Malignant mesothelioma in Israel, 1961-1992

Our plain-English summary of Malignant mesothelioma in Israel, 1961-1992, by J. Iscovich, A. Fischbein, J. Witt-Kushner, et al (International Journal of Occupational and Environmental Health, 1999).

The study

• Authors: J. Iscovich, A. Fischbein, J. Witt-Kushner, G. Ginsberg, E. Richter, T. Tulchinsky
• Journal: International Journal of Occupational and Environmental Health
• Published: 1999;5(3):157-63
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The authors monitored time trends in the incidences and distributions of malignant mesotheliomas during 1961-92 in 223 Israeli persons, including 21 men from a cohort of 3,057 asbestos-cement workers (83,122 person-years). The annual incidence rates of malignant mesotheliomas in Jewish men ranged between 2.5 per million in 1961-82 and 4.6 per million in 1985-92. The male-to-female incidence ratio rose from 1.2 in the 1960s to 2.9 during 1985-92, as a result of increases in risk among Israeli-born males. Females accounted for 37.6% of all cases, after exclusion of the cohort of asbestos workers. Of the 223 cases, 202 (91%) had no indication of direct occupational exposure to asbestos. In Jewish females, the incidence of malignant mesotheliomas did not increase after 1961. The mean age at diagnosis in all cases was lowest in the Israeli-born (53.0 years). High levels of asbestos exposure in the 1970s and the relatively early age of onset of the disease indicate that exposure began at a younger age in Israel than in European countries. Asbestos manufacture and use peaked in Israel during the mid-1970s, so the maximum impact of these trends has yet to be seen.

In plain English

Using the Israel Cancer Registry, the authors tracked malignant mesothelioma across Israel from 1961 to 1992. They kept 223 of 279 reported cases after checking diagnoses, and they cross-checked records of a cohort of 3,057 male asbestos-cement plant workers. Imported asbestos was 90% chrysotile and 10% crocidolite. In Jewish men, the age-adjusted rate reached 4.6 per million in 1985-92, up from between 1.3 and 2.5 in earlier periods. Rates in Jewish women stayed unchanged. The male-to-female ratio rose from 1.2 in the 1960s to 2.9 in 1985-92. With the plant workers excluded, rates in men still rose, from 1.75 per million in 1961-1976 to 3.4 in 1985-1992. Of the 223 cases, 202 (91%) had no indication of direct occupational exposure. Women made up 37.6% of cases outside the worker cohort. In 1985-92, mean age at diagnosis was 53.0 years in Israeli-born Jewish cases and 64.8 in European- or American-born Jews. The authors concluded that the data strongly suggested the rise came from growing national use of and work exposure to asbestos since the 1950s. They added that young ages suggested early exposure, possibly from dust workers carried home.

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-based study of time trends in registered cancer incidence, using the national cancer registry with diagnosis validation and cross-checking against an asbestos-cement worker cohort
• Who was studied: 223 validated cases of malignant mesothelioma registered in Israel, 1961-1992 (from 279 originally reported). Analyses covered immigrants and native-born Israelis, Jews and non-Jews, with and without a cohort of 3,057 male asbestos-cement plant workers.
• Exposure: National asbestos use, with imports described as 90% chrysotile and 10% crocidolite, rising from 1,000 tons in the mid-1950s to almost 9,000 tons in the mid-1970s. Occupational exposure in a cohort of male asbestos-cement plant workers. Individual exposures of non-cohort cases were not measured.
• Main results:
  • In Jewish men, the age-adjusted incidence was 4.6 per million in 1985-1992 (71 cases), a marked increase over earlier periods (2.2, 1.3 and 2.5 per million in Table 3).
  • In Jewish women, overall incidence rates remained unchanged over the study period.
  • The male-to-female incidence ratio rose from 1.2 in the 1960s to 2.9 in 1985-92, attributed to increased risk among Israeli-born males.
  • After excluding the asbestos-cement workers, rates in men rose from 1.75 per million in 1961-1976 to 3.4 in 1985-1992. The worker cohort accounted for 26.1% of total national incidence in Jewish males.
  • Of the 223 cases, 202 (91%) had no indication of direct occupational exposure to asbestos.
  • After exclusion of the worker cohort (men only), women accounted for 37.6% of cases (76 women, 126 men).
  • In 1985-1992, mean age at diagnosis was 53.0 years in Jewish Israeli-born cases and 64.8 years in European- or American-born Jews.
  • 45 of the 143 male cases (31.4%) were under 50 years old. The authors said this difference between age groups may be real, with p = 0.15.
  • In men, the ratio of pleural to peritoneal mesothelioma rose from 0.9 in the 1960s to 3.8 in 1985-1992.
• The authors' conclusion: The authors concluded that incidence rose in men but stayed constant in women, at a relatively high share. They said the low age at diagnosis in native-born Israelis suggests exposure at an early age; household exposure from asbestos on workers' clothes was one possible explanation. They added that the data strongly suggest the rise came from increased national use of and occupational exposure to asbestos since the 1950s.
• Limitations the authors state:
  • 24 cases were excluded because diagnostic data were considered inadequate, despite a possible loss of specificity in case ascertainment.
  • The number of cases among non-Jewish residents was small.

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, Asbestos-Cement, Incidence, Occupational Exposure, Asbestos Exposure.

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• Epidemiology of mesothelioma in Israel — C. Lemesch, R. Steinitz, et al. (1976)
• Residential proximity to naturally occurring asbestos and mesothelioma risk in California — X.L. Pan, H.W. Day, et al. (2005)
• Cancer in ex-asbestos cement workers in Israel, 1953-1992 — T.H. Tulchinsky, G.M. Ginsberg, et al. (1999)
• Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom — A. Reid, P. Franklin, et al. (2018)

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