Malignant mesothelioma--the rising epidemic

Our plain-English summary of Malignant mesothelioma--the rising epidemic, by D. Ferguson (The Medical Journal of Australia, 1989).

The study

• Author: D. Ferguson
• Journal: The Medical Journal of Australia
• Published: 1989;150(5):233-5
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this editorial, the author commented on a study by Musk et al. in the same issue, which traced 674 Australian cases of malignant mesothelioma from 1947 to 1980. He argued that the rise in incidence was real rather than an artefact of better diagnosis. He cited unpublished data on 1400 cases collected by the Australian Mesothelioma Surveillance Program and Register since 1980. The overall incidence rate rose from 12.8 cases per million people aged 20 years or older in 1982 to 18.1 in 1986. The rate in men rose by over a quarter and the rate in women by nearly two-thirds. In 1982-1985 the rate in men in Western Australia (43.5 per million) far exceeded the national rate (27.0), which he explained by the Wittenoom crocidolite mine. Of 726 patients assessed by the Australian Mesothelioma Surveillance Program, past occupational exposure was 'definite' in 45%, 'probable' in 7% and 'possible' in 11%, and environmental exposure was found in 6%. He stated that risk depended on fibre type, size and persistence, and that the risk from chrysotile was probably zero unless it was contaminated by an amphibole. He expected incidence to rise for another 10 to 15 years and then decline. He called for continued surveillance, research on low-level exposure and observation of risk occupations such as asbestos removalists.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This was an editorial, not a research study. It accompanied an article by Musk and colleagues on mesothelioma in Australia in the same journal issue. The author, convenor of the Australian Mesothelioma Surveillance Program, discussed factors in the occurrence of diffuse malignant mesothelioma. Citing unpublished program data, the editorial reported that the overall Australian incidence rate rose from 12.8 cases per million people aged 20 or older in 1982 to 18.1 per million in 1986. The rate in men rose by over a quarter from 23.1 per million, and the rate in women rose by nearly two-thirds from 2.8 per million. Citing an earlier program report, it stated that in 1982 to 1985 the rate in Western Australian men, 43.5 per million, far exceeded other states, against a national rate in men of 27.0. The author attributed this to the Wittenoom crocidolite mine. The program graded past occupational exposure in 726 patients as "definite" in 45% and judged exposure likely substantial in only 52%. The author expected incidence to rise for another 10 to 15 years and then decline, and called for continued monitoring and research.

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: Editorial commentary (no original study methods), accompanying the article by Musk et al. and drawing on published and unpublished data of the Australian Mesothelioma Surveillance Program and Register
• Who was studied: Mesothelioma cases in Australia; the incidence figures discussed are based on about 1400 cases collected by the Australian Mesothelioma Surveillance Program and Register since 1980 (unpublished data)
• Exposure: Asbestos exposure in Australia. Wittenoom miners, millers and residents were exposed solely to crocidolite. Australians generally were exposed to mixed dust containing at least some amphibole asbestos, almost entirely amosite and crocidolite.
• Main results:
  • Overall Australian incidence rate rose from 12.8 cases per million population aged 20 or older in 1982 to 18.1 per million in 1986 (unpublished data)
  • In men the incidence rate rose by over a quarter from 23.1 cases per million in 1982; the author linked this to past occupational asbestos exposure
  • In women the rate rose by nearly two-thirds from 2.8 cases per million in 1982; the author linked this to domestic, neighbourhood and other environmental exposure
  • In 1982 to 1985 the rate in men in Western Australia was 43.5 cases per million, far exceeding any other state, against an overall Australian rate in men of 27.0 per million aged 20 or older; the author attributed this to the Wittenoom crocidolite mine (cited from an earlier program report)
  • Among 726 patients with mesothelioma, the program categorized past occupational exposure as definite in 45%, probable in 7% and possible in 11%; environmental (paraoccupational) exposure was found in 6% (cited from an earlier program report)
  • Exposure to asbestos was likely to have been substantial in only 52% of these cases
  • The author stated that labourers and carpenters, whose jobs are not mainly associated with asbestos work, yield most cases
  • The author noted that in Australia, death-certificate diagnoses not confirmed by pathologists missed about 40% of cases
• The authors' conclusion: The author projected that incidence would rise for another 10 to 15 years and then decline. The author concluded that the epidemic will occur but must be handled and contained. The author called for continued monitoring, research on low-level exposure and other topics, and observation of risk occupations such as asbestos removalists.
• Limitations the authors state:
  • The exposure categories estimate how definite exposure was, not the dose
  • Australia's high incidence compared with other countries may partly reflect fuller case finding in Australia
  • Projections of future cases diverge widely because past exposure estimates are inaccurate

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, Incidence, Wittenoom, Crocidolite, Occupational Exposure, Environmental Exposure, Chrysotile.

Related studies

• The European mesothelioma epidemic — J. Peto, A. Decarli, et al. (1999)
• The asbestos cancer epidemic — J. LaDou (2004)
• Epidemic of mesothelioma in Egypt — R.M. Gaafar, N.H. Eldin (2005)
• Genetic predisposition to fiber carcinogenesis causes a mesothelioma epidemic in Turkey — A.U. Dogan, Y.I. Baris, et al. (2006)
• An outbreak of pleural mesothelioma and chronic fibrosing pleurisy in the village of Karain/Urgüp in Anatolia — Y.I. Baris, A.A. Sahin, et al. (1978)
• Environmental mesothelioma associated with tremolite asbestos: lessons from the experiences of Turkey, Greece, Corsica, New Caledonia and Cyprus — S.H. Constantopoulos (2008)

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