Mesothelioma mortality in Brazil, 1980-2003

Our plain-English summary of Mesothelioma mortality in Brazil, 1980-2003, by F. Pedra, A.T. Tambellini, B. Pereira Bde, et al (International Journal of Occupational and Environmental Health, 2008).

The study

• Authors: F. Pedra, A.T. Tambellini, B. Pereira Bde, A.C. da Costa, H.A. de Castro
• Journal: International Journal of Occupational and Environmental Health
• Published: 2008;14(3):170-5
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Although asbestos causes asbestosis, lung cancer, and mesothelioma, it remains widely used in Brazil, mostly in cement-fiber products. We report the Brazilian mesothelioma mortality trend 1980-2003, using records of the national System of Mortality Information of DATASUS, including all deaths with IX International Disease Classification (ICD9) codes 163.n--pleura cancer during the period 1980-1995; and ICD10 codes c45.n--mesotheliomas and c38.4--pleura cancer for the years 1996-2003. Mesothelioma mortality rates increased over the period studied, from 0.56 to 1.01 deaths per 1,000,000 [corrected] habitants. The total number of mesothelioma deaths nationwide in the period studied was 2,414; the majority (1,415) were in the Southeast region. Mortality was highest among males and people over age 65. Given the history of asbestos exposure in Brazil, our findings support the need for policies that limit or ban the use of this product.

In plain English

This study described deaths from mesothelioma recorded in Brazil's national mortality information system from 1980 to 2003. For 1980-1995, the authors counted all deaths coded as cancer of the pleura and assumed these were mesothelioma. For 1996-2003, they counted deaths coded as mesothelioma at any site plus pleural cancer. No individual asbestos exposure was measured. There were 2,414 deaths in total. Average yearly deaths rose from 68.4 in the 1980s to 110 in the following decade and 157 in 2000-2003. The article reports that the mortality rate rose from 0.56 to 1.10, giving the unit as per 100,000 inhabitants, although its methods state rates were expressed per 1,000,000. The Southeast region had 1,415 deaths (58.6% of the total) and the South had 18.1%. Almost 50% of deaths were in people over 65. Male deaths predominated, but rates in women were comparable. The authors said deaths were probably undercounted because of data quality, coding and limited diagnostic centers. They concluded that their report was further evidence of the need for an immediate global ban on asbestos.

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 study of national mortality records (death-certificate data) over time and by region
• Who was studied: All deaths in Brazil's national Mortality Information System (SIM, DATASUS) from 1980 to 2003 that were coded as follows. For 1980-1995: pleural cancer (ICD9 codes 163.0-163.9), all assumed to be mesothelioma. For 1996-2003: mesothelioma of the pleura, peritoneum, pericardium, other or unspecified sites (ICD10 C45.0-C45.9), plus malignant neoplasm of pleura (C38.4). The total was 2,414 deaths.
• Exposure: Individual asbestos exposure was not measured. The study relied on the general background of asbestos use in Brazil, which the article says is mostly in cement-fiber products. No fiber type is named.
• Main results:
  • Across all of Brazil over 1980-2003 there were 2,414 mesothelioma deaths.
  • Nationwide, average deaths per year were 68.4 in the 1980s, 110 in the following decade, and 157 in 2000-2003.
  • The national mortality rate rose from 0.56 to 1.10. The article prints the unit as per 100,000 inhabitants, but its methods say rates were expressed per 1,000,000 per year.
  • The Southeast region had the most deaths, 1,415 in total.
  • The Southeast region accounted for 58.6% of deaths and the South region for 18.1%.
  • Standardized mortality rates were highest in the southern region, reaching 1.52 per 1,000,000 in 1997.
  • Among states, Sao Paulo (691 deaths) and Rio de Janeiro (422 deaths) had the most deaths.
  • Deaths in state capital cities totaled 1022, which was 42.3% of the national total.
  • Deaths were predominantly male, but female death rates were comparable. The authors noted similar standardized mortality rates in men and women.
  • Almost 50% of the deaths were in people over 65 years of age.
  • High mortality rates were also seen in Brasilia and Goiania, which are near Brazil's only official asbestos mine. The authors suggested, without testing it, that these deaths may be related to the mine.
• The authors' conclusion: The authors concluded that their findings reflect labor and environmental exposures in Brazil and show increasing mesothelioma mortality from 1980 to 2003. They regarded their report as further evidence of the need for an immediate, global ban on asbestos use.
• Limitations the authors state:
  • The quality of the national mortality data, and changes in recordkeeping over the 25 years since the system began, limit the study.
  • Variation and ambiguity in disease coding may limit the study. This includes the assumption that all pleural cancer deaths were mesothelioma.
  • A lack of diagnostic centers equipped with immunohistochemical methods has likely led to under-diagnosis.
  • The authors state they probably underestimate total mesothelioma deaths in Brazil.

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, Lung Cancer, Pleura, Asbestos Exposure.

Related studies

• Mesothelioma mortality in Great Britain from 1968 to 2001 — D.M. McElvenny, A.J. Darnton, et al. (2005)
• Pleural cancer mortality in Spain: time-trends and updating of predictions up to 2020 — G. López-Abente, M. García-Gómez, et al. (2013)
• Geographic study of mortality due to mesothelioma in Peru and its evolution — J.S. Torres-Roman, V. Gomez-Rubio, et al. (2020)
• Mortality in a cohort of asbestos-exposed workers undergoing health surveillance — F. Barbiero, T. Zanin, et al. (2018)
• Cancer survival and prevalence in Australia: period estimates from 1982 to 2010 — Australian Institute of Health and Welfare (2013)
• Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa — J.L. Botha, L.M. Irwig, et al. (1986)

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