The impact of asbestos on mortality in Belgium: malignant mesothelioma (1969-2009)

Abstract

L Van den Borre, P Deboosere Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium Contact: Laura.Van.den.Borre@vub.ac.be Asbestos is one of the most serious environmental and occupational health problems in modern history. After nearly a century of extensive use, the E.U. decided for a total asbestos ban in 2005. Today, asbestos remains a major public health concern. Fatal diseases occur decades after exposure. A recent study from the WHO [1] indicates a significant rise in mesothelioma deaths worldwide. Despite the presence of one of Europe’s biggest asbestos groups, Eternit, Belgian asbestosrelated mortality has been scarcely researched. This paper aims to improve the understanding of the impact of asbestos in an international perspective by providing a descriptive analysis of mesothelioma mortality in Belgium. Within a quantitative demographic research design, we analyzed cause-specific mortality data from the WHO Mortality Database (1969-1997) and from the Scientific Institute of Public Health (1987-2009). The impact of asbestos is represented by the burden of mesothelioma (ICD-8 = 163.0; ICD-9 = 163; ICD-10 = C45). Compared to the WHO study [1], Belgian mesothelioma mortality is among the highest in the world. With an ageadjusted mortality rate (AAMR) of 8.9 per million in 19942008, Belgium immediately follows the top three: the United Kingdom (17.8), Australia (16.5) and Italy (10.3). Belgian mesothelioma deaths have strongly increased over time. AAMRs are nearly 7 times higher from 1.6 deaths in 1969 to 10.5 deaths per million in 2009. After a progressive increase of male deaths in the mid-1980s, large differences between sexes are apparent. Our results suggest an important impact of the asbestos industry. Mesothelioma deaths are mostly concentrated in specific geographic areas related to former asbestos industries. Belgian mesothelioma mortality has long been underestimated. With the long latency periods of asbestos-related diseases and the current existence of asbestos in buildings, asbestos entails an important impact on health today and in the future. Key messages Belgian mesothelioma mortality has experienced a strong increase since the mid-1980s, providing new evidence for the long time underestimation of the asbestos problem in Belgium. Belgium mesothelioma mortality entails very large sex differences compared to other countries. The mesothelioma burden primarily affects men, suggesting an important role for occupational differences.