Variations in mesothelioma mortality rates among migrants to Australia and Australian-born

Our plain-English summary of Variations in mesothelioma mortality rates among migrants to Australia and Australian-born, by S. Si, S. Peters, A. Reid (Ethnicity & Health, 2018).

The study

• Authors: S. Si, S. Peters, A. Reid
• Journal: Ethnicity & Health
• Published: 2018;23(5):480-487
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Australia's use and consumption of asbestos occurred at the same time as its immigration boom. Our objective was to investigate mesothelioma death rates among migrants and Australian-born between 1981 and 2012.

Methods: Australian national mesothelioma deaths from 1981 to 2002 and 2006 to 2012 together with national censuses from 1981 to 2011 were extracted and combined. Directly standardised rates and negative binomial regression were applied examining differences in mesothelioma death rates with regard to country of birth.

Results: Migrants from the UK and Ireland, Italy and Germany had significantly higher mesothelioma death rates than Australian-born; lower rates were observed among migrants from other countries.

Conclusions: Our findings suggest there may have been differences in occupational health and safety between foreign and Australian-born. Because of changes in the demographics of migrants to Australia since the 1970s and changes in occupational circumstances over time, further comparisons of occupational-related health outcomes between foreign and Australian-born could identify potential occupational inequalities that may still exist today.

In plain English

Using Australian national death records and census data, the authors compared mesothelioma death rates between people born overseas and people born in Australia. They analysed 9339 mesothelioma deaths registered in 1981–2002 and 2006–2012. Death data for 2003 to 2005 could not be obtained. After adjusting for sex, age at death, calendar year and years since arrival, death rates were higher than among the Australian-born for migrants from the UK and Ireland (rate ratio 1.60, 95% CI 1.46 to 1.76), Germany (1.43, 1.19 to 1.71) and Italy (1.20, 1.05 to 1.37). Rates were lower for migrants from most other regions, including Greece, New Zealand, Asia, the Americas, and Africa and the Middle East. Overall rates rose across the three decades and were four times higher in men than in women. The study had no information on individuals' asbestos exposure. The authors noted that some migrants' higher rates may reflect exposure before they arrived in Australia. The authors concluded that there may have been differences in occupational health and safety between foreign-born and Australian-born workers.

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: population-based mortality study combining national death records with national census data; directly standardised rates and negative binomial regression
• Who was studied: 9339 malignant mesothelioma deaths registered in Australia in 1981–2002 and 2006–2012, grouped by country or region of birth. The population at risk came from the national censuses of 1981 to 2011.
• Exposure: Country or region of birth compared with being Australian-born. The study had no information on individual asbestos exposure and named no fiber types.
• Main results:
  • Age-standardised mesothelioma death rates per million were higher among migrants born in the UK and Ireland (17.98), Germany (15.91) and Italy (14.88) than among the Australian-born (10.79).
  • Adjusted mortality rate ratio for migrants born in the UK and Ireland compared with the Australian-born: 1.60 (95% CI 1.46, 1.76).
  • Adjusted mortality rate ratio for migrants born in Germany compared with the Australian-born: 1.43 (95% CI 1.19, 1.71).
  • Adjusted mortality rate ratio for migrants born in Italy compared with the Australian-born: 1.20 (95% CI 1.05, 1.37).
  • Lower adjusted rate ratios were seen among migrants from most other regions, including New Zealand, Asia, the Americas, Africa and the Middle East, and Greece. Examples: China 0.20 (0.12, 0.34) and Vietnam 0.25 (0.13, 0.46).
  • Greek-born migrants had significantly lower mesothelioma death rates than the Australian-born (adjusted rate ratio 0.57, 95% CI 0.45, 0.73).
  • For some groups the confidence interval included 1: Other Southern and Eastern Europe 0.89 (0.77, 1.02), South Africa 0.84 (0.57, 1.25), All Other Countries 0.99 (0.87, 1.12).
  • Rates were four times higher in males than in females (19.57 versus 4.17 per million). They were also higher among those aged 65 and older and among those in Australia for more than 10 years.
  • Standardised mesothelioma death rates increased over the three decades studied. Rates for UK-, Italian- and German-born migrants were higher than for the Australian-born in each decade.
• The authors' conclusion: The authors concluded that there may have been differences in occupational health and safety between foreign-born and Australian-born workers. They also called for further comparisons of work-related health outcomes to identify occupational inequalities that may still exist.
• Limitations the authors state:
  • Mortality data for 2003 to 2005 were missing.
  • Mesothelioma is often misclassified as lung cancer on death certificates, especially in earlier years. This may underestimate rates, although the authors considered any misclassification likely to be non-differential.
  • There was no information on asbestos exposure among the deceased. Higher rates among migrants from the UK, Italy and Germany may have resulted from exposure before migrating to Australia.
  • Dutch migrants could not be examined separately because census denominator data were not available for the Netherlands. They were included in All Other Countries.

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.

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