Potential years of life lost (PYLL) caused by asbestos-related diseases in the world

Our plain-English summary of Potential years of life lost (PYLL) caused by asbestos-related diseases in the world, by R. Diandini, K. Takahashi, E.K. Park, et al (American Journal of Industrial Medicine, 2013).

The study

• Authors: R. Diandini, K. Takahashi, E.K. Park, Y. Jiang, M. Movahed, G.V. Le, L.J. Lee, V. Delgermaa, R. Kim
• Journal: American Journal of Industrial Medicine
• Published: 2013;56(9):993-1000
• Cited by: 28 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: We applied the well-established, but rather under-utilized, indicator of Potential Years of Life Lost (PYLL) to estimate the global burden of mesothelioma and asbestosis.

Methods: We analyzed all deaths caused by mesothelioma and asbestosis that were reported by 82 and 55 countries, respectively, to the World Health Organization (WHO) from 1994 to 2010.

Results: The 128,015 and 13,885 persons who died of mesothelioma and asbestosis, potentially lost a total of 2.18 million and 180,000 years of life (PYLL), or, an annual average PYLL of 201,000 years and 17,000 years, respectively. The average PYLL per decedent were 17.0 and 13.0 years for mesothelioma and asbestosis, respectively.

Conclusions: The current burden of asbestos-related diseases (ARDs) in terms of PYLL is substantial. The future burden of ARDs can be eliminated by stopping the use of asbestos.

Copyright © 2013 Wiley Periodicals, Inc.

In plain English

This study used World Health Organization (WHO) death records to estimate how many years of life were lost early to two asbestos-related diseases worldwide. The authors took deaths at age 30 and over recorded as malignant mesothelioma (82 countries) or asbestosis (55 countries) from 1994 to 2010. For each death they counted the remaining life expectancy for that country, sex and age group. The 128,015 people who died of mesothelioma lost about 2.18 million potential years of life in total. That was about 201,000 years per year, or 17.0 years per person on average (15.3 for men, 18.4 for women). Peritoneal mesothelioma deaths lost the most years per person (20.0). The 13,885 people who died of asbestosis lost about 180,000 years in total, about 17,000 per year, or 13.0 years per person. The authors noted that many countries, including China, India and Russia, had no data and that deaths are under-reported, so these figures should be seen as a minimum. The authors concluded that the burden is substantial and that the future burden can be eliminated by stopping the use of 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 analysis of national death records in the WHO Mortality Database, using potential years of life lost (PYLL) as the main measure, with a rough estimate of disability-adjusted life years (DALY)
• Who was studied: All deaths aged 30 and over recorded as malignant mesothelioma in 82 countries/entities and as asbestosis in 55 countries/entities and reported to the WHO, 1994 to 2010. Countries with death data but no life-expectancy data were excluded.
• Exposure: No individual asbestos exposure was measured and fiber types were not studied. The study counted deaths coded as malignant mesothelioma (ICD-10 C45) and asbestosis (ICD-10 J61), diseases the authors describe as caused by asbestos.
• Main results:
  • Mesothelioma, all 82 countries: 128,015 deaths (78% men, 22% women). Total PYLL was about 2.18 million years (2,175,698 in the table), an annual average of about 201,000 years (200,785 in the table). Average age at death was 69.2 years.
  • Average years of life lost per mesothelioma death were 17.0 overall: 15.3 years for men and 18.4 years for women.
  • By anatomical site, average years lost per mesothelioma death were 20.0 for the peritoneum, 17.3 for the pleura and 16.5 for 'others'. Average age at death was 65.9 years for peritoneal and 69.3 years for pleural mesothelioma.
  • Average years lost per mesothelioma death were 19.0 in low to middle income countries and 16.8 in high income countries.
  • Asbestosis: 13,885 deaths (93% men, 7% women). Total PYLL was about 180,000 years (180,494 in the table), an annual average of about 17,000 years. Average years lost per death were 13.0 (11.7 for men, 13.7 for women), and average age at death was 73.4 years.
  • For mesothelioma, average years lost per death generally fell over time. For men it went from 17.8 years in 1995 to 14.8 years in 2010, and for women from 20.3 to 18.2 years, while average age at death rose.
  • Estimated annual disability-adjusted life years were about 215,000 for mesothelioma and 54,000 to 73,000 for asbestosis, depending on the assumption used. These were smaller than an earlier estimate by Driscoll et al. (38% for mesothelioma; 14% or 19% for asbestosis).
• The authors' conclusion: The authors concluded that the current burden of mesothelioma and asbestosis in years of life lost is substantial and results from historical use of asbestos, and that the future burden of asbestos-related diseases can be eliminated by stopping the use of asbestos.
• Limitations the authors state:
  • Data covered only 82 (mesothelioma) and 55 (asbestosis) countries, and many countries did not report for the whole period.
  • Countries such as China, India and Russia had no national data and could not be included.
  • Reported deaths likely under-represent true mortality, so the estimates should be considered a minimum (a 'floor value').
  • The DALY estimate was crude. It ignored the age at which disease began and assumed disease was present up to death, and the assumptions may overestimate DALY for asbestosis.
  • Deaths are a poor measure of the total burden of asbestosis, because only a small proportion of patients die from it.
  • Only 41% of mesothelioma deaths were coded as pleural and 54% as 'others', because some countries mainly use the 'unspecified' code.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Diseases attributable to asbestos exposure: years of potential life lost, United States, 1999-2010 — K.M. Bang, J.M. Mazurek, et al. (2014)
• Global mesothelioma deaths reported to the World Health Organization between 1994 and 2008 — V. Delgermaa, K. Takahashi, et al. (2011)
• Asbestos and Asbestos-related Diseases in Vietnam: In reference to the International Labor Organization/World Health Organization National Asbestos Profile — V.H. Pham, T.N. Lan Tran, et al. (2013)
• Determinants of malignant pleural mesothelioma survival and burden of disease in France: a national cohort analysis — C. Chouaid, J.B. Assié, et al. (2018)
• Medical costs of asbestos-related diseases in Spain between 2004 and 2011 — M. García-Gómez, R.U. Garrido, et al. (2017)
• The global health dimensions of asbestos and asbestos-related diseases — C. Ramazzini (2016)

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