Increasing incidence of malignant mesothelioma after exposure to asbestos during home maintenance and renovation

Our plain-English summary of Increasing incidence of malignant mesothelioma after exposure to asbestos during home maintenance and renovation, by N.J. Olsen, P.J. Franklin, A. Reid, et al (The Medical Journal of Australia, 2011).

The study

• Authors: N.J. Olsen, P.J. Franklin, A. Reid, N.H. de Klerk, T.J. Threlfall, K. Shilkin, B. Musk
• Journal: The Medical Journal of Australia
• Published: 2011;195(5):271-4
• Cited by: 94 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: To determine trends in incidence of malignant mesothelioma (MM) caused by exposure to asbestos during home maintenance and renovation.

Design, Setting And Participants: Using the Western Australian Mesothelioma Register, we reviewed all cases of MM diagnosed in WA from 1960 to the end of 2008, and determined the primary source of exposure to asbestos. Categories of exposure were collapsed into seven groups: asbestos miners and millers from Wittenoom; all other asbestos workers; residents from Wittenoom; home maintenance/renovators; other people exposed but not through their occupation; and people with unknown asbestos exposure; or no known asbestos exposure. Latency periods and age at diagnosis for each group were calculated and compared.

Results: In WA, 1631 people (1408 men, 223 women) were diagnosed with MM between 1960 and 2008. Since 1981, there have been 87 cases (55 in men) of MM attributed to asbestos exposure during home maintenance and renovation, and an increasing trend in such cases, in both men and women. In the last 4 years of the study (2005-2008), home renovators accounted for 8.4% of all men and 35.7% of all women diagnosed with MM. After controlling for sex and both year and age at diagnosis, the latency period for people exposed to asbestos during home renovation was significantly shorter than that for all other exposure groups, but the shorter follow-up and difficulty recalling when exposure first occurred in this group may partly explain this.

Conclusions: MM after exposure to asbestos during home renovation is an increasing problem in WA, and these cases seem to have a shorter latency period than other types of exposure. MM cases related to renovation will probably continue to increase because of the many homes that have contained, and still contain, asbestos building products.

In plain English

This study used the Western Australian Mesothelioma Register to review all 1631 cases of malignant mesothelioma diagnosed in Western Australia from 1960 to December 2008 (1408 men, 223 women). A register committee classified each person's main source of asbestos exposure. Eighty-seven cases (55 men, 32 women) were attributed to taking part in, or being present during, home maintenance or renovation. The first such case was registered in 1981. Compared with 1980–1984, incidence of these cases, adjusted for age and sex, was significantly higher in 2000–2004 (incidence rate ratio 13.03, 95% CI 1.76–96.66) and 2005–2008 (44.96, 95% CI 6.19–326.32). In 2005–2008, home renovation accounted for 8.4% of cases in men and 35.7% in women. Home renovators had a significantly shorter adjusted average latency (33.1 years, 95% CI 27.5–38.8) than all other exposure groups. The authors said this may be partly explained by shorter follow-up and difficulty recalling first exposure. The authors concluded that cases attributable to home renovation are likely to increase further because asbestos cement products remain widespread in Western Australian homes.

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: Population register-based study of all diagnosed mesothelioma cases, with exposure classification by a register committee; Poisson regression for incidence trends and linear regression for latency and age at diagnosis
• Who was studied: All 1631 people (1408 men, 223 women) diagnosed with malignant mesothelioma in Western Australia between 1960 and December 2008, of whom 1562 had died
• Exposure: Asbestos exposure during home renovation or home maintenance, either as a participant or as a bystander, coded only when no other source of exposure was identified. This group was compared with Wittenoom workers, other asbestos workers, Wittenoom residents and other non-occupational exposure. Fiber type is not specified for the home renovator group.
• Main results:
  • The first case attributed to home maintenance and renovation was registered in 1981. There were 87 such cases in total (55 men, 32 women): 84 pleural (53 men) and three peritoneal (two men).
  • Compared with the base period 1980–1984, the age- and sex-adjusted incidence rate ratio for home renovation cases was 13.03 (95% CI 1.76–96.66, P 0.012) for 2000–2004 and 44.96 (95% CI 6.19–326.32, P 0.001) for 2005–2008. The authors marked these two periods as significantly higher than the base rate.
  • In 2005–2008, home renovation accounted for 8.4% of mesothelioma cases in men and 35.7% of cases in women.
  • After controlling for sex and year and age at diagnosis, latency for home renovators was significantly shorter than for all other exposure groups.
  • For home renovators, the adjusted mean latency was 33.1 years (95% CI 27.5–38.8) and the adjusted mean age at diagnosis was 66.5 years (95% CI 61.9–71.1).
  • Over 1960–2008, occupational exposure was the main source of exposure for 82.8% of men but 16.6% of women.
• The authors' conclusion: The authors concluded that, because asbestos cement products remain widespread in WA homes and mesothelioma has a long latency period, further cases attributable to home renovation are likely.
• Limitations the authors state:
  • The home renovator group had a shorter follow-up period than the occupational groups, which may partly explain its shorter latency.
  • Recalling when exposure first occurred is difficult, particularly for non-occupational exposure, so some latency periods may have been underestimated.
  • The authors could not predict how long the increasing trend will continue because there are no published data on past or current community exposure to asbestos.

Mines named here

Asbestos mines this study is about. Each mine's page says who ran it, when it worked, and what it produced.

• Wittenoom, Western Australia

All asbestos mines

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelioma, Wittenoom, Asbestos Exposure, Latency.

Related studies

• Asbestos exposure during home renovation in New South Wales — E.K. Park, D.H. Yates, et al. (2013)
• Asbestos exposure during home renovation in New South Wales — R.A. Lemen, A.L. Frank, et al. (2014)
• Asbestos exposure during home renovation in New South Wales — A.R. Johnson, D.H. Yates (2014)
• Renovation and renewal — A. Katelaris (2011)
• Medicolegal aspects of the third wave of asbestos-related disease in Australia — J.R. Gordon, J. Leigh (2011)
• A radiographic survey of public school building maintenance and custodial employees — H.A. Anderson, L.P. Hanrahan, et al. (1992)

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