Abstract

The geographical distribution of mortality from mesothelioma of the pleura during the years 1968-78 in England and Wales has been studied using extracts from the death records held by the Office of Population Censuses and Surveys. Using the national death rate as standard, Local Authority areas with raised mortality are identified. The patterns are somewhat different for each sex. In men the high-mortality areas are mainly the major ports where shipbuilding and repairing have been concentrated, whereas in women areas where gas masks are manufactured are predominant. In both sexes there are also high death rates on the eastern side of London. Nearly all the areas of high mortality are known to have had a major asbestos-using industry in the past. Over the 11-year period the annual number of deaths from pleural mesothelioma rose by approximately 75%. This marked increase was virtually confined to men, in whom the number of deaths had reached almost 200 per annum by 1978. The indications are that the effect of past high exposures, in particular to amphibole asbestos, have not yet reached a peak in terms of mortality. On the other hand imports and usage of amphiboles, particularly crocidolite, have decreased rapidly since the mid-1960s, and dust levels in the working environment have improved even more radically.

Highlights

  • MATERIAL AND METHODThe basic data are computer-tape abstracts from the death records held by the Office of Population Censuses and Surveys (OPCS) for the years 1968-78

  • Summary.-The geographical distribution of mortality from mesothelioma of the pleura during the years 1968-78 in England and Wales has been studied using extracts from the death records held by the Office of Population Censuses and Surveys

  • Evidence has been published from two villages in Turkey showing that pleural mesotheliomas in man may be related to zeolites in the soil (Baris et al, 1981)

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Summary

MATERIAL AND METHOD

The basic data are computer-tape abstracts from the death records held by the Office of Population Censuses and Surveys (OPCS) for the years 1968-78. The cause of death is coded according to the 8th Revision of the International Classification of Diseases (ICD), and deaths from malignant neoplasms of the pleura, including mesothelioma, are assigned to ICD 163.0 (WHO, 1967). Before 1968, and before the 8th Revision of the ICD came into use, mesothelioma deaths were scattered among a variety of code numbers, and it has not been practicable to include them in the analysis. It had been our intention to examine mortality from mesothelioma of the peritoneum in a similar manner, but less than 20% of cancer deaths assigned to ICD 158.9 (malignant neoplasm of the peritoneum) were from mesothelial tumours. The populations by sex and age of the 1366 areas at the time of the 1971 census have been used to calculate standardized mortality ratios (SMRs) based on the age-sex specific death rates from pleural mesothelioma in England and Wales overall. The statistical significance of SMRs has been assessed using the standard test based on the Poisson distribution (Bailar & Ederer, 1964)

RESULTS
Calendar year
Age group
Exposure to asbestos
DISCUSSION
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