Analysis of Mortality from Asbestos-Related Diseases in Brazil Using Multiple Health Information Systems, 1996-2017

Area of Science:

• Public Health
• Epidemiology
• Occupational Health

Background:

• Brazil extensively used asbestos from the 1960s until its 2017 ban.
• Asbestos-related diseases (ARD-T) include mesothelioma, asbestosis, and pleural plaques.
• Death records from 1996-2017 were accessed to build a national ARD-T database.

Purpose of the Study:

• To establish a national database of asbestos-related disease deaths in Brazil.
• To analyze trends and characteristics of ARD-T mortality.
• To inform public health strategies post-asbestos ban.

Main Methods:

• Utilized national health information systems (HIS) with ICD-10 coded diagnoses.
• Linked HIS data to create a comprehensive database of ARD-T deaths (underlying or contributory cause).
• Focused analysis on adults aged 30 years and older.

Main Results:

• Identified 3,057 ARD-T death records; 76.4% were malignant mesotheliomas (MM).
• Male mortality for MM significantly increased by 131.1% (0.98 to 2.26 per million) from 1996 to 2017.
• Higher male-to-female ratios for MM (1.4:1) and non-malignant ARD-T (asbestosis 3.5:1, pleural plaques 2.4:1) suggest occupational exposure.

Conclusions:

• Despite data linkage, ARD-T deaths remain underrepresented in records.
• Elevated MM mortality in men and higher male predominance in ARD-T indicate prevalent occupational asbestos exposure.
• Enhanced workplace/environmental asbestos exposure monitoring and worker surveillance are essential post-ban.