Abstract
BackgroundA total of 2,514,346 metric tons (Mt) of asbestos were imported into Spain from 1906 until the ban on asbestos in 2002. Our objective was to study pleural cancer mortality trends as an indicator of mesothelioma mortality and update mortality predictions for the periods 2011–2015 and 2016–2020 in Spain.MethodsLog-linear Poisson models were fitted to study the effect of age, period of death and birth cohort (APC) on mortality trends. Change points in cohort- and period-effect curvatures were assessed using segmented regression. Fractional power-link APC models were used to predict mortality until 2020. In addition, an alternative model based on national asbestos consumption figures was also used to perform long-term predictions.ResultsPleural cancer deaths increased across the study period, rising from 491 in 1976–1980 to 1,249 in 2006–2010. Predictions for the five-year period 2016–2020 indicated a total of 1,319 pleural cancer deaths (264 deaths/year). Forecasts up to 2020 indicated that this increase would continue, though the age-adjusted rates showed a levelling-off in male mortality from 2001 to 2005, corresponding to the lower risk in post-1960 generations. Among women, rates were lower and the mortality trend was also different, indicating that occupational exposure was possibly the single factor having most influence on pleural cancer mortality.ConclusionThe cancer mortality-related consequences of human exposure to asbestos are set to persist and remain in evidence until the last surviving members of the exposed cohorts have disappeared. It can thus be assumed that occupationally-related deaths due to pleural mesothelioma will continue to occur in Spain until at least 2040.
Highlights
A total of 2,514,346 metric tons (Mt) of asbestos were imported into Spain from 1906 until the ban on asbestos in 2002
The lower rates and different mortality trend registered by women would appear to indicate that occupational exposure is possibly the single factor having most influence on this trend
It can be assumed that occupationally-related deaths due to pleural mesothelioma will continue to occur in Spain until at least 2040, bearing in mind the fact that in 2006 the life expectancy of Spanish men born in the 1960s was 37.4 years
Summary
A total of 2,514,346 metric tons (Mt) of asbestos were imported into Spain from 1906 until the ban on asbestos in 2002. Our objective was to study pleural cancer mortality trends as an indicator of mesothelioma mortality and update mortality predictions for the periods 2011–2015 and 2016–2020 in Spain. Imports increased steadily from 1906 until 1974 and peaked in the five-year period 1973–1977, with an average of 113,921 tons per year and a maximum of 130,293 tons in 1974 [7]. This figure was slightly lower than that recorded in 1975 for neighbouring countries, such as Italy (132,184 Mt), France (136,587 Mt) and the United Kingdom (137,487 Mt) [8]. In Spain, as in Italy and France, imports decreased gradually from 1980 onwards, while in other countries such as the USA, Australia, United Kingdom and Scandinavia, the decline began some 10 to 20 years earlier [9]
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