Recent Mortality from Pleural Mesothelioma, Historical Patterns of Asbestos Use, and Adoption of Bans: A Global Assessment

Abstract

BackgroundIn response to the health risks posed by asbestos exposure, some countries have imposed strict regulations and adopted bans, whereas other countries have intervened less and continue to use varying quantities of asbestos.ObjectivesThis study was designed to assess, on a global scale, national experiences of recent mortality from pleural mesothelioma, historical trends in asbestos use, adoption of bans, and their possible interrelationships.MethodsFor 31 countries with available data, we analyzed recent pleural mesothelioma (International Classification of Diseases, 10th Revision) mortality rates (MRs) using age-adjusted period MRs (deaths/million/year) from 1996 to 2005. We calculated annual percent changes (APCs) in age-adjusted MRs to characterize trends during the period. We characterized historical patterns of asbestos use by per capita asbestos use (kilograms per capita/year) and the status of national bans.ResultsPeriod MRs increased with statistical significance in five countries, with marginal significance in two countries, and were equivocal in 24 countries (five countries in Northern and Western Europe recorded negative APC values). Countries adopting asbestos bans reduced use rates about twice as fast as those not adopting bans. Turning points in use preceded bans. Change in asbestos use during 1970–1985 was a significant predictor of APC in mortality for pleural mesothelioma, with an adjusted R2 value of 0.47 (p < 0.0001).ConclusionsThe observed disparities in global mesothelioma trends likely relate to country-to-country disparities in asbestos use trends.

Global mesothelioma deaths reported to the World Health Organization between 1994 and 2008

“…These trends are consistent with previous reports 9, [21][22][23] and may reflect the wax and wane of disease with historical asbestos use. 24 Accordingly, the burden of disease may be shifting towards countries that used asbestos more recently, such as those in Asia and, to a lesser extent, middleand low-income countries.…”

Novel systemic therapy against malignant pleural mesothelioma

“…Asbestos exposure was first identified as a cause of MPM in the 1960's, and it is estimated that up to 80% of cases of MPM are related to asbestos exposure with the onset of disease generally occurring 20-70 years after exposure through mechanisms of chronic inflammation (3)(4)(5). The incidence of MPM in the United States has stabilized over the past few years likely due to decreased asbestos use since the 1970's (1); however, the incidence of MPM in developing countries is expected to increase and represents a substantial health and economic burden (6,7). Risk factors for mesothelioma also include environmental, occupational, and para-occupational exposure to asbestos and other mineral fibers such as erionite (8).…”

Malignant Mesothelioma in Eastern Asia

“…The geographic distribution of the tumor is relevant with reference to its etiology. Various studies have revealed a relationship between mesothelioma incidence at a country level and consumption of asbestos in the previous decades (Tossavainen, 2003;Tossavainen, 2004;Lin et al, 2007;Nishikawa et al, 2008). Moreover, in a given country the areas with high mesothelioma incidence exactly correspond to the location of the industries and activities, in which asbestos use has been heavy .…”