Journal Entries
Mesothelioma
Posted Feb 10, 2004
http://news.bbc.co.uk/1/hi/scotland/3444567.stm
http://news.bbc.co.uk/1/hi/england/cumbria/3159622.stm
Discuss this Journal entry [1]
Latest reply: Feb 10, 2004
Mesothelioma
Posted Jan 19, 2004
From: http://www.hse.gov.uk/statistics/causdis/meso.htm
• The annual number of mesothelioma deaths has increased from 153 in 1968 to 1631 in 2000 and 1848 in 2001.
• The latest projections suggest that male deaths from mesothelioma may peak around the year 2011, at about 1700 deaths per year.
• Occupations with the highest risk of mesothelioma for males include: metal plate workers (including shipyard workers), vehicle body builders (including rail vehicles), plumbers and gas fitters, carpenters and electricians.
• The industry groups with the highest incidence rates of Industrial Injuries Scheme assessments for mesothelioma in 2000-2002 were construction (including insulation and asbestos removal workers) and extraction, energy and water supply.
Mesothelioma is a form of cancer which principally affects the lining of the lungs (pleura) and lower digestive tract (peritoneum). The typically long delay between first exposure to asbestos and death from mesothelioma (seldom less than 15 years, but possibly as long as 60 years) means that deaths occurring now and most of those expected to occur in the future reflect industrial conditions of the past rather than current work practices. This latency period means that the effectiveness of current controls cannot yet be assessed from the mesothelioma mortality figures.
The annual number of mesothelioma deaths in Great Britain has risen fairly constantly since 1968 (when the HSE register of mesothelioma deaths was introduced) – see Table MESO01 and Figure 1. The total number of deaths in 2001 was 1848, an increase of 13% from 2000. Most of those who die from mesothelioma each year are male: in 2001 there were 1579 male deaths, 85% of the total number.
Although the vast majority of mesothelioma cases are caused by exposure to asbestos, a small number of deaths each year occur in people with no history of exposure. There is some evidence to suggest that there could be as many as 50-100 of these so called spontaneous mesotheliomas each year (1).
Previous analysis of mesothelioma deaths up to 1991 was used by HSE as a basis for predictions that deaths would continue to rise well beyond the year 2000, based on an assumption that the pattern of age-specific death rates would be the same regardless of the year of birth. However, more recent data have departed from this prediction, with people born early in the century having higher numbers of deaths and those born more recently having lower numbers than predicted.
A new projection approach has been used to assess the potential benefits of a proposed duty to manage asbestos in buildings and was presented as part of the Regulatory Impact Assessment for the amendment to the control of asbestos at work regulations 1987 and its associated approved code of practice (2). This approach used the observed mortality and the assumed form of the relationship between asbestos exposure and mesothelioma (3) to estimate the historic 'collective dose' of asbestos to the working population in GB, and examined the predicted effects of assumed collective exposures on the future course of mesothelioma deaths.
This approach – which was last carried out using mesothelioma deaths up to and including 2000 – tells us that the peak of asbestos exposure occurred in the 1960s. For all models considered, the implied total exposure fell steeply in the period following its peak, and by the mid 1970s had fallen by at least 75% from the peak level, more likely by 80 or 90%. Since there is a lag of at least 20 years and possibly up to 60 years between asbestos exposure and the occurrence of mesothelioma, the strength of the inferences that can be drawn about exposure levels falls quite rapidly towards the end of the observation period, and our observations of mortality (up to 2000 in this modelling) tell us little or nothing (directly) about exposure levels since 1980.
The predicted peak annual number of cases of mesothelioma in men implied by this modelling lies in the range 1500 (reached around 2008) to 1800 (reached around 2014). A reasonable illustrative central estimate is that the peak in male deaths will occur around the year 2011, at around 1700 deaths per year. Although these projections rest on a number of uncertain (and largely unverifiable) assumptions, the timing and scale of the maximum annual death toll is not highly sensitive to these uncertainties. What is highly uncertain, is the rate at which the numbers will fall after this peak is reached.
It should be noted that the number of male mesothelioma deaths observed in 2001 already exceeds the lower limit of 1500 mentioned above. Modelling which includes data for the most recent year is currently being carried out and is likely to lead to revised estimates for the size and timing of the peak number of deaths. These results are planned to be released in a separate fact sheet later in the Autumn. It should also be noted that the projections are for men aged between 20 and 89 only. Approximately 99% of the mesothelioma deaths among males occur within this age range. The lower numbers of mesothelioma deaths in women do not provide an adequate basis for detailed modelling.
The number of female mesothelioma deaths has always been much smaller than the corresponding number of male deaths. The proportion of annual deaths which were female has tended to fall since 1968, although there has been a slight increase over the last few years. In the early 1970s over 20% of deaths were female. The proportion fell to just below 15% by the early 1990s and remains around that level. There are 269 deaths provisionally recorded for females in 2001.
Table MESO02 shows numbers of mesothelioma deaths and death rates by age and sex for the eleven three-year time periods from 1969-2001. Death rates for males are also shown in Figure 2. There are large differences in the magnitude of the rates between the different age groups for males, with rates since 1990 in the two oldest age groups (65-74 and 75+) being at least 100 times those in the lowest age category (0-44 years), and following an increasing upward trend over time. In the 55-64 age group, the increase in the rate over time has generally not been as steep. After an increasing trend in the earlier time periods, rates in the lowest two age groups both show some evidence of a decrease towards the end of the period. This is strongest in the 0-44 age group where the rate starts to decrease during the early 1990s. The pattern of progressively higher rates in older people and a decrease in the rates in younger people is consistent with that expected as the peak of an epidemic is approached. The rates for females over time tend to fluctuate to some extent because of greater statistical variation due to the smaller overall numbers, however similar trends are evident. Rates for females are generally speaking an order of magnitude lower than those for males.
Table MESO03 shows age-standardized mesothelioma death rates per million by 3-year time period, government office region and sex. The age-standardization allows for changes in the underlying population structure over time and between regions. For example, crude death rates tend to increase by a larger amount over time than the age-standardized rates presented due to greater survival of the population in later time periods to ages where mesothelioma is more prevalent.
For both males and females the rates for Great Britain follow an upward trend over time - reaching 49.0 and 8.3 deaths per million respectively in 1999-2001 compared with 27.7 and 4.1 in 1987-89. For males, upward trends were evident in the rates over the period for all regions. There is some evidence of rates for the different regions converging over time in that regions with the lowest rates in earlier periods tended to increase most, and those with higher rates increased to a lesser extent. For example, the largest relative increase – nearly threefold - was in the West Midlands, rising from 12.3 deaths per million in 1987-89 to 35.1 in 1999-2001. In contrast the region with the highest rate in any period – the North East – increased by 53% from 54.7 to 83.9. Although the numbers of cases are much smaller for females and so the pattern in the rates over time is more erratic, an upward trend is fairly clear in most regions. More detailed mesothelioma statistics by region are available in two separate fact sheets.
• Mesothelioma area statistics: county districts in Great Britain 1986-2000
Mesothelioma area statistics: county districts in Great Britain 1976-1991
Detailed mesothelioma death statistics for males and females and relative mortality for different occupational groups are available in a separate factsheet (Mesothelioma occupation statistics for males and females aged 16-74 in Great Britain, 1980-2000 ). This analysis showed that occupations where males had the highest risk of mesothelioma were metal plate workers (which includes shipyard workers) and vehicle body builders (which includes railway carriage and locomotive building). A number of the other high-risk occupations identified are associated with the construction industry, such as plumbers and gas fitters, carpenters and electricians. The analysis also showed that although the total number of male mesothelioma cases has increased almost three-fold since the early 1980s, in most cases proportions of mesothelioma deaths across occupational groups have remained stable over time. Occupations identified as relatively high risk for females included metal plate workers, chemical workers (which includes those classified as “process workers”), plastics workers and other foremen/labourers (which includes those classified as “factory workers”).
Figure 1 above also shows the number of disablement benefit cases made each year for mesothelioma. The sharp increase in claims registered in 2002 may be due to the introduction of a new method of collecting statistical information April 2002. Analysis of average rates of new assessments in 2000-2002 by industry (Table IIS10 ) showed that, with a rate of 19.9 cases per 100 000 employees per year, the construction industry (including insulation and asbestos removal workers) had the highest rate, followed by extraction, energy and water supply industries with an annual rate of 5.1 cases per 100 000 employees.
Mesothelioma killed actor Steve McQueen on 7 November 1980.
Other links
http://society.guardian.co.uk/cance...comment/0%2C8146%2C975072%2C00.html
http://www.telegraph.co.uk/news/mai...tml?xml=/news/2002/04/18/nlaw18.xml
http://www.butterworths.co.uk/pionline/whatsnew/2000/Feb.htm#Fir
Discuss this Journal entry [1]
Latest reply: Jan 19, 2004
Mesothelioma
Posted Jan 19, 2004
From: http://www.hse.gov.uk/statistics/causdis/meso.htm
• The annual number of mesothelioma deaths has increased from 153 in 1968 to 1631 in 2000 and 1848 in 2001.
• The latest projections suggest that male deaths from mesothelioma may peak around the year 2011, at about 1700 deaths per year.
• Occupations with the highest risk of mesothelioma for males include: metal plate workers (including shipyard workers), vehicle body builders (including rail vehicles), plumbers and gas fitters, carpenters and electricians.
• The industry groups with the highest incidence rates of Industrial Injuries Scheme assessments for mesothelioma in 2000-2002 were construction (including insulation and asbestos removal workers) and extraction, energy and water supply.
Mesothelioma is a form of cancer which principally affects the lining of the lungs (pleura) and lower digestive tract (peritoneum). The typically long delay between first exposure to asbestos and death from mesothelioma (seldom less than 15 years, but possibly as long as 60 years) means that deaths occurring now and most of those expected to occur in the future reflect industrial conditions of the past rather than current work practices. This latency period means that the effectiveness of current controls cannot yet be assessed from the mesothelioma mortality figures.
The annual number of mesothelioma deaths in Great Britain has risen fairly constantly since 1968 (when the HSE register of mesothelioma deaths was introduced) – see Table MESO01 and Figure 1. The total number of deaths in 2001 was 1848, an increase of 13% from 2000. Most of those who die from mesothelioma each year are male: in 2001 there were 1579 male deaths, 85% of the total number.
Although the vast majority of mesothelioma cases are caused by exposure to asbestos, a small number of deaths each year occur in people with no history of exposure. There is some evidence to suggest that there could be as many as 50-100 of these so called spontaneous mesotheliomas each year (1).
Previous analysis of mesothelioma deaths up to 1991 was used by HSE as a basis for predictions that deaths would continue to rise well beyond the year 2000, based on an assumption that the pattern of age-specific death rates would be the same regardless of the year of birth. However, more recent data have departed from this prediction, with people born early in the century having higher numbers of deaths and those born more recently having lower numbers than predicted.
A new projection approach has been used to assess the potential benefits of a proposed duty to manage asbestos in buildings and was presented as part of the Regulatory Impact Assessment for the amendment to the control of asbestos at work regulations 1987 and its associated approved code of practice (2). This approach used the observed mortality and the assumed form of the relationship between asbestos exposure and mesothelioma (3) to estimate the historic 'collective dose' of asbestos to the working population in GB, and examined the predicted effects of assumed collective exposures on the future course of mesothelioma deaths.
This approach – which was last carried out using mesothelioma deaths up to and including 2000 – tells us that the peak of asbestos exposure occurred in the 1960s. For all models considered, the implied total exposure fell steeply in the period following its peak, and by the mid 1970s had fallen by at least 75% from the peak level, more likely by 80 or 90%. Since there is a lag of at least 20 years and possibly up to 60 years between asbestos exposure and the occurrence of mesothelioma, the strength of the inferences that can be drawn about exposure levels falls quite rapidly towards the end of the observation period, and our observations of mortality (up to 2000 in this modelling) tell us little or nothing (directly) about exposure levels since 1980.
The predicted peak annual number of cases of mesothelioma in men implied by this modelling lies in the range 1500 (reached around 2008) to 1800 (reached around 2014). A reasonable illustrative central estimate is that the peak in male deaths will occur around the year 2011, at around 1700 deaths per year. Although these projections rest on a number of uncertain (and largely unverifiable) assumptions, the timing and scale of the maximum annual death toll is not highly sensitive to these uncertainties. What is highly uncertain, is the rate at which the numbers will fall after this peak is reached.
It should be noted that the number of male mesothelioma deaths observed in 2001 already exceeds the lower limit of 1500 mentioned above. Modelling which includes data for the most recent year is currently being carried out and is likely to lead to revised estimates for the size and timing of the peak number of deaths. These results are planned to be released in a separate fact sheet later in the Autumn. It should also be noted that the projections are for men aged between 20 and 89 only. Approximately 99% of the mesothelioma deaths among males occur within this age range. The lower numbers of mesothelioma deaths in women do not provide an adequate basis for detailed modelling.
The number of female mesothelioma deaths has always been much smaller than the corresponding number of male deaths. The proportion of annual deaths which were female has tended to fall since 1968, although there has been a slight increase over the last few years. In the early 1970s over 20% of deaths were female. The proportion fell to just below 15% by the early 1990s and remains around that level. There are 269 deaths provisionally recorded for females in 2001.
Table MESO02 shows numbers of mesothelioma deaths and death rates by age and sex for the eleven three-year time periods from 1969-2001. Death rates for males are also shown in Figure 2. There are large differences in the magnitude of the rates between the different age groups for males, with rates since 1990 in the two oldest age groups (65-74 and 75+) being at least 100 times those in the lowest age category (0-44 years), and following an increasing upward trend over time. In the 55-64 age group, the increase in the rate over time has generally not been as steep. After an increasing trend in the earlier time periods, rates in the lowest two age groups both show some evidence of a decrease towards the end of the period. This is strongest in the 0-44 age group where the rate starts to decrease during the early 1990s. The pattern of progressively higher rates in older people and a decrease in the rates in younger people is consistent with that expected as the peak of an epidemic is approached. The rates for females over time tend to fluctuate to some extent because of greater statistical variation due to the smaller overall numbers, however similar trends are evident. Rates for females are generally speaking an order of magnitude lower than those for males.
Table MESO03 shows age-standardized mesothelioma death rates per million by 3-year time period, government office region and sex. The age-standardization allows for changes in the underlying population structure over time and between regions. For example, crude death rates tend to increase by a larger amount over time than the age-standardized rates presented due to greater survival of the population in later time periods to ages where mesothelioma is more prevalent.
For both males and females the rates for Great Britain follow an upward trend over time - reaching 49.0 and 8.3 deaths per million respectively in 1999-2001 compared with 27.7 and 4.1 in 1987-89. For males, upward trends were evident in the rates over the period for all regions. There is some evidence of rates for the different regions converging over time in that regions with the lowest rates in earlier periods tended to increase most, and those with higher rates increased to a lesser extent. For example, the largest relative increase – nearly threefold - was in the West Midlands, rising from 12.3 deaths per million in 1987-89 to 35.1 in 1999-2001. In contrast the region with the highest rate in any period – the North East – increased by 53% from 54.7 to 83.9. Although the numbers of cases are much smaller for females and so the pattern in the rates over time is more erratic, an upward trend is fairly clear in most regions. More detailed mesothelioma statistics by region are available in two separate fact sheets.
• Mesothelioma area statistics: county districts in Great Britain 1986-2000
Mesothelioma area statistics: county districts in Great Britain 1976-1991
Detailed mesothelioma death statistics for males and females and relative mortality for different occupational groups are available in a separate factsheet (Mesothelioma occupation statistics for males and females aged 16-74 in Great Britain, 1980-2000 ). This analysis showed that occupations where males had the highest risk of mesothelioma were metal plate workers (which includes shipyard workers) and vehicle body builders (which includes railway carriage and locomotive building). A number of the other high-risk occupations identified are associated with the construction industry, such as plumbers and gas fitters, carpenters and electricians. The analysis also showed that although the total number of male mesothelioma cases has increased almost three-fold since the early 1980s, in most cases proportions of mesothelioma deaths across occupational groups have remained stable over time. Occupations identified as relatively high risk for females included metal plate workers, chemical workers (which includes those classified as “process workers”), plastics workers and other foremen/labourers (which includes those classified as “factory workers”).
Figure 1 above also shows the number of disablement benefit cases made each year for mesothelioma. The sharp increase in claims registered in 2002 may be due to the introduction of a new method of collecting statistical information April 2002. Analysis of average rates of new assessments in 2000-2002 by industry (Table IIS10 ) showed that, with a rate of 19.9 cases per 100 000 employees per year, the construction industry (including insulation and asbestos removal workers) had the highest rate, followed by extraction, energy and water supply industries with an annual rate of 5.1 cases per 100 000 employees.
Mesothelioma killed actor Steve McQueen on 7 novemebr 1980.
Other links
http://society.guardian.co.uk/cance...comment/0%2C8146%2C975072%2C00.html
http://www.telegraph.co.uk/news/mai...tml?xml=/news/2002/04/18/nlaw18.xml
http://www.butterworths.co.uk/pionline/whatsnew/2000/Feb.htm#Fir
Discuss this Journal entry [1]
Latest reply: Jan 19, 2004
Mesothelioma
Posted Jan 19, 2004
From: http://www.hse.gov.uk/statistics/causdis/meso.htm
• The annual number of mesothelioma deaths has increased from 153 in 1968 to 1631 in 2000 and 1848 in 2001.
• The latest projections suggest that male deaths from mesothelioma may peak around the year 2011, at about 1700 deaths per year.
• Occupations with the highest risk of mesothelioma for males include: metal plate workers (including shipyard workers), vehicle body builders (including rail vehicles), plumbers and gas fitters, carpenters and electricians.
• The industry groups with the highest incidence rates of Industrial Injuries Scheme assessments for mesothelioma in 2000-2002 were construction (including insulation and asbestos removal workers) and extraction, energy and water supply.
Mesothelioma is a form of cancer which principally affects the lining of the lungs (pleura) and lower digestive tract (peritoneum). The typically long delay between first exposure to asbestos and death from mesothelioma (seldom less than 15 years, but possibly as long as 60 years) means that deaths occurring now and most of those expected to occur in the future reflect industrial conditions of the past rather than current work practices. This latency period means that the effectiveness of current controls cannot yet be assessed from the mesothelioma mortality figures.
The annual number of mesothelioma deaths in Great Britain has risen fairly constantly since 1968 (when the HSE register of mesothelioma deaths was introduced) – see Table MESO01 and Figure 1. The total number of deaths in 2001 was 1848, an increase of 13% from 2000. Most of those who die from mesothelioma each year are male: in 2001 there were 1579 male deaths, 85% of the total number.
Although the vast majority of mesothelioma cases are caused by exposure to asbestos, a small number of deaths each year occur in people with no history of exposure. There is some evidence to suggest that there could be as many as 50-100 of these so called spontaneous mesotheliomas each year (1).
Previous analysis of mesothelioma deaths up to 1991 was used by HSE as a basis for predictions that deaths would continue to rise well beyond the year 2000, based on an assumption that the pattern of age-specific death rates would be the same regardless of the year of birth. However, more recent data have departed from this prediction, with people born early in the century having higher numbers of deaths and those born more recently having lower numbers than predicted.
A new projection approach has been used to assess the potential benefits of a proposed duty to manage asbestos in buildings and was presented as part of the Regulatory Impact Assessment for the amendment to the control of asbestos at work regulations 1987 and its associated approved code of practice (2). This approach used the observed mortality and the assumed form of the relationship between asbestos exposure and mesothelioma (3) to estimate the historic 'collective dose' of asbestos to the working population in GB, and examined the predicted effects of assumed collective exposures on the future course of mesothelioma deaths.
This approach – which was last carried out using mesothelioma deaths up to and including 2000 – tells us that the peak of asbestos exposure occurred in the 1960s. For all models considered, the implied total exposure fell steeply in the period following its peak, and by the mid 1970s had fallen by at least 75% from the peak level, more likely by 80 or 90%. Since there is a lag of at least 20 years and possibly up to 60 years between asbestos exposure and the occurrence of mesothelioma, the strength of the inferences that can be drawn about exposure levels falls quite rapidly towards the end of the observation period, and our observations of mortality (up to 2000 in this modelling) tell us little or nothing (directly) about exposure levels since 1980.
The predicted peak annual number of cases of mesothelioma in men implied by this modelling lies in the range 1500 (reached around 2008) to 1800 (reached around 2014). A reasonable illustrative central estimate is that the peak in male deaths will occur around the year 2011, at around 1700 deaths per year. Although these projections rest on a number of uncertain (and largely unverifiable) assumptions, the timing and scale of the maximum annual death toll is not highly sensitive to these uncertainties. What is highly uncertain, is the rate at which the numbers will fall after this peak is reached.
It should be noted that the number of male mesothelioma deaths observed in 2001 already exceeds the lower limit of 1500 mentioned above. Modelling which includes data for the most recent year is currently being carried out and is likely to lead to revised estimates for the size and timing of the peak number of deaths. These results are planned to be released in a separate fact sheet later in the Autumn. It should also be noted that the projections are for men aged between 20 and 89 only. Approximately 99% of the mesothelioma deaths among males occur within this age range. The lower numbers of mesothelioma deaths in women do not provide an adequate basis for detailed modelling.
The number of female mesothelioma deaths has always been much smaller than the corresponding number of male deaths. The proportion of annual deaths which were female has tended to fall since 1968, although there has been a slight increase over the last few years. In the early 1970s over 20% of deaths were female. The proportion fell to just below 15% by the early 1990s and remains around that level. There are 269 deaths provisionally recorded for females in 2001.
Table MESO02 shows numbers of mesothelioma deaths and death rates by age and sex for the eleven three-year time periods from 1969-2001. Death rates for males are also shown in Figure 2. There are large differences in the magnitude of the rates between the different age groups for males, with rates since 1990 in the two oldest age groups (65-74 and 75+) being at least 100 times those in the lowest age category (0-44 years), and following an increasing upward trend over time. In the 55-64 age group, the increase in the rate over time has generally not been as steep. After an increasing trend in the earlier time periods, rates in the lowest two age groups both show some evidence of a decrease towards the end of the period. This is strongest in the 0-44 age group where the rate starts to decrease during the early 1990s. The pattern of progressively higher rates in older people and a decrease in the rates in younger people is consistent with that expected as the peak of an epidemic is approached. The rates for females over time tend to fluctuate to some extent because of greater statistical variation due to the smaller overall numbers, however similar trends are evident. Rates for females are generally speaking an order of magnitude lower than those for males.
Table MESO03 shows age-standardized mesothelioma death rates per million by 3-year time period, government office region and sex. The age-standardization allows for changes in the underlying population structure over time and between regions. For example, crude death rates tend to increase by a larger amount over time than the age-standardized rates presented due to greater survival of the population in later time periods to ages where mesothelioma is more prevalent.
For both males and females the rates for Great Britain follow an upward trend over time - reaching 49.0 and 8.3 deaths per million respectively in 1999-2001 compared with 27.7 and 4.1 in 1987-89. For males, upward trends were evident in the rates over the period for all regions. There is some evidence of rates for the different regions converging over time in that regions with the lowest rates in earlier periods tended to increase most, and those with higher rates increased to a lesser extent. For example, the largest relative increase – nearly threefold - was in the West Midlands, rising from 12.3 deaths per million in 1987-89 to 35.1 in 1999-2001. In contrast the region with the highest rate in any period – the North East – increased by 53% from 54.7 to 83.9. Although the numbers of cases are much smaller for females and so the pattern in the rates over time is more erratic, an upward trend is fairly clear in most regions. More detailed mesothelioma statistics by region are available in two separate fact sheets.
• Mesothelioma area statistics: county districts in Great Britain 1986-2000
Mesothelioma area statistics: county districts in Great Britain 1976-1991
Detailed mesothelioma death statistics for males and females and relative mortality for different occupational groups are available in a separate factsheet (Mesothelioma occupation statistics for males and females aged 16-74 in Great Britain, 1980-2000 ). This analysis showed that occupations where males had the highest risk of mesothelioma were metal plate workers (which includes shipyard workers) and vehicle body builders (which includes railway carriage and locomotive building). A number of the other high-risk occupations identified are associated with the construction industry, such as plumbers and gas fitters, carpenters and electricians. The analysis also showed that although the total number of male mesothelioma cases has increased almost three-fold since the early 1980s, in most cases proportions of mesothelioma deaths across occupational groups have remained stable over time. Occupations identified as relatively high risk for females included metal plate workers, chemical workers (which includes those classified as “process workers”), plastics workers and other foremen/labourers (which includes those classified as “factory workers”).
Figure 1 above also shows the number of disablement benefit cases made each year for mesothelioma. The sharp increase in claims registered in 2002 may be due to the introduction of a new method of collecting statistical information April 2002. Analysis of average rates of new assessments in 2000-2002 by industry (Table IIS10 ) showed that, with a rate of 19.9 cases per 100 000 employees per year, the construction industry (including insulation and asbestos removal workers) had the highest rate, followed by extraction, energy and water supply industries with an annual rate of 5.1 cases per 100 000 employees.
Other links
http://society.guardian.co.uk/cancer/comment/0%2C8146%2C975072%2C00.html
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2002/04/18/nlaw18.xml
http://www.butterworths.co.uk/pionline/whatsnew/2000/Feb.htm#Fir
Discuss this Journal entry [1]
Latest reply: Jan 19, 2004
Mesothelioma
Posted Jan 19, 2004
• The annual number of mesothelioma deaths has increased from 153 in 1968 to 1631 in 2000 and 1848 in 2001.
• The latest projections suggest that male deaths from mesothelioma may peak around the year 2011, at about 1700 deaths per year.
• Occupations with the highest risk of mesothelioma for males include: metal plate workers (including shipyard workers), vehicle body builders (including rail vehicles), plumbers and gas fitters, carpenters and electricians.
• The industry groups with the highest incidence rates of Industrial Injuries Scheme assessments for mesothelioma in 2000-2002 were construction (including insulation and asbestos removal workers) and extraction, energy and water supply.
Overall scale of disease including trends
Mesothelioma is a form of cancer which principally affects the lining of the lungs (pleura) and lower digestive tract (peritoneum). The typically long delay between first exposure to asbestos and death from mesothelioma (seldom less than 15 years, but possibly as long as 60 years) means that deaths occurring now and most of those expected to occur in the future reflect industrial conditions of the past rather than current work practices. This latency period means that the effectiveness of current controls cannot yet be assessed from the mesothelioma mortality figures.
The annual number of mesothelioma deaths in Great Britain has risen fairly constantly since 1968 (when the HSE register of mesothelioma deaths was introduced) – see Table MESO01 and Figure 1. The total number of deaths in 2001 was 1848, an increase of 13% from 2000. Most of those who die from mesothelioma each year are male: in 2001 there were 1579 male deaths, 85% of the total number.
Although the vast majority of mesothelioma cases are caused by exposure to asbestos, a small number of deaths each year occur in people with no history of exposure. There is some evidence to suggest that there could be as many as 50-100 of these so called spontaneous mesotheliomas each year (1).
Previous analysis of mesothelioma deaths up to 1991 was used by HSE as a basis for predictions that deaths would continue to rise well beyond the year 2000, based on an assumption that the pattern of age-specific death rates would be the same regardless of the year of birth. However, more recent data have departed from this prediction, with people born early in the century having higher numbers of deaths and those born more recently having lower numbers than predicted.
A new projection approach has been used to assess the potential benefits of a proposed duty to manage asbestos in buildings and was presented as part of the Regulatory Impact Assessment for the amendment to the control of asbestos at work regulations 1987 and its associated approved code of practice (2). This approach used the observed mortality and the assumed form of the relationship between asbestos exposure and mesothelioma (3) to estimate the historic 'collective dose' of asbestos to the working population in GB, and examined the predicted effects of assumed collective exposures on the future course of mesothelioma deaths.
This approach – which was last carried out using mesothelioma deaths up to and including 2000 – tells us that the peak of asbestos exposure occurred in the 1960s. For all models considered, the implied total exposure fell steeply in the period following its peak, and by the mid 1970s had fallen by at least 75% from the peak level, more likely by 80 or 90%. Since there is a lag of at least 20 years and possibly up to 60 years between asbestos exposure and the occurrence of mesothelioma, the strength of the inferences that can be drawn about exposure levels falls quite rapidly towards the end of the observation period, and our observations of mortality (up to 2000 in this modelling) tell us little or nothing (directly) about exposure levels since 1980.
The predicted peak annual number of cases of mesothelioma in men implied by this modelling lies in the range 1500 (reached around 2008) to 1800 (reached around 2014). A reasonable illustrative central estimate is that the peak in male deaths will occur around the year 2011, at around 1700 deaths per year. Although these projections rest on a number of uncertain (and largely unverifiable) assumptions, the timing and scale of the maximum annual death toll is not highly sensitive to these uncertainties. What is highly uncertain, is the rate at which the numbers will fall after this peak is reached.
It should be noted that the number of male mesothelioma deaths observed in 2001 already exceeds the lower limit of 1500 mentioned above. Modelling which includes data for the most recent year is currently being carried out and is likely to lead to revised estimates for the size and timing of the peak number of deaths. These results are planned to be released in a separate fact sheet later in the Autumn. It should also be noted that the projections are for men aged between 20 and 89 only. Approximately 99% of the mesothelioma deaths among males occur within this age range. The lower numbers of mesothelioma deaths in women do not provide an adequate basis for detailed modelling.
The number of female mesothelioma deaths has always been much smaller than the corresponding number of male deaths. The proportion of annual deaths which were female has tended to fall since 1968, although there has been a slight increase over the last few years. In the early 1970s over 20% of deaths were female. The proportion fell to just below 15% by the early 1990s and remains around that level. There are 269 deaths provisionally recorded for females in 2001.
Table MESO02 shows numbers of mesothelioma deaths and death rates by age and sex for the eleven three-year time periods from 1969-2001. Death rates for males are also shown in Figure 2. There are large differences in the magnitude of the rates between the different age groups for males, with rates since 1990 in the two oldest age groups (65-74 and 75+) being at least 100 times those in the lowest age category (0-44 years), and following an increasing upward trend over time. In the 55-64 age group, the increase in the rate over time has generally not been as steep. After an increasing trend in the earlier time periods, rates in the lowest two age groups both show some evidence of a decrease towards the end of the period. This is strongest in the 0-44 age group where the rate starts to decrease during the early 1990s. The pattern of progressively higher rates in older people and a decrease in the rates in younger people is consistent with that expected as the peak of an epidemic is approached. The rates for females over time tend to fluctuate to some extent because of greater statistical variation due to the smaller overall numbers, however similar trends are evident. Rates for females are generally speaking an order of magnitude lower than those for males.
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