutes and road paving and asphalt mixing companies in 15 European countries.
Results: Research institutes and asphalt companies in 12 countries responded. It was found that at least 44 companies in seven countries can be included in a retrospective mortality study of a minimum of 32,000 employees with 356,000 person-years (over 100 lung cancers). Coal tar will be an important confounder for these data. The power of a cohort study of workers who have never worked with tar-containing materials remains insufficient. Even in an ambispective study extending to the year 2005, the expected lung cancer deaths in a tar-free cohort would be only four.
Conclusions: The results suggest that a case-referent study of lung cancer, nested in an international cohort of asphalt workers, represents the design of choice, conditionally on the possibility of assessing relevant individual life-time exposures. A cross-sectional determination of relevant biomarkers of exposure such as adducts in lymphocytes or the presence of metabolites of polycyclic aromatic compounds in urine in a group of workers exposed to bitumen fumes will provide further relevant information.