An analysis of gastrointestinal (GI) cancer mortality in occupations associated with high asbestos (1332214) exposures was performed. Data were taken from the National Occupational Mortality Surveillance (NOMS) system for the period 1979 to 1990 to identify all deaths from malignant mesothelioma that occurred among 473 occupational categories. Occupations associated with significantly increased proportionate mortality ratios (PMRs) for mesothelioma, were considered to be occupations having high asbestos exposure. All cases of GI cancer that occurred in white males in these occupations were identified. Twelve occupations were associated with significantly increased PMRs for malignant mesothelioma: insulation worker; construction painter supervisor; plumber; sheet metal worker; furnace, kiln, and oven operator; mechanical engineer; factory stationary engineer; electrical and electronic engineer; supervisors in production occupations; construction carpenter; construction electrician; and manager. There were 15,224 deaths from GI cancer identified in the 12 occupations. When all occupations were combined, the risks for esophageal, gastric, and colorectal cancer were significantly increased, PMRs 108, 110, and 109, respectively. By specific occupation, the esophageal cancer risk was elevated in sheet metal workers and mechanical engineers, PMRs 142 and 132, respectively. Gastric cancer risk was significantly elevated in production supervisors and managers, PMRs 124 and 111, respectively. The colorectal cancer risk was significantly increased in mechanical, electrical and electronic engineers, PMRs 133 and 130, respectively. The authors conclude that occupational associations do exist between elevated asbestos exposures and some types of GI cancer, although the magnitude of the effects is rather small.

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