Mortality due to IPF and mesothelioma in Europe – A link with historic asbestos use?

Abstract

Background: Mortality due to idiopathic pulmonary fibrosis (IPF) in the UK is rising in parallel to that of mesothelioma, with both conditions being significantly associated with historic asbestos imports. Aims: To establish whether there was any association between IPF and mesothelioma mortality in Europe, and to investigate whether IPF mortality varied depending on historic asbestos usage. Methods: Age-standardised mortality rates for IPF were plotted against mesothelioma mortality (2005-10) for 31 countries. A correlation co-efficient was calculated for IPF mortality rates against each countries per capita asbestos consumption (averaged over 1920-70). Results: Figure 1 shows that there was a significant relationship between mortality rates for mesothelioma and IPF for each country (Pearson correlation 0.52, p=0.003). A significant relationship was also seen between per capita asbestos consumption and IPF mortality rates (Pearson correlation 0.37, p= 0.046). Conclusion : Across Europe, IPF mortality is significantly correlated to mesothelioma mortality and historic asbestos consumption. Given the difficulties of differentiating asbestosis and IPF clinically, this may in part be explained by underestimating lifetime asbestos exposure in patients with diffuse pulmonary fibrosis.