Epidemiology of mesothelioma in Israel

Our plain-English summary of Epidemiology of mesothelioma in Israel, by C. Lemesch, R. Steinitz, M. Wassermann (Environmental Research, 1976).

The study

• Authors: C. Lemesch, R. Steinitz, M. Wassermann
• Journal: Environmental Research
• Published: 1976;12(2):255-61
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004364).

Abstract

During the period 1960-1972, 65 cases of mesothelioma were registered at the Israel Cancer Registry. In 13 cases the histologic diagnosis was not considered as definite and they were, therefore, excluded. A review of the medical and occupational histories where available of the remaining 52 cases reported. The diagnosis was made by biopsy in 34 cases (65%) and by autopsy in 18 cases (35%). Twenty-seven cases (52%) were located in the pleura and 25 (48%) in the peritoneum. There were 30 males (58%) and 22 females (42%). The age at diagnosis ranged from 1.5 to 85 years and the highest age-specific rate (5.0/million) corresponded to the age group 66-74 years. The average annual incidence rate for the total population was 1.5 cases per million. Distribution by country of origin showed that Jews born in Europe or America had the highest incidence rate (3.4/million) and the lowest rate (0.6/million) was found among Jews born in Israel. The age-standardized rates indicated that these differences were due to a dissimilar age distribution among the country of origin groups. Only one case had a definite occupational history of exposure to asbestos. It is suggested that, in addition to occupational exposure other etiological factors may play an important role in the epidemiology of mesothelioma in Israel.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

The authors reviewed the 65 cases of mesothelioma registered at the Israel Cancer Registry from 1960 to 1972. They excluded 13 whose diagnosis was not considered definite and analyzed the remaining 52. These were 30 males and 22 females, aged 1.5 to 85 years. Twenty-seven tumors were in the pleura and 25 in the peritoneum. Mean survival was 10.5 months for pleural cases and 8.0 months for peritoneal cases. The average annual incidence was 1.5 cases per million people. Crude rates were highest among Jews born in Europe or America (3.4 per million) and lowest among Jews born in Israel (0.6 per million). The authors attributed these differences to differing age distributions. Differences by district and between towns and rural areas were not statistically significant. Occupational information was available for only 28 cases. One had definite occupational asbestos exposure, seven possible exposure, and 20 probably none. Citing cases under age 15 and no significant difference in the sex distribution, the authors concluded that factors other than occupational asbestos exposure may contribute to mesothelioma in Israel. They cautioned that rates may be underestimated.

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 epidemiological study of all mesothelioma cases recorded in a national cancer registry, supplemented by hospital records, questionnaires to relatives and National Insurance Institute records
• Who was studied: 65 mesothelioma cases registered in Israel from 1960 to 1972. Thirteen with a non-definite diagnosis were excluded, leaving 52 cases. Of these, 34 were diagnosed by biopsy and 18 by autopsy. There were 30 males and 22 females.
• Exposure: Occupational and residential exposure to asbestos, assessed through hospital records, questionnaires to relatives (20 returned with usable information) and National Insurance Institute records (12 cases). Fiber types were not specified. Occupations listed included asbestos-cement factory worker, building worker, electrician, metalworker, motor mechanic and welder.
• Main results:
  • Of the 52 cases, 30 were males with an average age at diagnosis of 52 years, and 22 were females with an average age at diagnosis of 47 years.
  • 27 cases (52%) were pleural mesothelioma and 25 (48%) were peritoneal mesothelioma.
  • Mean survival time was 10.5 months in the pleural mesothelioma group and 8.0 months in the peritoneal group.
  • The average annual incidence rate for the total population of Israel was 1.5 cases per million. The highest age-specific rate (5.0 per million in Table 4) was in the 60 to 74 age group.
  • Jews born in Europe or America had the highest crude annual incidence rate (3.4 per million) and Jews born in Israel the lowest (0.6 per million). Age-standardized rates indicated these differences were due to differing age distributions. Table 4 marks the age-standardized comparison as P greater than 0.05.
  • The Haifa district (1.8 per million) and the Southern district (3.1 per million) had rates above the average. The two large asbestos plants are not located in these districts. Table 5 marks the district differences as P greater than 0.05.
  • The incidence rate was 1.6 per million in areas with more than 5,000 inhabitants and 1.0 per million in rural areas. This difference was not statistically significant.
  • Occupational information was obtained for 28 of the 52 cases (54%). One case had definite occupational asbestos exposure, seven worked in trades where exposure was most probable, and 20 had occupations where asbestos exposure is not common.
  • Israel's rate of 1.50 per million (1960 to 1972) was compared with Canada's 1.40 (1960 to 1970) and Great Britain's 2.29 (1967 to 1968). The authors judged that Israel's rate did not seem very different.
• The authors' conclusion: The authors concluded that there may be factors apart from occupational asbestos exposure contributing to mesothelioma in Israel. They cited three findings: cases occurred in people under 15, there was no significant difference in the sex distribution, and most cases with a known occupation were not in trades where asbestos exposure is common. Because the asbestos industry in Israel began only in the early 1950s and latency is about 20 years or more, they considered it possible that more clearly occupational cases would appear.
• Limitations the authors state:
  • Registered cases may not include all cases that occurred, because diagnosis requires histological confirmation that is lacking where no autopsy was done. Incidence rates may therefore be underestimated.
  • Some cases included as mesothelioma might have been rejected by a panel of pathologists.
  • Differences among ethnic origin groups may partly reflect unequal access to medical care and differing frequency of postmortem examinations.
  • No occupational history was available for 46% of cases.

Topics

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

Medical terms in this study, explained in our Lexicon: Epidemiology, Mesothelioma, Cancer Registry, Biopsy, Autopsy, Pleura, Peritoneum, Incidence.

Related studies

• Epidemiology of primary malignant mesothelial tumors in Canada — A.D. McDonald, A. Harper, et al. (1970)
• Malignant mesothelioma in Israel, 1961-1992 — J. Iscovich, A. Fischbein, et al. (1999)
• Mesothelioma trends in the United States: an update based on Surveillance, Epidemiology, and End Results Program data for 1973 through 2003 — B. Price, A. Ware (2004)
• Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues — A. Marinaccio, A. Binazzi, et al. (2015)
• Epidemiology study of the use of asbestos-cement pipe for the distribution of drinking water in Escambia County, Florida — J.R. Millette, G.F. Craun, et al. (1983)
• The epidemiology and treatment of mesothelioma in South East England 1985-2002 — V. Mak, E. Davies, et al. (2008)

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