Mesothelioma in Great Britain in 1968-1983

Our plain-English summary of Mesothelioma in Great Britain in 1968-1983, by R.D. Jones, D.M. Smith, P.G. Thomas (Scandinavian Journal of Work, Environment & Health, 1988).

The study

• Authors: R.D. Jones, D.M. Smith, P.G. Thomas
• Journal: Scandinavian Journal of Work, Environment & Health
• Published: 1988;14(3):145-52
• Cited by: 28 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000914).

Abstract

The British mesothelioma register records deaths in Great Britain when the word "mesothelioma" is on the death certificate. In 1968-1983 the mesothelioma deaths among men increased from 114 to 467, while those among women increased from 38 to 90. In 1983 the crude mesothelioma death rates were 17.5 per million and 3.2 per million for the men and women, respectively. The Northern region had the highest crude rates. At the county level, the highest crude deaths rates in 1976-1983 were recorded for the men in Devon and for the women in Lancashire. Marked differences occurred in the ratio of deaths among men to deaths among women for mesothelioma of the pleura (4.6:1) and for mesothelioma of the peritoneum (2:1). The age-specific death rates for men and women diverged markedly for pleural mesothelioma but not for peritoneal mesothelioma. Trends in the use of asbestos and in age- and sex-specific death rates suggest that the annual number of mesothelioma deaths will continue to increase, possibly until the turn of the century. This increase will be concentrated among the men as the main asbestos exposure of women occurred during the war and the annual deaths due to this exposure may have already peaked.

In plain English

This study analysed Britain's national mesothelioma register, which counts deaths in Great Britain when "mesothelioma" appears on the death certificate. The authors examined deaths recorded from 1968 to 1983, 4,095 among men and 989 among women, by sex, year, age, home area and tumour site. Deaths among men rose from 114 in 1968 to 467 in 1983. Among women they rose from 38 to 90, peaking at 104 in 1980 and then levelling off at around 90 a year. In 1983 the crude death rate was 17.5 per million for men and 3.2 per million for women. The Northern region had the highest rates for men in every period. For 1976 to 1983, Devon had the highest county rate for men (31 per million) and Lancashire the highest for women (11 per million). The male-to-female ratio was 4.6 to 1 for pleural and 2 to 1 for peritoneal mesothelioma. The authors said their projections were speculative. They concluded that deaths among men would keep rising until after 2000, while women's deaths may already have peaked, possibly reflecting the end of wartime asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive analysis of national register data on death certificates mentioning mesothelioma, with trends and a projection to 1996
• Who was studied: Deaths in Great Britain from 1968 to 1983 where mesothelioma was mentioned on the death certificate, recorded in the British mesothelioma register: 4,095 among men and 989 among women
• Exposure: Individual asbestos exposure was not analysed in this paper. Occupational data were to be analysed in a separate paper. Cases were analysed by sex, year, age, area of usual residence at death, and tumour site.
• Main results:
  • Among men, mesothelioma deaths rose from 114 in 1968 to 467 in 1983.
  • Among women, mesothelioma deaths rose from 38 in 1968 to 90 in 1983.
  • Women's deaths peaked in 1980 at 104 and then levelled off at around 90 per year.
  • In 1983 the crude mesothelioma death rate was 17.5 per million for men and 3.2 per million for women.
  • In 1968-1971, 37% of the men and 42% of the women who died of mesothelioma were aged 65 or over. By 1980-1983 these figures were 49% and 53%.
  • The Northern region had the highest death rates for men in all periods, and the highest rate for women in 1980-1983.
  • For 1976-1983, the counties with the highest rates for men were Devon (31 per million) and Cumbria and Tyne and Wear (both 28 per million). The authors noted that these counties contain, contained, or are close to cities with large shipbuilding and repair industries.
  • For 1976-1983, the counties with the highest rates for women were Lancashire (11 per million), Durham (8 per million) and Essex (8 per million).
  • Mesothelioma of the pleura made up 64% of all mesothelioma deaths among men and 58% among women. 28% of cases were not classified by site.
  • The ratio of male to female deaths was 4.6 to 1 for pleural mesothelioma and 2 to 1 for peritoneal mesothelioma.
  • For pleural mesothelioma, the ratio of the men's death rate to the women's rose with age, from 1.6 to 1 at ages 25-34, through 6.1 to 1 at ages 45-54, to 8.2 to 1 at 75 and over. For peritoneal mesothelioma, men's rates were higher in every age group, but this divergence was absent.
  • The authors projected 730 deaths among men (26.8 per million) and 143 among women (5.0 per million) in 1996. This totals 873, compared with 557 deaths in 1983, an increase of 57%.
• The authors' conclusion: The authors concluded that the rise was more likely due mainly to increased occupational asbestos exposure from the 1930s onwards than to greater clinical vigilance alone. They expected deaths among men to keep increasing and not level off until after 2000. They suggested that the levelling off among women may stem from the end of asbestos exposure in wartime industries such as gas mask manufacture.
• Limitations the authors state:
  • For most cases the only document received was the death certificate, so the available information was limited.
  • The figures count death certificates mentioning mesothelioma. In some cases mesothelioma was an associated cause, or possibly an incidental finding at postmortem, rather than the underlying cause of death.
  • Mesothelioma may have been underreported in the register's earlier years, and growing medical awareness may account for part of the increase.
  • Peritoneal mesotheliomas may be less often identified and may be misdiagnosed as tumours of other abdominal sites.
  • The projection for men is speculative, and the projection for women could well be too high.
  • Analysis at county level dilutes the effects of asbestos on the exposed population, so it does not show all known local concentrations of mesothelioma deaths.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Death Certificate, Pleura, Peritoneum, Pleural Mesothelioma, Peritoneal Mesothelioma, Asbestos Exposure.

Related studies

• The expected burden of mesothelioma mortality in Great Britain from 2002 to 2050 — J.T. Hodgson, D.M. McElvenny, et al. (2005)
• Mesothelioma mortality in Great Britain from 1968 to 2001 — D.M. McElvenny, A.J. Darnton, et al. (2005)
• Occupational cancer burden in Great Britain — L. Rushton, S.J. Hutchings, et al. (2012)
• The effect of smoking on the risk of lung cancer mortality for asbestos workers in Great Britain (1971-2005) — G. Frost, A. Darnton, et al. (2011)
• Estimating the number of asbestos-related lung cancer deaths in Great Britain from 1980 to 2000 — A.J. Darnton, D.M. McElvenny, et al. (2006)
• Experience with asbestos disease and its control in Great Britain's naval dockyards — P.G. Harries (1976)

Browse more research in Scandinavian Journal of Work, Environment & Health, or return to medical research.