Global use of asbestos and the incidence of mesothelioma

Our plain-English summary of Global use of asbestos and the incidence of mesothelioma, by A. Tossavainen (International Journal of Occupational and Environmental Health, 2004).

The study

• Author: A. Tossavainen
• Journal: International Journal of Occupational and Environmental Health
• Published: 2004;10(1):22-5
• Cited by: 96 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In Western Europe, Scandinavia, North America, and Australia the manufacture and use of asbestos products peaked in the 1970s. Current incidences of mesothelioma range from 14 to 35 cases/million/year in 11 industrialized countries that had used asbestos 2.0 to 5.5 kg/capita/year about 25 years earlier. A significant linear correlation (r = 0.80, p 0.01) exists between the two variables. Accordingly, about 170 tons of produced and consumed asbestos will cause at least one death from mesothelioma, most often as a consequence of occupational exposure.

In plain English

This ecological study compared countries, not individuals. The author estimated each country's per-capita consumption of raw asbestos about 25 to 30 years earlier from production, import and export data, and its current mesothelioma incidence among people over 15, using cancer registries where available. Eleven industrialized countries had both figures. In 1995-2000, incidence ranged from 14 cases per million per year (Norway) to 35 (Australia), with a mean of 18 and 8,236 cases in total. About 25 years earlier these countries had used 2.0 to 5.5 kg of asbestos per person per year, averaging 2.8. Higher past use went with higher incidence: the Spearman rank correlation was 0.73 and the regression coefficient 0.80. The author concluded that about 170 tons of asbestos will cause at least one death from mesothelioma, most often from occupational exposure; national figures ranged from 110 to 230 tons. Stated limitations included missing data on past use, differences in how mesothelioma is diagnosed and registered, countries chosen only by data availability, and possible underestimation because the effect of 1970s peak use had not yet fully appeared.

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: Ecological (country-level) correlation study using linear regression and Spearman rank correlation on national asbestos consumption and mesothelioma incidence data
• Who was studied: 11 industrialized countries (Australia, Finland, France, Germany, Great Britain, Italy, Netherlands, New Zealand, Norway, Sweden, United States) with published asbestos consumption figures for the early 1970s and mesothelioma incidence (or mortality) after 1995. Incidence was calculated for the population over 15 years of age, about 470 million people.
• Exposure: National apparent per-capita consumption of raw asbestos (all types of asbestos products, not broken down by fiber type) about 25 to 30 years earlier, in kg per person per year, calculated from production, import and export data
• Main results:
  • In 1995-2000, mesothelioma incidence in the 11 countries ranged from 14 (Norway) to 35 (Australia) cases per million per year, with a mean of 18 cases per million per year in the population over 15
  • A total of 8,236 mesothelioma cases were recorded across the 11 countries
  • About 25 years earlier, the 11 countries had used 2.0 to 5.5 kg of asbestos per person per year
  • Average past use was 2.8 kg per person per year across the 500 million people (all ages) in these countries; their combined annual consumption was 1.4 million tons, about one third of worldwide use at the time
  • Mesothelioma incidence was associated with earlier per-capita asbestos consumption: Spearman correlation coefficient r = 0.73 and regression coefficient r = 0.80 for the linear model, each with a P value printed as 0.01 (the comparison symbol is missing from the text). The author described the relationship as significant.
  • The regression formula linking incidence (Y, cases per million per year) to consumption (X, kg per person per year) was Y = 6.82 X + 0.43
  • Tons of asbestos used per mesothelioma case varied between countries within a twofold range, from 110 to 230 tons
• The authors' conclusion: The author concluded that about 170 tons of produced and consumed asbestos will cause at least one death from mesothelioma, most often as a consequence of occupational exposure
• Limitations the authors state:
  • Data on past asbestos use were lacking, and countries differed substantially in how mesothelioma cases were diagnosed and registered
  • Countries were selected only on the basis of data availability, and other regions or time periods would produce different results
  • The figures may underestimate the true risks because the full impact of peak use and exposure in the 1970s had not yet appeared
  • Crude rates for people over 15 were used without age or gender standardization, so they are roughly 20% higher than all-age or world-standardized incidences

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, Occupational Exposure.

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