Diseases attributable to asbestos exposure: years of potential life lost, United States, 1999-2010

Our plain-English summary of Diseases attributable to asbestos exposure: years of potential life lost, United States, 1999-2010, by K.M. Bang, J.M. Mazurek, J.M. Wood, et al (American Journal of Industrial Medicine, 2014).

The study

• Authors: K.M. Bang, J.M. Mazurek, J.M. Wood, S.A. Hendricks
• Journal: American Journal of Industrial Medicine
• Published: 2014;57(1):38-48
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Although asbestos use has been restricted in recent decades, asbestos-associated deaths continue to occur in the United States.

Objectives: We evaluated premature mortality and loss of potentially productive years of life attributable to asbestos-associated diseases.

Methods: Using 1999-2010 National Center for Health Statistics mortality data, we identified decedents aged ≥25 years whose death certificate listed asbestosis and malignant mesothelioma as the underlying cause of death. We computed years of potential life lost to life expectancy (YPLL) and to age 65 (YPLL65 ).

Results: During 1999-2010, a total of 427,005 YPLL and 55,184 YPLL65 were attributed to asbestosis (56,907 YPLL and 2,167 YPLL65 ), malignant mesothelioma (370,098 YPPL and 53,017 YPLL65 ). Overall and disease-specific asbestos-attributable total YPLL and YPLL65 and median YPLL and YPLL65 per decedent did not change significantly from 1999 to 2010.

Conclusions: The continuing occurrence of asbestos-associated diseases and their substantial premature mortality burden underscore the need for maintaining prevention efforts and for ongoing surveillance to monitor temporal trends in these diseases.

© 2013 Wiley Periodicals, Inc.

In plain English

This study used U.S. national death certificate data for 1999–2010 to measure years of life lost early to asbestosis and malignant mesothelioma. The authors counted deaths of people aged 25 and older with either disease as the underlying cause. The asbestosis group also included some deaths where pneumoconiosis associated with tuberculosis or pleural plaques with presence of asbestos was the underlying cause and asbestosis was a contributing cause. They calculated years lost compared with life expectancy, and years lost before age 65. There were 35,929 such deaths, accounting for 427,005 years of potential life lost (median 10.0 years per person). Malignant mesothelioma accounted for 29,639 deaths and 370,098 years. Asbestosis accounted for 6,290 deaths and 56,907 years. Of these deaths, 6,594 occurred at ages 25 to 64, losing 55,184 years before age 65. Annual totals did not change significantly over the period. Women and Black decedents had significantly higher median years lost per death than men and white decedents. The authors concluded that these diseases are associated with a substantial loss of potentially productive years of life. They noted that some deaths may have been miscoded and that no occupation data were available.

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 analysis of national mortality (death certificate) data, calculating years of potential life lost to life expectancy (YPLL) and before age 65 (YPLL65), with tests for time trends and group differences
• Who was studied: 35,929 people aged 25 and older who died in the United States in 1999–2010, identified in National Center for Health Statistics multiple-cause-of-death files (median age at death 75 years). They had mesothelioma or asbestosis as the underlying cause of death, or pneumoconiosis associated with tuberculosis or pleural plaques with presence of asbestos as the underlying cause with asbestosis as a contributing cause.
• Exposure: Asbestos exposure was not measured directly. Deaths were selected by cause of death: asbestosis (ICD-10 code J61, plus certain J65 or J92.0 deaths with asbestosis as a contributing cause) and mesothelioma (C45). No fiber types, products, jobs or doses were studied, and no industry or occupation information was available.
• Main results:
  • All 35,929 asbestosis and malignant mesothelioma decedents together accounted for 427,005 YPLL, a median of 10.0 years per decedent.
  • Asbestosis was the underlying cause for 6,290 decedents (median age at death 79), accounting for 56,907 YPLL (median 8.0 per decedent).
  • Malignant mesothelioma was the underlying cause for 29,639 decedents (median age at death 74), accounting for 370,098 YPLL (median 10.6 per decedent).
  • Of the 35,929 decedents, 6,594 (18.4%) were aged 25–64 at death, accounting for 55,184 years lost before age 65 (median 6.0 per decedent).
  • Malignant mesothelioma accounted for nearly 96% of the total years lost before age 65 from the two diseases.
  • Annual YPLL from both diseases combined did not change significantly over the study period (34,357 in 1999; 35,818 in 2010).
  • For both diseases combined, median YPLL per decedent was significantly greater for females (10.7) than for males (9.9), with p less than 0.001.
  • For both diseases combined, median YPLL per decedent was significantly greater for Black decedents (12.1) than for white decedents (9.9), with p less than 0.001.
  • Among decedents aged 25–64, median years lost before age 65 from both diseases combined were significantly greater for females than for males (9.0 vs. 6.0), with p less than 0.001.
  • By state, the age-adjusted YPLL rate per million was greatest in Maine (331).
• The authors' conclusion: The authors concluded that asbestos-attributable diseases are associated with a substantial loss of potentially productive years of life. They said the continuing deaths underscore the need to maintain prevention and intervention efforts and ongoing surveillance of trends.
• Limitations the authors state:
  • Years lost may be undercounted because some asbestosis and mesothelioma deaths may have been miscoded.
  • Because ICD-10 has no separate code for cancers associated with asbestos exposure, total years lost to those cancers (such as asbestos-related lung cancer) could not be calculated.
  • Disability-adjusted life years could not be estimated because no information on years lost to disability was available.
  • The state issuing the death certificate may differ from the state where the person was exposed to asbestos.
  • No industry or occupation information was available, so specific industries and occupations could not be linked to years lost.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Death Certificate, Malignant Mesothelioma, Life Expectancy.

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