Burden of Mesothelioma Deaths by National Income Category: Current Status and Future Implications

Our plain-English summary of Burden of Mesothelioma Deaths by National Income Category: Current Status and Future Implications, by O. Chimed-Ochir, D. Arachi, T. Driscoll, et al (International Journal of Environmental Research and Public Health, 2020).

The study

• Authors: O. Chimed-Ochir, D. Arachi, T. Driscoll, R.T. Lin, J. Takala, K. Takahashi
• Journal: International Journal of Environmental Research and Public Health
• Published: 2020;17(18)
• Cited by: 26 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: This study compares estimates of the global-level mesothelioma burden with a focus on how existing national mortality data were utilized and further assesses the interrelationship of country-level mesothelioma burden and asbestos use with national income status. Methods: Country-level mesothelioma deaths in the WHO Mortality Database as of December 2019 were analyzed by national income category of countries in terms of data availability and reliability. Numbers of mesothelioma deaths from the study of Odgerel et al. were reanalyzed to assess country-level mesothelioma death burdens by national income status. Results: Among 80 high-income countries, 54 (68%) reported mesothelioma to the WHO and 26 (32%) did not, and among 60 upper middle-income countries, the respective numbers (proportions) were 39 (65%) countries and 21 (35%) countries, respectively. In contrast, among 78 low- and lower middle-income countries, only 11 (14%) reported mesothelioma deaths while 67 (86%) did not. Of the mesothelioma deaths, 29,854 (78%) were attributed to high- and upper middle-income countries, and 8534 (22%) were attributed to low- and lower middle- income countries. Conclusions: The global mesothelioma burden, based on reported numbers, is currently shouldered predominantly by high-income countries; however, mesothelioma burdens will likely manifest soon in upper middle-income and eventually in low and lower middle-income countries.

In plain English

This study grouped 218 countries by World Bank income category for 2019 to 2020, combining low-income with lower middle-income countries, and examined mesothelioma deaths (ICD code C45). The authors used WHO mortality data as of December 2019. They also reanalyzed earlier country estimates by Odgerel et al., compared them with Global Burden of Disease (GBD) 2017 estimates, and looked at US Geological Survey data on asbestos use. Of 80 high-income countries, 54 (68%) reported mesothelioma deaths to the WHO. So did 39 of 60 upper middle-income countries (65%), but only 11 of 78 lower-income countries (14%). Only one lower-income country reported data judged reliable. The Odgerel et al. figures totaled 38,388 annual deaths: 37% in high-income, 41% in upper middle-income and 22% in lower-income countries. In the two lower groups, 92% and 99.9% of the numbers were estimates rather than reported deaths. GBD 2017 placed 58% of deaths in high-income countries. In the last decade, almost no asbestos use was recorded in high-income countries. The authors concluded that mesothelioma burdens will likely appear soon in upper middle-income countries and eventually in lower-income countries.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive country-level (ecological) analysis of national mortality data from the WHO Mortality Database, with a reanalysis of earlier estimates by Odgerel et al. and a comparison with GBD 2017 estimates, grouped by national income category
• Who was studied: 218 countries classified by the World Bank's 2019–2020 income categories (high, upper middle, and lower middle combined with low income). Mesothelioma deaths reported to the WHO from 1994 to 2018 were included.
• Exposure: National asbestos use from the US Geological Survey, defined as production plus imports minus exports, by country, 1920–2016. No fiber types are specified.
• Main results:
  • Reporting of mesothelioma deaths to the WHO by income group: 54 of 80 high-income countries (68%), 39 of 60 upper middle-income countries (65%), and 11 of 78 lower middle- and low-income countries (14%).
  • Among 78 lower middle- and low-income countries, only 11 (14%) reported mesothelioma deaths.
  • Most high-income countries reported data judged reliable. This was true for only about half of upper middle-income countries and only one lower-income country.
  • Estimated global mesothelioma deaths were about 30,000 (GBD) and about 38,000 (Odgerel et al.).
  • GBD and Odgerel et al. attributed 58% and 37% of global mesothelioma deaths, respectively, to high-income countries, and 25% and 41% to upper middle-income countries.
  • In the Odgerel et al. figures, 98% of the numbers for high-income countries were reported deaths. For upper middle-income and lower-income countries, 92% and 99.9% of the numbers were estimates.
  • Estimated annual mesothelioma deaths (not reported counts) were 10,000+ for China, about 1300 for Russia, and about 1200 for Brazil.
  • Global asbestos use passed 2.0 million metric tonnes in 1960 and peaked around 1980 at about 5.0 million metric tonnes.
  • In the last decade, almost no asbestos consumption was recorded by high-income countries. The authors note that the US has reduced its use to a low but nonzero level.
  • Among the top ten asbestos users since 1980 in each income group, asbestos had been banned in eight high-income, one upper middle-income, and zero lower-income countries.
• The authors' conclusion: The authors concluded that the global mesothelioma burden, based on reported numbers, currently falls mainly on high-income countries. They added that, based on past and current asbestos use, mesothelioma burdens will likely appear soon in upper middle-income countries and eventually in lower-income countries.
• Limitations the authors state:
  • The study combined a reanalysis of earlier data (as of November 2015) with new data (as of December 2019), four years apart.
  • The income category reflected only each country's most recent economic status, which can change over time.
  • Raw asbestos consumption was used as the indicator of asbestos use; asbestos-containing products were not included.
  • The margin of error for estimated numbers is expected to be smallest in high-income countries and largest in lower-income countries.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

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