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EXHIBIT 138
FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020
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ORIGINAL ARTICLE
Occupational and non-occupational attributable
risk of asbestos exposure for malignant
pleural mesothelioma
A Lacourt, 1• C Gramond, 1• P
S Chamming's, 6 A Gilg llg, 4· 7 M 12
· C
4,8
3 69 1
E .7 J C Pairon, · M Goldberg,7 P Brochard ·
1> Additional material ABSTRACT
Objectives To estimate the of
mesothelioma cases that can be attributed to asbestos
exposure in France including exposure.
What is the key question?
Methods A case-control study
.,.. What is the overall impact of asbestos exposure
437 incident cases and 87 4 controls
including non-occupational exposure on pleural
conducted from 1998 to 200 2.
Correspondence to
mesothelioma?
Dr Aude Lacourt, ISPED ESSAT. What is the bottom line?
146 rue leo Bordeaux .,.. Occupational asbestos exposure explains less
33076, to
than half the pleural mesothelioma cases
and
among women, thus, there is a need to
isped. u·bordeaux2. fr asbestos exposure were estimated
quantify the impact of non-occupational
conditional
asbestos exposure for mesothelioma.
Results A
Why read on?
,. This study provides insights regarding
non-occupational exposure impact in pleural
mesothelioma occurrence, among
INTRODUCTION
arc the
mesothelioma. 1 2
Asbestos had been evt1,nu\1Plv used in many indus-
the world, and was countries.
banned in most industrialised countries, with such France, the National Jv1esothelioma
action first m I 980s and (PNSM) 998
Co~r;igbtrAlrticle ~ms(O:ttttltllil6em'pltb~t)?~444. Produced by BMJ Publishing Group Ltd (& BTS) under licence.
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to relevant information on the health effects of asbestos
Table 1 Description of the exposure parameters used to assess
exposure on the French population. It relies on the exhaustive
asbestos exposure at job level
of all incident primary tumours in
Asbestos exposure Numerical
parameters Definition values*
Probability of Degree of confidence that exposure really
exposure occurred, expressed in percent (%)
Not exposed 0 0
Possible >0-50 0.5
MATERIALS AND METHODS Definite >50-100
Study design Frequency of Expressed in percent of work time (%)
The exposure
Sporadic >0-5 0.025
Occasional >5-30 0.25
Two Frequent or >30-100 0.75
matched with cases for sex, age (±5 and district of resi- continuous
dence. rares of cases and controls were 61.1 ()1b and Intensity of exposure Expressed in f/ml
20.WVci, respectively. Low >0-0.1 0.1
Trained interviewers administered a standardised question- Medium >0.1-1
naire to each subject. alive at rhe time of the inter- High >1-10 10
included. Information about lifetime Very high >10 100
*Numerical values assigned to each category in order to calculate cumulative
exposure index.
Asbestos exposure assessment
tion. 20 asbestos exposure ARp
duration of exposure of each job held estimated among matched sets where cases and controls were
job occupational exposure parameters are semiquantitative, not occupationally exposed to asbestos. Considering all asbestos
numeric1l values were to each of them l ). These exposure, the overall was estimated OR
Lacourt A, et al. Thorax 2014;0 1-8. doi: 10.1136/thoraxjnl-2013-203744
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NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023
were versus 77.WVci
of controls.
The rr>l~t11•m:h between mesotbelioma and occupa-
tional asbestos exposure is reporred in table 4.
ORs for mesorhelioma were
and a
OR for
to those
41.7). The estimated asbestos exposure was
83.!0A1 (99% Cl 74.5% to 91.7%) in men and 41.7% (9SCVc1 Cl
RESULTS 25.3% to 58.0%) in women.
The 437 (362 75 Table S presents the association between
and 874 controls (724 men, 150 women). Table 2 presents the asbestos exposure and pleural mesothelioma among
mam characteristics. Cases were ascertained in average never occupationally that is, 9 matched sets among
near 12 months after had been hut males (9 cases and 18 and 36 matched sets among
interviewed before the cc:rtification of the on (36 cases and OR for men
average, .1 months after had been recorded. The soc10-
economic category differed between cases and controls: 59.4(}(,
of male cases were blue-collar workers versus 32.2% for con-
4 l. l % of and
Table 2 Main characteristics of 437 cases men; 75 and 874 controls (724 men; 150 French case-control
998-2002
Men (1 086) Women (225)
Cases (362) Controls (724) Cases (75) Controls (150)
Ii % 11 % 11 %
Age (years)
Mean (SD) 67.6 (9.3) 66.8 (91) 66.6 (9.1) 65.8 (89)
Range 41-93 41-89 41-92 41-89
Education level (years)
185 .1 275 38.0 33 44.0 40.0
>14 177 48.9 449 62.0 42 56.0 90 60()
period (months)
Mean (SD) (188)
Range 0-97.1 0.2-65.9
Mean (SD) 3A 3A (4.4)
Range 0-43.7 0-363
Last held occupation (iSCO 1968 major group)*
0/1 Professional, technical and related workers 49 13.5 146 20.2 5 6.9 31 21.5
2 Administrative and managerial workers 15 4.1 68 9.4 3 4.1 0.7
3 Clerical and related workers 34 9.4 91 12.6 30 41.1 41 285
4 Sales workers 23 6.4 69 9.5 9.6 13 9.0
5 Service workers 16 4.4 48 6.6 16 21.9 34 23.6
6 Agricultural, animal husbandry and forestry 10 2.8 69 9.5 3 4.1 4 2.8
workers; fishermen; hunters
71819 Production and related workers, transport 215 59.4 233 32.2 9 12.3 20 13.9
equipment operators and labourers
*Among women, two cases and six controls had never worked.
Lacourt A, et al. Thorax 2014;0: 1--8. doi: 10. 1136/thoraxjnl-2013-2037 44
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Table 3 Occupational asbestos exposure: proportion of exposed men in the most represented occupations and industries, French case-control
study, 1998-2002
Cases (362) Controls (724)
Exposed within job Exposed within job
n % n %
11 % 11 %
Occupations (ISCO Edition 1968)
8-73 Sheet-metal workers 54 14.9 49 90.7 27 3.7 21 77.8
8-49 Machinery fitters, machine assemblers n.e.c. * 46 12.7 31 67.4 37 5.1 25 67.6
7-00 Production supervisors and general foremen 44 12.2 31 70.5 56 7.7 40 71.4
8-71 Plumbers and pipe fitters 39 10.8 36 92.3 14 1.9 12 85.7
8-41 Machinery fitters and machine assemblers 37 10.2 21 56.8 30 4.1 13 43.3
9-99 Labourers n.e.c. * 36 9.9 24 66.7 27 3.7 15 55.6
6-21 General farm workers 31 8.6 0 0.0 86 11.9 4 4.7
9-51 Bricklayers, stonemasons and tile setters 29 8.0 25 86.2 31 4.3 26 83.9
8-34 Machine-tool operators 26 7.2 14 53.8 29 4.0 7 24.1
9-54 Carpenters, joiners and parquetry workers 26 7.2 21 80.8 27 3.7 20 74.1
Industries (!SIC Revision 2)
5000 Construction 129 35.6 109 84.5 140 19.3 105 75.0
3841 Ship building and repairing 65 18.0 58 89.2 20 2.8 19 95.0
3813 Manufacture of structural metal products 52 14.4 43 82.7 30 4.1 20 66.7
1110 Agriculture and livestock production 48 13.3 5 10.4 145 20.0 32 22.1
6200 Retail trade 33 9.1 8 24.2 94 13.0 19 20.2
6100 Wholesale trade 29 8.0 9 31.0 74 10.2 13 17.6
3819 Manufacture of fabricated metal 24 6.6 13 54.2 24 3.3 6 25.0
except machinery and equipment n.e.c.
9100 Public administration 24 6.6 6 25.0 71 9.8 11 15.5
3845 Manufacture of aircraft 23 6.4 10 43.5 27 3.7 10 37.0
9310 Education services 23 9 82 11.3 19 23.2
· not elsewhere classified.
occurrence
several case-control studies have envir-
rmd all confirmed the causal link hetween onmental exposure due to residence near asbestos mines. 11 10
Bourdes et al reported a summary relative risk for environmen-
risk of asbestos tal asbestos mines or asbestos
4 Lacourt A, et al. Thorax 2014;0:1-8. doi:10.1136/thoraxjnl-2013-203744
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Table 5 Non occupational asbestos exposure and risk of pleural mesothelioma among subjects non-exposed to occupational asbestos
exposure, 45 cases (9 men; 36 women) and 90 controls (18 men; 72 women), French case-control study, 1998-2002
Men Women
Cases (9) Controls (18) Cases (36) Controls (72)
Non-occupational
asbestos exposure n % n % OR 99% Cl n % n % OR 99% Cl
Not exposed 6 66.7 15 833 LO 17 4U 56 ne LO
Exposed 3 333 3 16J 2.4 0.2 to 2U 19 sn 16 2U 43 U to 15.1
probability
exposure
Possible 0 0.0 5.6 11 30.6 13 18.1 3.2 0.8 to 13.2
Definite 3 33.3 11.1 4.6 0.2 to 96.9 8 22.2 3 4.1 7.5 1.2 to 48.0
Attributable risk 20.0 (-335 to 735) 38.7 (84 to 69.0)
(99% Cl)(%)
processing plant of 7.0 (95CVi1CJ 4.7 to 11.0). To date, there is distributions of male and female incidence of mesothelioma
only weak evidence of a effect of exposure m cases with and without any identified occupational or non-
asbestos on the occurrence of asbestos exposure ""'"'"'wn the influence of
mesothelioma. 15 :isbestos in female
the limitation of this
assessment of exposure. While we are
of ilie and para-
asbestos exposure assessment, this is not the case
and environmental In
Table 6 All asbestos exposure and risk of mesothelioma, 437 cases (362 men; 75 women) and 874 controls (724 men; 150 women),
French case-control 1998-2002
Men (1 086) Women (225)
Cases (362) Controls (724) Cases (75) Controls (150)
-------
All asbestos exposure n % 11 % OR 99% Cl n % n % OR 99% Cl
Not exposed 17 4.7 263 36.3 1.0 19 25.3 104 69.3 1.0
Exposed 345 95.3 461 63.7 13.0 6.2 to 27.5 56 74.7 46 30.7 8.0 2.9 to 21.8
Occupational only 264 76.5 317 68.7 26 46.4 9 19.6
Non occupational only 3.2 64 13.9 22 39.3 35 76.1
Occupational and non-occupational 70 20.3 80 17.4 8 14.3 4.3
Highest probability of exposure
Possible 42 11.6 104 14.4 6.8 2.8 to 16.2 32 42.7 38 25.3 5.8 2.0 to 17.0
Probable 303 83.7 357 49.3 14.8 7.0 to 31.6 24 32.0 8 5.4 14.7 4.0 to 54.2
Attributable risk (99% CJ) (%) 87.3 (78.9 to 95.7) 64.8 (45.4 to 84.3)
6 Lacourt A, et al. Thorax 2014;0:1--8. doi:10. 1136/thoraxjnl-2013-203744
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of the definition on the
estimation. 40% of female cases are attrih-
utable to the overall
response
istics of cases who died before interview or refused to answer
did not differ from those of the cases included in this
18
Cases who bad died before the interview seemed to he
exposed than those included
80.3CJ1J vs 92.3%1, among women, 18.7% vs 45.3%,
respectively). However, occupational asbestos exposure was
derived from simplified questionnaires and mainly assessed
through job titles. According to controls selection,
that there were more blue-collar workers among
trols and more white-collar workers among
trols, to a underestimation
asbestos exposure among our control
As in all
Competing interests
Ethics approval
Provenance and peer review
Data sharing statement
rniJP"OnfifHJJn dLJthor Upon
REFERENCES
CONCLUSION
Author affiliations
·univ. Bordeaux, !SPED, INSlP.M U897 Lpidemiolo.gie-Biostatistiquc
environnement, Bordeaux,
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Bordeaux, France ill low levels of asbestos exposure in il Frnnch population-based case-control study.
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Bordeaux, France 9 Pintos J, Parent ME, BW, ct al. Risk of mcsothcliom0 and occuputional
a Vocation Nationale des lvlesotheliomes Pleuraux exposure to asbestos and mcin,made vitreous fibers: evidence from two case-control
!a Cote de l,Jacre, Caen, France studies in Mont rear, Car; ad a. I Occup Environ Med 2009;5l:1117 84.
Lacourt A, et al. Thorax 2014;01-8. doi:10.1136/thoraxjni-2013·203744
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10 Rake C, Gilham C, Hatch J, et al. Occupational, domestic and environmental Vianna ~1J, Polan AK. Non-occupational exposure to asbestos and malignar1t
mesothelioma risks in the British population: a case-control study. Br J Cancer mesothelioma in females. lancet 1978; 11061-3.
2009;100 1175·83. 25 Magnani C, Agudo A, Gonzalez CA, al. Multicentric study on malignant pieural
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Africa. S Afr Med J 1999;89 627--34. 2000;83 104 11
12 Bourdes V, to asbestos oi
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Goldberg The health exposure to asbestos· 1066-71
v1!m do we knowl Eur J Cancer Prev 2009;18:489 -503. 29 Musti M, Poll!co Cavono D, N
16 Magnani C, Dalmasso P, A, et al. Increased risk of malignant mesothelioma mosothelioma and an cement
of the pleura after or domestic exposure to asbestos: a case-control study case-control study in the city of Bari (Italy).
in Casale Monferrato, :taly Environ /-lea/th Perspccr 2001; 109 915-19 2009;82 489-97
17 Goldberg M, lmbernon Rolland P, et al. The French National Mesothelioma 30 Kielkowski D, Nelson G, Rees D. Risk of mesothelioma frorn exposure to crocidolite
Surveillance Program. Occup Environ Med 2006;63 390-5. asbestos: a 1995 update of a South African mortality study. Occup Environ Med
18 Rolland P, Gramond C, lacourt A., et al. Occupations and industries in France at 2000;57 563-7.
high risk for pleural mesothelioma: A population-based case-control study 31 Rothman KJ, Greenland S, Lash TL. Modern epidemioiogy. Third edn. Philadelphia
(1998-2002) Am J Ind Med 2010;531207-19 Lippincott Williams & Wilkins, 2008.
i9 Gramond C, Rolland P, Lacour\ al. Choice of rating for assessing Goldberg S, Rey D, al. effect of environmental exposure to
occupational asbestos exposure: study for compensation purposes in France. Am J on geographicol in mesothelioma rates Occup Environ Ivied
Ind Med 2010;67 .417
20 GreC'nland S. Variance for fraction estimates consistent in I acourt .A, Roil and AttribLrtatde risk men in t\NO
both large strata and sparse data. Stat Ivied 1987;6 701-8. case-control studies Eur J Epidemic/
Cicioni C, London SJ, Occupational asbestos 2010;25 799-806
of Riohiardi L, Rarone-f\desi F.
adjustmer1t for socioeconomic status in
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15 j, De!g0do-Rodrrguez
n ~
9
Lacourt A, et al. Thorax 2014;0:1-8. doi:10.1136/thoraxjnl-2013-203744
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INDEX NO. 815818/2020
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Occupational and non-occupational
attributable risk of asbestos exposure for
malignant pleural mesothelioma
A c p et al.
Thorax published online February 7, 2014
doi: 10.1136/thoraxjnl-2013-203744
Updated information and services can be found at:
These include:
Data Supplement "Supplementary Data"
References This article cites 34 articles, 8 of which can be accessed free at:
P
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FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 EXHIBIT 138 FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 ORIGINAL ARTICLE Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma A Lacourt, 1• C Gramond, 1• P S Chamming's, 6 A Gilg llg, 4· 7 M 12 · C 4,8 3 69 1 E .7 J C Pairon, · M Goldberg,7 P Brochard · 1> Additional material ABSTRACT Objectives To estimate the of mesothelioma cases that can be attributed to asbestos exposure in France including exposure. What is the key question? Methods A case-control study .,.. What is the overall impact of asbestos exposure 437 incident cases and 87 4 controls including non-occupational exposure on pleural conducted from 1998 to 200 2. Correspondence to mesothelioma? Dr Aude Lacourt, ISPED ESSAT. What is the bottom line? 146 rue leo Bordeaux .,.. Occupational asbestos exposure explains less 33076, to than half the pleural mesothelioma cases and among women, thus, there is a need to isped. u·bordeaux2. fr asbestos exposure were estimated quantify the impact of non-occupational conditional asbestos exposure for mesothelioma. Results A Why read on? ,. This study provides insights regarding non-occupational exposure impact in pleural mesothelioma occurrence, among INTRODUCTION arc the mesothelioma. 1 2 Asbestos had been evt1,nu\1Plv used in many indus- the world, and was countries. banned in most industrialised countries, with such France, the National Jv1esothelioma action first m I 980s and (PNSM) 998 Co~r;igbtrAlrticle ~ms(O:ttttltllil6em'pltb~t)?~444. Produced by BMJ Publishing Group Ltd (& BTS) under licence. FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 to relevant information on the health effects of asbestos Table 1 Description of the exposure parameters used to assess exposure on the French population. It relies on the exhaustive asbestos exposure at job level of all incident primary tumours in Asbestos exposure Numerical parameters Definition values* Probability of Degree of confidence that exposure really exposure occurred, expressed in percent (%) Not exposed 0 0 Possible >0-50 0.5 MATERIALS AND METHODS Definite >50-100 Study design Frequency of Expressed in percent of work time (%) The exposure Sporadic >0-5 0.025 Occasional >5-30 0.25 Two Frequent or >30-100 0.75 matched with cases for sex, age (±5 and district of resi- continuous dence. rares of cases and controls were 61.1 ()1b and Intensity of exposure Expressed in f/ml 20.WVci, respectively. Low >0-0.1 0.1 Trained interviewers administered a standardised question- Medium >0.1-1 naire to each subject. alive at rhe time of the inter- High >1-10 10 included. Information about lifetime Very high >10 100 *Numerical values assigned to each category in order to calculate cumulative exposure index. Asbestos exposure assessment tion. 20 asbestos exposure ARp duration of exposure of each job held estimated among matched sets where cases and controls were job occupational exposure parameters are semiquantitative, not occupationally exposed to asbestos. Considering all asbestos numeric1l values were to each of them l ). These exposure, the overall was estimated OR Lacourt A, et al. Thorax 2014;0 1-8. doi: 10.1136/thoraxjnl-2013-203744 FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 were versus 77.WVci of controls. The rr>l~t11•m:h between mesotbelioma and occupa- tional asbestos exposure is reporred in table 4. ORs for mesorhelioma were and a OR for to those 41.7). The estimated asbestos exposure was 83.!0A1 (99% Cl 74.5% to 91.7%) in men and 41.7% (9SCVc1 Cl RESULTS 25.3% to 58.0%) in women. The 437 (362 75 Table S presents the association between and 874 controls (724 men, 150 women). Table 2 presents the asbestos exposure and pleural mesothelioma among mam characteristics. Cases were ascertained in average never occupationally that is, 9 matched sets among near 12 months after had been hut males (9 cases and 18 and 36 matched sets among interviewed before the cc:rtification of the on (36 cases and OR for men average, .1 months after had been recorded. The soc10- economic category differed between cases and controls: 59.4(}(, of male cases were blue-collar workers versus 32.2% for con- 4 l. l % of and Table 2 Main characteristics of 437 cases men; 75 and 874 controls (724 men; 150 French case-control 998-2002 Men (1 086) Women (225) Cases (362) Controls (724) Cases (75) Controls (150) Ii % 11 % 11 % Age (years) Mean (SD) 67.6 (9.3) 66.8 (91) 66.6 (9.1) 65.8 (89) Range 41-93 41-89 41-92 41-89 Education level (years) 185 .1 275 38.0 33 44.0 40.0 >14 177 48.9 449 62.0 42 56.0 90 60() period (months) Mean (SD) (188) Range 0-97.1 0.2-65.9 Mean (SD) 3A 3A (4.4) Range 0-43.7 0-363 Last held occupation (iSCO 1968 major group)* 0/1 Professional, technical and related workers 49 13.5 146 20.2 5 6.9 31 21.5 2 Administrative and managerial workers 15 4.1 68 9.4 3 4.1 0.7 3 Clerical and related workers 34 9.4 91 12.6 30 41.1 41 285 4 Sales workers 23 6.4 69 9.5 9.6 13 9.0 5 Service workers 16 4.4 48 6.6 16 21.9 34 23.6 6 Agricultural, animal husbandry and forestry 10 2.8 69 9.5 3 4.1 4 2.8 workers; fishermen; hunters 71819 Production and related workers, transport 215 59.4 233 32.2 9 12.3 20 13.9 equipment operators and labourers *Among women, two cases and six controls had never worked. Lacourt A, et al. Thorax 2014;0: 1--8. doi: 10. 1136/thoraxjnl-2013-2037 44 FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM VI l ~VIUI V! ! f ' £...V I ' - I Ul.Jlh.:>! rvu u J INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 Table 3 Occupational asbestos exposure: proportion of exposed men in the most represented occupations and industries, French case-control study, 1998-2002 Cases (362) Controls (724) Exposed within job Exposed within job n % n % 11 % 11 % Occupations (ISCO Edition 1968) 8-73 Sheet-metal workers 54 14.9 49 90.7 27 3.7 21 77.8 8-49 Machinery fitters, machine assemblers n.e.c. * 46 12.7 31 67.4 37 5.1 25 67.6 7-00 Production supervisors and general foremen 44 12.2 31 70.5 56 7.7 40 71.4 8-71 Plumbers and pipe fitters 39 10.8 36 92.3 14 1.9 12 85.7 8-41 Machinery fitters and machine assemblers 37 10.2 21 56.8 30 4.1 13 43.3 9-99 Labourers n.e.c. * 36 9.9 24 66.7 27 3.7 15 55.6 6-21 General farm workers 31 8.6 0 0.0 86 11.9 4 4.7 9-51 Bricklayers, stonemasons and tile setters 29 8.0 25 86.2 31 4.3 26 83.9 8-34 Machine-tool operators 26 7.2 14 53.8 29 4.0 7 24.1 9-54 Carpenters, joiners and parquetry workers 26 7.2 21 80.8 27 3.7 20 74.1 Industries (!SIC Revision 2) 5000 Construction 129 35.6 109 84.5 140 19.3 105 75.0 3841 Ship building and repairing 65 18.0 58 89.2 20 2.8 19 95.0 3813 Manufacture of structural metal products 52 14.4 43 82.7 30 4.1 20 66.7 1110 Agriculture and livestock production 48 13.3 5 10.4 145 20.0 32 22.1 6200 Retail trade 33 9.1 8 24.2 94 13.0 19 20.2 6100 Wholesale trade 29 8.0 9 31.0 74 10.2 13 17.6 3819 Manufacture of fabricated metal 24 6.6 13 54.2 24 3.3 6 25.0 except machinery and equipment n.e.c. 9100 Public administration 24 6.6 6 25.0 71 9.8 11 15.5 3845 Manufacture of aircraft 23 6.4 10 43.5 27 3.7 10 37.0 9310 Education services 23 9 82 11.3 19 23.2 · not elsewhere classified. occurrence several case-control studies have envir- rmd all confirmed the causal link hetween onmental exposure due to residence near asbestos mines. 11 10 Bourdes et al reported a summary relative risk for environmen- risk of asbestos tal asbestos mines or asbestos 4 Lacourt A, et al. Thorax 2014;0:1-8. doi:10.1136/thoraxjnl-2013-203744 FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 Table 5 Non occupational asbestos exposure and risk of pleural mesothelioma among subjects non-exposed to occupational asbestos exposure, 45 cases (9 men; 36 women) and 90 controls (18 men; 72 women), French case-control study, 1998-2002 Men Women Cases (9) Controls (18) Cases (36) Controls (72) Non-occupational asbestos exposure n % n % OR 99% Cl n % n % OR 99% Cl Not exposed 6 66.7 15 833 LO 17 4U 56 ne LO Exposed 3 333 3 16J 2.4 0.2 to 2U 19 sn 16 2U 43 U to 15.1 probability exposure Possible 0 0.0 5.6 11 30.6 13 18.1 3.2 0.8 to 13.2 Definite 3 33.3 11.1 4.6 0.2 to 96.9 8 22.2 3 4.1 7.5 1.2 to 48.0 Attributable risk 20.0 (-335 to 735) 38.7 (84 to 69.0) (99% Cl)(%) processing plant of 7.0 (95CVi1CJ 4.7 to 11.0). To date, there is distributions of male and female incidence of mesothelioma only weak evidence of a effect of exposure m cases with and without any identified occupational or non- asbestos on the occurrence of asbestos exposure ""'"'"'wn the influence of mesothelioma. 15 :isbestos in female the limitation of this assessment of exposure. While we are of ilie and para- asbestos exposure assessment, this is not the case and environmental In Table 6 All asbestos exposure and risk of mesothelioma, 437 cases (362 men; 75 women) and 874 controls (724 men; 150 women), French case-control 1998-2002 Men (1 086) Women (225) Cases (362) Controls (724) Cases (75) Controls (150) ------- All asbestos exposure n % 11 % OR 99% Cl n % n % OR 99% Cl Not exposed 17 4.7 263 36.3 1.0 19 25.3 104 69.3 1.0 Exposed 345 95.3 461 63.7 13.0 6.2 to 27.5 56 74.7 46 30.7 8.0 2.9 to 21.8 Occupational only 264 76.5 317 68.7 26 46.4 9 19.6 Non occupational only 3.2 64 13.9 22 39.3 35 76.1 Occupational and non-occupational 70 20.3 80 17.4 8 14.3 4.3 Highest probability of exposure Possible 42 11.6 104 14.4 6.8 2.8 to 16.2 32 42.7 38 25.3 5.8 2.0 to 17.0 Probable 303 83.7 357 49.3 14.8 7.0 to 31.6 24 32.0 8 5.4 14.7 4.0 to 54.2 Attributable risk (99% CJ) (%) 87.3 (78.9 to 95.7) 64.8 (45.4 to 84.3) 6 Lacourt A, et al. Thorax 2014;0:1--8. doi:10. 1136/thoraxjnl-2013-203744 FILED: ERIE COUNTY CLERK 03/17/2023 09:21 PM INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 of the definition on the estimation. 40% of female cases are attrih- utable to the overall response istics of cases who died before interview or refused to answer did not differ from those of the cases included in this 18 Cases who bad died before the interview seemed to he exposed than those included 80.3CJ1J vs 92.3%1, among women, 18.7% vs 45.3%, respectively). However, occupational asbestos exposure was derived from simplified questionnaires and mainly assessed through job titles. According to controls selection, that there were more blue-collar workers among trols and more white-collar workers among trols, to a underestimation asbestos exposure among our control As in all Competing interests Ethics approval Provenance and peer review Data sharing statement rniJP"OnfifHJJn dLJthor Upon REFERENCES CONCLUSION Author affiliations ·univ. Bordeaux, !SPED, INSlP.M U897 Lpidemiolo.gie-Biostatistiquc environnement, Bordeaux, !SPED, Centre l~JSERM U897-Epidemiologie Biostatistique, Equipe 8 lwatsubo Pairon Boutin C, el u/, mesothelioma: dose-response relation Bordeaux, France ill low levels of asbestos exposure in il Frnnch population-based case-control study. iPn."m'-nw111 Sante Travail, lnstitut de Veille Sanitaire, Fquipe Associee en Sante Am J Epidemiol 1998;148133 Bordeaux, France 9 Pintos J, Parent ME, BW, ct al. 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Thorax 2014;0:1-8. doi:10.1136/thoraxjnl-2013-203744 FILED: ERIE COUNTY CLERK 03/17/2023 ........ ''09:21 PM .... .... .....,,, , ,....,,, ,_...,,' '....,....,,,,_,,,....., } INDEX NO. 815818/2020 NYSCEF DOC. NO. 349 RECEIVED NYSCEF: 03/17/2023 Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma A c p et al. Thorax published online February 7, 2014 doi: 10.1136/thoraxjnl-2013-203744 Updated information and services can be found at: These include: Data Supplement "Supplementary Data" References This article cites 34 articles, 8 of which can be accessed free at: P