Epidemiology of Asbestosis between 2010-2014 and 2015-2019 Periods in Colombia: Descriptive Study

Our plain-English summary of Epidemiology of Asbestosis between 2010-2014 and 2015-2019 Periods in Colombia: Descriptive Study, by G. Camero, G. Villamizar, L.M. Pombo, et al (Annals of Global Health, 2023).

The study

• Authors: G. Camero, G. Villamizar, L.M. Pombo, M. Saba, A.L. Frank, A.A. Teherán, G.M. Acero
• Journal: Annals of Global Health
• Published: 2023;89(1):54
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Asbestosis is a prevalent worldwide problem, but scarce data sourced from developing countries are available. We describe the sociodemographic characteristics and patterns in the occurrence of care provided for asbestosis in Colombia during the periods 2010-2014 and 2015-2019 to establish the behavior, trends, and variables associated with concentrations among people attended by asbestosis.

Methods: A retrospective descriptive study was carried out with data from the Integrated Social Protection Information System (SISPRO) for two 5-year periods. People attended by asbestosis (ICD-10: J61) were identified; the frequency of patient visits, sociodemographic characteristics, case distribution patterns, and trends in both five-year periods were described, as was the crude frequency (cFr, 95% CI) of asbestosis (1,000,000 people/year) in both five-year periods (cFr ratio, 95% CI).

Results: During the period 2010-2019, 765 people attended by asbestosis were identified; there were 308 people attended by asbestosis between 2010-2014 (cFr: 2.20, 1.96-2.47), and ther were 457 people attended by asbestos between 2015-2019 (cFr: 3.14, 2.92-3.50). In both periods, the estimated cFr in men was nine times the estimated cFr in women. The cFr increased in the 2015-2019 period (cFr_ratio: 1.23, 1.06-1.43). Compared with the 2010-2014 period, the cFr of asbestosis increased in women (cFr_ratio: 1.44, 1.03-2.01), in the Andean (cFr_ratio: 1.61, 1.35-1.95) and Caribbean regions (cFr_ratio: 1. 66, 1.21-2.30), in the urban area (cFr_ratio: 1.24, 1.05-1.48), and in the age groups 45-59 years (cFr_ratio: 1.34, 1.001-1.79) and ≥60 years (cFr_ratio: 1.43, 1.13-1.83).

Discussion: During two five-year periods, the cFr of asbestosis was higher in men; between the first and second five-year periods, it increased significantly, especially in urbanized geographic areas and in populations aged ≥45 years. The estimates possibly reflect the effect of disease latency or the expected impact of public health policies to monitor asbestos exposure and complications.

Copyright: © 2023 The Author(s).

In plain English

This retrospective descriptive study used Colombia's national health records (SISPRO) to count people treated under the asbestosis diagnosis code (ICD-10 J61). The authors identified 765 people: 308 in 2010–2014 and 457 in 2015–2019. Frequency was calculated against the whole health system, not residents, though the Methods calls the denominator visits and the Discussion people treated. It was 2.20 (95% CI 1.96–2.47) per million in the first period and 3.14 (2.92–3.50) in the second. The authors reported this as a 23% increase (ratio 1.23), although 3.14 divided by 2.20 is about 1.43. About four in five patients were men. Between periods, frequency rose significantly in women (ratio 1.44, 1.03–2.01) but not significantly in men (1.12, 0.96–1.32). It also rose in the Andean and Caribbean regions, urban areas, and people aged 45–59 and 60 or older. The study did not measure anyone's asbestos exposure. The authors concluded that frequency rose significantly and was higher in men, people 45 or older and urbanized areas. They noted the records cannot separate new from returning patients, so figures are not incidence rates. Other figures also conflict.

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: Retrospective descriptive study of national administrative health records (SISPRO), comparing two five-year periods
• Who was studied: People recorded in Colombia's SISPRO database as attended for asbestosis (ICD-10 code J61): 765 people in 2010–2019, of whom 308 were in 2010–2014 and 457 in 2015–2019
• Exposure: Individual asbestos exposure was not measured and no fiber types were studied. The authors assumed active and passive asbestos exposure before the measurement period. The outcome was being attended in the health system under the asbestosis diagnosis code.
• Main results:
  • The crude frequency per million was 2.20 (95% CI 1.96–2.47) for the whole 2010–2014 period and 3.14 (95% CI 2.92–3.50) for the whole 2015–2019 period. The denominator was the whole health system, described in Methods as visits and in the Discussion as people treated.
  • The authors reported a 23% increase (frequency ratio 1.23) in 2015–2019 compared with 2010–2014. This does not match their own period rates: 3.14 divided by 2.20 is about 1.43.
  • In both periods about four out of five people attended for asbestosis were men
  • Between periods, only women showed a significant increase: a 44% average risk excess, with a frequency ratio of 1.44 (95% CI 1.03–2.01). The ratio for men was 1.12 (0.96–1.32).
  • Frequency ratio for 2015–2019 versus 2010–2014 in the Andean region: 1.61 (95% CI 1.35–1.95)
  • Frequency ratio for 2015–2019 versus 2010–2014 in the Caribbean region: 1.66 (95% CI 1.21–2.30)
  • Frequency ratio for 2015–2019 versus 2010–2014 in urban areas: 1.24 (95% CI 1.05–1.48)
  • Frequency ratio for 2015–2019 versus 2010–2014 in people aged 45–59: 1.34 (95% CI 1.001–1.79)
  • Frequency ratio for 2015–2019 versus 2010–2014 in people aged 60 and over: 1.43 (95% CI 1.13–1.83)
  • Bogotá had the highest occurrence among the departments. The authors suggested this may reflect referral of patients to its highly complex health institutions.
• The authors' conclusion: The authors concluded that, between 2010–2014 and 2015–2019, the frequency of people attended for asbestosis in Colombia increased significantly, from 2.2 to 3.14 per million people treated in the health system. They found it was higher in men, in people aged 45 or older and in highly urbanized areas. They considered that the disease should be actively monitored.
• Limitations the authors state:
  • Administrative data cannot show whether patients counted each year were new or returning for follow-up, so results cannot be expressed as incidence
  • The denominator was the whole health system (described here as people treated, though Methods says visits), not the exposed population
  • Distribution patterns may reflect availability of health care and practitioner experience
  • The long latency of the disease limits identifying the events behind the estimates and may influence the frequency in people aged 45 or older
  • International diagnosis and monitoring guidelines adopted in Colombia may have influenced case identification

Topics

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

Medical terms in this study, explained in our Lexicon: Epidemiology, Latency, Asbestos Exposure.

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