Patterns of asbestosis in New Jersey

Our plain-English summary of Patterns of asbestosis in New Jersey, by P.K. Henneberger, M.J. Stanbury (American Journal of Industrial Medicine, 1992).

The study

• Authors: P.K. Henneberger, M.J. Stanbury
• Journal: American Journal of Industrial Medicine
• Published: 1992;21(5):689-97
• Cited by: 5 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. 004864).

Abstract

Hospital discharge data from New Jersey were used to identify cases of asbestosis for the 8 years 1979-1986. Multiple admissions were deleted so that each individual was counted once at the time of his/her first hospitalization with an asbestosis diagnosis. White males had the highest age-adjusted average annual discharge rate of 19.3 cases/100,000 population, followed by black males (12.3 cases/100,000) and white females (1.2 cases/100,000). The discharge rate was positively associated with age in each race/sex category. The relationship between rates for black males and white males depended on age: under 65 years, the rates were almost equal, and at 65 years and older, the white rates were nearly twice the black rates. There were two areas of the state where the rates were highest: the north-central and southwest regions. These two areas represent manufacturing and shipbuilding applications of asbestos, respectively. During the years 1979-1986, the annual percentage increase in asbestosis rates was 20% for white males, 17% for black males, and 8% for white females. Continued surveillance will reveal when the rates for asbestosis stop increasing.

In plain English

This study used New Jersey hospital discharge records from 1979 to 1986 to track asbestosis in residents aged 25 and older. Each person was counted once, at the first hospitalization with an asbestosis diagnosis, giving 3,136 individuals. Age-adjusted average annual discharge rates were 19.3 cases per 100,000 for white males, 12.3 for black males and 1.2 for white females. Under age 65, black and white males had nearly the same rates. At 65 and older, white male rates were nearly twice those of black males. A model assuming steady yearly change estimated average annual increases of 20% for white males, 17% for black males and 8% for white females. Among white males, age-adjusted average annual county rates ranged from 3.6 per 100,000 (Sussex) to 105.8 (Somerset). Somerset was near asbestos manufacturing plants; three other high-rate counties were near Philadelphia/Camden shipyards. The authors noted that hospital data miss outpatient, Veterans Administration and out-of-state cases, so rates are very likely underestimates. They also noted that greater awareness may have increased diagnosis. The authors concluded that rates were still rising through 1986.

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 surveillance study of hospital discharge records, with trends over time analyzed by log-linear regression
• Who was studied: 3,136 individuals aged at least 25 and living in New Jersey who were discharged from New Jersey acute-care hospitals (Veterans Administration hospitals exempt) with a primary or secondary diagnosis of asbestosis, 1979 to 1986. Of these, 2,698 were white males, 147 black males and 227 white females.
• Exposure: Asbestos exposure was not measured for individuals, and the records contained no occupational information. The authors linked the high-rate areas to asbestos manufacturing and shipbuilding. No fiber types were named.
• Main results:
  • There were 3,708 discharges with an asbestosis diagnosis in 1979 to 1986. Only 260 (7.0%) had asbestosis as the primary diagnosis.
  • White males had the highest age-adjusted average annual discharge rate, at 19.3 cases per 100,000 population.
  • The age-adjusted average annual rate was 12.3 cases per 100,000 for black males and 1.2 cases per 100,000 for white females.
  • Under age 65, males had nearly the same rates regardless of race. Among males 65 and older, white males had rates nearly twice those of black males.
  • Using two age categories, the estimated annual percentage change in rates was 8% for white females, 17% for black males and 20% for white males. These came from a log-linear model that assumed a constant annual percentage change. They are fitted trends, not the observed change in every year.
  • Among white males, using four age categories, the annual age-adjusted rate rose from 8.5 cases per 100,000 in 1979 to 32.4 in 1986, an estimated annual percentage change of 21%.
  • Among white males, estimated annual increases in rates were 14% in each of the 25-54 and 55-64 age groups, 20% for ages 65-74 and 31% for ages 75 and older.
  • By 1986, rates among white males were 103.1 cases per 100,000 for ages 65-74 and 156.3 cases per 100,000 for ages 75 and older.
  • Among white males, age-adjusted average annual discharge rates by county ranged from 3.6 cases per 100,000 (Sussex County) to 105.8 cases per 100,000 (Somerset County).
  • The four highest-rate counties (Somerset, Camden, Gloucester and Salem) accounted for 1,423 of the 2,698 white male cases. Somerset was in the north-central area, near asbestos manufacturing. The other three were in the southwest, near the Philadelphia/Camden shipyards.
• The authors' conclusion: The authors concluded that the patterns were consistent with past asbestos use in New Jersey. They found that hospitalized cases showed an upward trend in asbestosis rates through 1986, and they stated that continued surveillance would show when rates stop increasing.
• Limitations the authors state:
  • Hospitalized cases are a sample, not a complete count. Cases diagnosed in outpatient clinics, Veterans Administration hospitals or out-of-state facilities were excluded, so the authors judged the rates very likely to be underestimates.
  • The records lacked case details such as date of first asbestos exposure, date of first diagnosis and severity at hospitalization.
  • Heightened awareness by patients and physicians, publicity and the possibility of compensation may have increased the likelihood of diagnosis.
  • Changes in reporting during the study may have influenced reporting of asbestosis. These included more total hospital discharges and an increase in the maximum number of diagnoses allowed per form, from 7 to 9.

Topics

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

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