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Published on: December 21, 2019
Malignant mesothelioma incidence by nation-wide cancer registry: a population-based study
Kristinn Tomasson1, Gunnar Gudmundsson2, Haraldur Briem3
1Department of Occupational Medicine, Administration of Occupational Safety and Health, Reykjavik, Iceland.
Background:
Malignant mesothelioma caused by asbestos exposure has a long latency period. A ban on asbestos use may not be apparent in decreased incidence in the population until after several decades. The aim was to evaluate changes in the incidence of malignant mesothelioma, and the possible impact of the asbestos ban implemented in Iceland in 1983.
Methods:
This is a population study on aggregate level; the source of data was the Icelandic Cancer Registry, the National Cause-of-Death Registry, and the National Register. Volume of asbestos import was obtained from Customs Tariff. The import figures reflect fairly accurately the amount used, as there are no mines in the country.
Results:
Asbestos import peaked in 1980 at 15.0 kg/capita/year, diminishing to 0.3 kg/capita/year ten years after the ban in 1983, and to zero in the most recent years. Seventy-nine per cent of the cases of malignant mesothelioma were men, and 72 % were of pleural origin. Mesothelioma incidence increased steadily from 1965 to 2014, when it reached 21.4 per million among men, and 5.6 among women. Mortality in 2014 was 22.2 per million among men, and 4.8 among women.
Conclusion:
Malignant mesothelioma incidence and mortality increased in the population during the period, despite the ban on asbestos use from 1983. This is in agreement with the long latency time for malignant mesothelioma. In line with the previously high per capita volume of asbestos import, many buildings, equipment, and structures contain asbestos, so there is an on-going risk of asbestos exposure during maintenance, renovations and replacements. It is thus difficult to predict when the incidence of malignant mesothelioma will decrease in the future. During the last ten-year period, the incidence in Iceland was higher than the recently reported incidence in neighbouring countries.
Insights
Despite Iceland's 1983 asbestos ban, malignant mesothelioma incidence and mortality continued to rise due to the material's long latency period. Ongoing exposure risks from existing asbestos mean future decreases are uncertain.
Area of Science:
- Environmental Health
- Epidemiology
- Occupational Health
Background:
- Malignant mesothelioma is strongly linked to asbestos exposure, exhibiting a significant latency period.
- Asbestos bans' effects on incidence may not be evident for decades.
- Iceland implemented an asbestos ban in 1983, necessitating an evaluation of its impact on mesothelioma rates.
Purpose of the Study:
- To assess trends in malignant mesothelioma incidence in Iceland.
- To evaluate the impact of the 1983 asbestos ban on mesothelioma rates.
- To analyze mesothelioma mortality patterns in relation to asbestos exposure.
Main Methods:
- Population-based study utilizing data from the Icelandic Cancer Registry, National Cause-of-Death Registry, and National Register.
- Asbestos import volumes were tracked via Customs Tariff data, serving as a proxy for usage.
- Analysis covered the period from 1965 to 2014, correlating asbestos import with mesothelioma incidence and mortality.
Main Results:
- Asbestos imports peaked in 1980 and significantly decreased post-1983, reaching zero in recent years.
- Malignant mesothelioma incidence and mortality steadily increased from 1965 to 2014, particularly among men.
- In 2014, incidence reached 21.4/million (men) and 5.6/million (women); mortality was 22.2/million (men) and 4.8/million (women).
Conclusions:
- Malignant mesothelioma incidence and mortality rose despite the asbestos ban, consistent with its long latency.
- Residual asbestos in infrastructure poses ongoing exposure risks during maintenance and renovation.
- Predicting a future decline in mesothelioma incidence remains challenging; recent Icelandic rates exceed those in neighboring countries.
