Occupational exposure to asbestos: population at risk and projected mortality--1980-2030

Our plain-English summary of Occupational exposure to asbestos: population at risk and projected mortality--1980-2030, by W.J. Nicholson, G. Perkel, I.J. Selikoff (American Journal of Industrial Medicine, 1982).

The study

• Authors: W.J. Nicholson, G. Perkel, I.J. Selikoff
• Journal: American Journal of Industrial Medicine
• Published: 1982;3(3):259-311
• Cited by: 169 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000700).

Abstract

Estimates have been made of the numbers of cancers that are projected to result from past exposures to asbestos in a number of occupations and industries. From 1940 through 1979, 27,500,000 individuals had potential asbestos exposure at work. Of these, 18,800,000 had exposure in excess of that equivalent to two months employment in primary manufacturing or as an insulator (greater than 2-3 f-yr/ml). 21,000,000 of the 27,500,000 and 14,100,000 of the 18,800,000 are estimated to have been alive on January 1, 1980. It is further estimated that approximately 8,200 asbestos-related cancer deaths are now occurring annually. This will rise to about 9,700 annually by the year 2000. Thereafter, the mortality rate from past exposure will decrease, but still remain substantial for another three decades.

In plain English

This analysis, prepared for the US Department of Labor, estimated how many US workers were potentially exposed to asbestos at work from 1940 through 1979. Some people counted this way, the authors noted, had no actual exposure. It then projected resulting cancer deaths to 2030. The authors scaled cancer risk data from insulation workers to each group's estimated exposure relative to insulators. The trades included shipbuilding, construction, insulation work, asbestos manufacturing and automobile maintenance. They estimated that 27,500,000 people had potential exposure. Of these, 18,800,000 had more than about 2-3 fiber-years per milliliter, equal to two months as an insulator or in primary asbestos manufacturing. They estimated that 21,000,000 and 14,100,000 respectively were alive on January 1, 1980. In 1982, when the article appeared, the authors estimated about 8,200 asbestos-related cancer deaths a year, rising to about 9,700 a year by 2000, with shipbuilding and construction the largest contributors. The authors concluded that deaths would then decline but remain substantial for three more decades. They called their estimates of new entrants into exposed jobs approximate and subjective, but said these affected the count exposed more than projected deaths.

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: Estimation and projection study (modeling of exposed populations and projected cancer mortality using employment statistics and risk data from earlier studies)
• Who was studied: Workers in selected occupations and industries in the United States with potential asbestos exposure from 1940 through 1979, estimated at 27,500,000 people; projections run to 2030
• Exposure: Potential occupational asbestos exposure only, in these groups: primary and secondary asbestos manufacturing, insulation work, shipbuilding and repair, construction trades, railroad steam engine repair, utility services, stationary engineers and firemen, chemical plant and refinery maintenance, automobile maintenance, and merchant marine engine rooms. Risk in each group was scaled relative to insulation workers. 'Lower exposure' was defined as less than about 2-3 f-yr/ml, equivalent to two months' work in primary manufacturing or as an insulator. Asbestos mining and milling was excluded.
• Main results:
  • Of the 27,500,000 potentially exposed workers, 18,800,000 had exposure above 2-3 f-yr/ml. An estimated 21,000,000 of the 27,500,000, and 14,100,000 of the 18,800,000, were alive on January 1, 1980.
  • About 8,200 asbestos-related cancer deaths were estimated to be occurring each year at the time of writing. The article was published in 1982, and its table gives 8,206 for 1982.
  • Annual asbestos-related cancer deaths were projected to rise to about 9,700 by the year 2000.
  • The shipbuilding and construction industries were projected to be the largest contributors to asbestos-related cancer deaths.
  • About 8,700,000 of those potentially exposed had lower exposure because of short employment. All individuals with lower exposure together accounted for 1.9% of the projected excess cancer mortality.
  • Of all mesotheliomas estimated to occur among these workers between 1940 and 2000, about one third were estimated to have already occurred.
  • Separately from the cancer projections, the authors roughly estimated that about 200 deaths a year were then occurring from asbestosis. They suggested this number might double over the next two decades.
• The authors' conclusion: The authors concluded that, after about the year 2000, the death rate from past occupational asbestos exposure would decrease but remain substantial for another three decades.
• Limitations the authors state:
  • The authors called their estimates of new entrants into exposed jobs approximate and subjective. They said a misestimate here would mainly change the number of people counted as exposed, with a small influence on total projected mortality.
  • The authors stated that the 27,500,000 figure is an approximation.
  • The figures count potential exposure. Counting whole work forces as potentially exposed includes some people with no actual exposure and leaves out others, such as managers, who were exposed.
  • The authors noted that the estimates leave out deaths from several other kinds of exposure: family contacts, environmental and consumer exposures, and Armed Forces service such as naval engine rooms.
  • The calculations used US white male death rates, although some Black workers and women were employed in these industries.

Topics

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

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Asbestos Exposure, Insulator.

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