Baseline serum ß-carotene concentration and mortality among long-term asbestos-exposed insulators

Background: Although interventional trials demonstrated that moderate-dose ß-carotene supplementation increases lung cancer mortality in smokers and asbestos-exposed workers, differences in serum concentrations in absence of supplementation have not been studied in asbestos-exposed workers. Methods: A mortality analysis was performed to assess the relationship of nonsupplemented serum ß-carotene to all-cause and cancer mortalities using 1981 to 1983 serum ß-carotene concentration measurements from 2,646 U.S. white male insulators (mean age, 57.7 years). Multivariable-adjusted Cox proportional hazard models that included terms for age, duration of asbestos exposure, smoking, season, and region were fitted to estimate mortality HRs and 95% confidence intervals (CI) according to serum ß-carotene concentrations. Results: Median follow-up was 12.8 years and 984 (33.8%) subjects died during the follow-up period, including 415 deaths from overall cancer and 219 deaths from lung cancer. The overall mortality HR for a serum ß-carotene increase of 10 µg/dL was 0.97 (95% CI, 0.96-0.99). Compared with the lowest quartile, HRs were 0.90 (95% CI, 0.76-1.07) for the second (38-65 µg/dL), 0.80 (95% CI, 0.67-0.96) for the third (66-104 µg/dL), and 0.63 (95% CI, 0.51-0.77) for the highest serum ß-carotene quartile (=105 µg/dL). There was no association between serum ß-carotene and overall cancer mortality (HR, 1.00; 95% CI, 0.97-1.02) or lung cancer mortality (HR, 0.99; 95% CI, 0.96-1.02). Conclusions: Higher nonsupplemented serum ß-carotene concentrations were negatively associated with all-cause mortality among asbestos-exposed individuals. Impact: Serum ß-carotene can be a marker of one or more determinants of reduced mortality in asbestos-exposed workers. © 2014 AACR.