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The British mesothelioma register contains all deaths from 1968 to 2001 where mesothelioma was mentioned on the death certificate. These data were used to predict the future burden of mesothelioma mortality in Great Britain. Poisson regression analysis was used to model male mesothelioma deaths from 1968 to 2001 as a function of the rise and fall of asbestos exposure during the 20th century, and hence to predict numbers of male deaths in the years 2002–2050. The annual number of mesothelioma deaths in Great Britain has risen increasingly rapidly from 153 deaths in 1968 to 1848 in 2001 and, using our preferred model, is predicted to peak at around 1950 to 2450 deaths per year between 2011 and 2015. Following this peak, the number of deaths is expected to decline rapidly. The eventual death rate will depend on the background level and any residual asbestos exposure. Between 1968 and 2050, there will have been approximately 90 000 deaths from mesothelioma in Great Britain, 65 000 of which will occur after 2001.

We obtained lifetime occupational and residential histories by telephone interview with 622 mesothelioma patients (512 men, 110 women) and 1420 population controls. Odds ratios (ORs) were converted to lifetime risk (LR) estimates for Britons born in the 1940s. Male ORs (95% confidence interval (CI)) relative to low-risk occupations for 410 years of exposure before the age of 30 years were 50.0 (25.8 -96.8) for carpenters (LR 1 in 17), 17.1 (10.3 -28.3) for plumbers, electricians and painters, 7.0 (3.2 -15.2) for other construction workers, 15.3 (9.0 -26.2) for other recognised high-risk occupations and 5.2 (3.1 -8.5) in other industries where asbestos may be encountered. The LR was similar in apparently unexposed men and women (B1 in 1000), and this was approximately doubled in exposed workers' relatives (OR 2.0, 95% CI 1.3 -3.2). No other environmental hazards were identified. In all, 14% of male and 62% of female cases were not attributable to occupational or domestic asbestos exposure. Approximately half of the male cases were construction workers, and only four had worked for more than 5 years in asbestos product manufacture. (Hodgson et al, 2005), or about 1 in 170 of all deaths. Substantial exposure to asbestos dust continued until about 1970 in parts of the asbestos industry, and until the early 1980s in the much larger workforce in construction and other occupations in which asbestos lagging was applied or asbestos insulation board (AIB) was sawn. The death rate is still increasing above 60 years of age, but the reduction in asbestos use since the mid-1970s has been followed 20 years later by a rapid fall in the number of mesothelioma deaths at 35 -49 years of age in British men

Background:Mesothelioma mortality has increased more than ten-fold over the past 40 years in Great Britain, with >1700 male deaths recorded in the British mesothelioma register in 2006. Annual mesothelioma deaths now account for >1% of all cancer deaths. A Poisson regression model based on a previous work by Hodgson et al has been fitted, which has allowed informed statistical inferences about model parameters and predictions of future mesothelioma mortality to be made.Methods:In the Poisson regression model, the mesothelioma risk of an individual depends on the average collective asbestos dose for the individual in a given year and an age-specific exposure potential. The model has been fitted to the data within a Bayesian framework using the Metropolis–Hastings algorithm, a Markov Chain Monte Carlo technique, providing credible intervals for model parameters as well as prediction intervals for the number of future cases of mortality.Results:Males were most likely to have been exposed to asbestos between the ages of 30 and 49 years, with the peak year of asbestos exposure estimated to be 1963. The estimated number of background cases was 1.08 cases per million population.Conclusion:Mortality among males is predicted to peak at approximately 2040 deaths in the year 2016, with a rapid decline thereafter. Approximately 91 000 deaths are predicted to occur from 1968 to 2050 with around 61 000 of these occurring from 2007 onwards.