Incidence of Cancer and Asbestos-Related Diseases among Residents Living near Abandoned Asbestos Mines in South Korea: A Retrospective Cohort Study Using National Health Insurance Database.

Kyeongmin Kwak,Domyung Paek,Kyung Ehi Zoh

doi:10.3390/ijerph18030875

Abstract

The use of asbestos has been banned since 2009 in South Korea. However, there is still a risk of exposure to environmental asbestos originating from abandoned asbestos mines. We constructed a retrospective dynamic cohort using the National Health Insurance Database of South Korea. We determined the risk of developing asbestos-related diseases (ARDs) among residents living near asbestos mines compared with those living in the control area and the general population. The risks of asbestosis (adjusted hazards ratio [HR] 65.40, 95% CI = 35.02–122.12) and pleural plaques (adjusted HR 3.55, 95% CI = 1.96–6.41) were significantly increased among residents living near the asbestos mines compared with the control area. The risk of malignant mesothelioma was increased near asbestos mines compared with the control area; however, it was not significant (adjusted HR 1.83, 95% CI = 0.61–5.47). When a separate analysis according to sex was conducted, the risk of mesothelioma among male residents was statistically significant (adjusted HR 8.30, 95% CI = 1.04–66.63), and the standardized incidence ratio (SIR) was significantly increased (SIR 3.48, 95% CI = 1.50–6.85). The risk of ARDs was increased due to environmental asbestos exposure near abandoned asbestos mines in South Korea.

Highlights

Exposure to asbestos causes various diseases such as malignant mesothelioma, lung cancer, asbestosis, pleural effusion, diffuse pleural thickening, laryngeal cancer, and ovarian cancer [1,2,3]
In 2007, Kang analyzed the data on patients with malignant mesothelioma for 10 years in Busan and found that the proportional hazards ratio (HR) of malignant mesothelioma was 6.5 for residents who had ever lived within 500 m of asbestos textile factories compared with those who had never lived near them [4]
Malignant mesothelioma showed a nearly two-fold increased risk in the vicinity of asbestos mines compared with the control area; this result was not statistically significant

Summary

Introduction

Exposure to asbestos causes various diseases such as malignant mesothelioma, lung cancer, asbestosis, pleural effusion, diffuse pleural thickening, laryngeal cancer, and ovarian cancer [1,2,3]. Heavy industrial exposure to asbestos is known to cause lung cancer, mesothelioma, and asbestosis, there is little evidence of how environmental exposure to asbestos causes these asbestos-related diseases (ARDs). In South Korea, concerns about environmental exposure to asbestos and ARDs among residents living near asbestos textile factories and asbestos mines are increasing. In 2007, Kang analyzed the data on patients with malignant mesothelioma for 10 years in Busan (excluding occupational exposure) and found that the proportional hazards ratio (HR) of malignant mesothelioma was 6.5 (95% CI = 3.0–14.2) for residents who had ever lived within 500 m of asbestos textile factories compared with those who had never lived near them [4]. A total of 128 residents had no experience of working in mining, and asbestosis and pleural plaques were confirmed by chest computerized tomography in 23

Methods

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Discussion

Conclusion