The Australian Mesothelioma Surveillance Program 1979‐1985

Abstract

Program was planned in 1977 in order to improve diagnostic criteria, to monitor the incidence of the disease, to develop methods of counting lung fibres, and to explore occupational and other associations of mesothelioma. This paper presents a preliminary analysis of data that were collected between January 1, 1980 and December 31, 1985 on the pathological findings and the work and environmental history of 858 cases of mesothelioma. The annual incidence rate of mesothelioma in Australia was 15 per million population who were aged 20 years and over. This is more than the incidence rate of mesothelioma in any other country for which data are available. However, uncertainty over diagnostic criteria and the degree of ascertainment of cases places doubt on the validity of such comparisons. In 69% of cases, a history of work with or other exposure to asbestos was obtained. Due to the long interval between the first exposure to asbestos and the provisional diagnosis of a mesothelioma (up to 60 years), more than three-quarters of the 456 exposed cases first contacted asbestos in the years of its heavy use between 1930 and 1959. This article analyses cases by the industry and the occupation in which exposure to asbestos first occurred.

The incidence of malignant mesothelioma in Australia 1982–1988

“…The Program received notification of 854 cases with a presumptive diagnosis of mesothelioma. Ferguson et al [1987] reported 871 cases as being notified to the Program. Subsequently, cases found not to be mesothelioma (prior to review by the RCPA Panel) have been subtracted from the number.…”

Malignant mesothelioma in Australia, 1945–2000*

“…The Australian Mesothelioma Surveillance Program (the Program, as it ®nally became known) endeavored to correct most of the weaknesses identi®ed in the 1960's and 70's in other such surveillance schemes throughout the world, viz., under-reporting of cases, uncertain diagnosis, poor elucidation of the role of occupational and environmental asbestos exposure, and less than comprehensive coverage [Ferguson et al, 1987].…”

“…According to history assessment of exposure of the ®rst 530 cases by the two hygienists, most cases (55%) had mixed amphibole-chrysotile exposure, 13% amphibole only, 7% amphibole, plus possible chrysotile, 6% chrysotile, with possible amphibole, and 4% chrysotile only, with 15% unknown ®ber type [Grimwood, 1988]. Mean latency from ®rst exposure to presumptive diagnosis was 37.4 years [Ferguson et al, 1987]. The range of latencies was 4±75 years.…”

Case‐control study of mesothelioma in South Africa

“…Australia is the only other country to have mined crocidolite in significant amounts and it has maintained a mesothelioma surveillance program since 1979. Ferguson et al [1987] presented exposure data on 726 cases collected from 1 /1/1980 to 12/31/1985. Environmental exposure had occurred in 43 of these cases (6%) and in only six of these (less than 1%) was environmental exposure due to residence in an asbestos mining region (Wittenoom, the crocidolite district).…”