Netherlands mesothelioma register

Our plain-English summary of Netherlands mesothelioma register, by H.T. Planteydt (Annals of the New York Academy of Sciences, 1979).

The study

• Author: H.T. Planteydt
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:467-71
• Cited by: 5 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. 003982).

Summary of the article

This article described the Netherlands Mesothelioma Register, started in 1969, to which all Dutch pathologists were asked to report histologically verified pleural and peritoneal mesotheliomas. The register held 419 cases. Of the 294 recorded from 1969 through 1975, most were pleural tumours in older men, with the largest concentration (77 cases) in Rotterdam and smaller ones around Amsterdam, Haarlem and Walcheren Island. National mortality statistics recorded 332 deaths from primary pleural tumours in 1969-72. The overall frequency was 6.2 per million inhabitants, but it exceeded 20 per million in Rotterdam and neighbouring towns and 40 per million in Flushing. These are river-mouth areas with heavy industry, especially shipyards. Detailed work histories of 67 cases and 67 matched controls showed definite or probable asbestos exposure in 72% of cases (84% from Rotterdam, 61% elsewhere) and definite exposure in 18% of controls. Three cases illustrated unexpected exposure routes: home renovation work, a laundry with asbestos-covered ironing equipment, and handling asbestos-covered stage props. Electron microscopy of lung tissue found chrysotile in all 28 mesothelioma patients and amphibole fibres in 25. Among 10 controls from an agrarian region, chrysotile was found in all and amphiboles in seven. The author named the register's goals as discovering unknown exposure sources and determining the presence, quantity and kind of asbestos in patients' lungs.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article described the Netherlands Mesothelioma Register, begun in 1969 to collect histologically verified pleural and peritoneal mesothelioma cases nationwide. Of its 419 cases, 294 were recorded from 1969 through 1975, mostly pleural tumors in older men. Grouped by the towns of the reporting laboratories, Rotterdam had the most (77). Clusters in university towns probably reflected patients at major university hospitals, whose residences were usually not directly available. National statistics recorded 332 deaths from primary pleural tumors in 1969-72, an average of more than 80 per year. Based on these deaths, the frequency per million inhabitants was 6.2 nationally, over 20 in Rotterdam and neighboring towns, and over 40 in Flushing. In a work-history study of 67 cases and 67 matched controls, asbestos exposure was definite or probable in 72% of cases and definite in 18% of controls. Some exposures were unexpected: hobby house renovation, a laundry job and stage work. Electron microscopy found chrysotile in the lungs of all 28 mesothelioma patients studied and amphibole fibers in 25. Chrysotile was also found in all 10 controls. The author stated that register data would not accurately measure frequency.

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 report of a national pathology register, with comparison to national death statistics, a work-history study of cases and matched controls, three illustrative case descriptions, and an electron microscopy study of lung fibers
• Who was studied: Histologically verified cases of pleural and peritoneal mesothelioma reported by pathologists across the Netherlands (about 13 million people) from 1969: 419 cases in total, 294 of them from 1969 through 1975. Subgroups studied were 67 cases (31 from the Rotterdam area, 36 from elsewhere), each with a matched control, and lung tissue from 28 mesothelioma patients plus 10 controls from an agrarian region in Zeeland.
• Exposure: Asbestos exposure in general. The occupational groups expected to be exposed included shipyard workers (welders), construction, waterworks (asbestos cement pipes) and the rubber industry (talc). Nonoccupational routes considered included hobby work, contaminated clothing and the environment. Fibers in lung tissue were distinguished as chrysotile or amphibole.
• Main results:
  • Of the 294 register cases from 1969 through 1975, the great majority were pleural tumors in older men.
  • Cases were grouped by the towns where the reporting pathology laboratories were located. On that basis, the largest concentration was 77 cases in Rotterdam.
  • Concentrations in university towns such as Leiden and Utrecht probably represented patients in major university hospitals. Where those people lived was usually not directly available.
  • National statistics recorded 332 deaths from primary pleural tumors in 1969-72, an average of more than 80 deaths per year. Peritoneal tumors were excluded because the high number in women suggested ovarian and similar tumors had been mixed in.
  • Calculated from these primary pleural tumor deaths, the overall frequency in the Netherlands was 6.2 per million inhabitants, and some areas showed much higher frequencies.
  • On the same basis (pleural tumor deaths, 1969-72), Rotterdam and neighboring towns had more than 20 cases per million inhabitants, and Flushing had more than 40 per million.
  • Among mesothelioma cases, asbestos exposure was definite or probable in 84% of the Rotterdam-area cases, 61% of the other cases, and 72% of all 67 cases.
  • Among the matched controls, asbestos exposure was definite in 19% and 17% respectively, or 18% of the 67 controls.
  • Asbestos exposure was unlikely or absent in 7% of Rotterdam-area cases, 33% of other cases, and 21% of all 67 cases.
  • Asbestos exposure was unlikely or absent in 68% and 81% of the respective control groups, or 75% of the 67 controls.
  • One man who died of pleural mesothelioma at 65 had no workplace exposure in his last 20 years but did house renovation as a hobby, including sawing asbestos cement plates.
  • One woman who died of pleural mesothelioma at 58 had worked for 8 months as a laundry ironer, where equipment had been covered with asbestos cloth.
  • One man who died of pleural mesothelioma at 53 had worked about 5 years as a stagehand handling props covered by asbestos for fire prevention.
  • In the 28 mesothelioma patients, chrysotile was always found in the slides and, in all but one case, in the KOH preparations.
  • Amphibole fibers were also found in 25 of the 28 mesothelioma patients.
  • In the 10 controls, chrysotile was found in all cases. Amphibole fibers appeared in the slides of only one control.
  • In the more concentrated KOH preparations, amphibole fibers were found in six more controls.
• Limitations the authors state:
  • The register data would not provide an accurate assessment of how often mesothelioma occurs.
  • Clusters in university towns probably reflect patients treated at major university hospitals, and where those patients lived was usually not directly known.
  • Obtaining work histories was not an easy method, and in many cases a complete history was difficult to obtain.
  • Electron microscopy for asbestos was performed in only a limited number of cases.
  • The control group had no fiber-free cases, so a special control group was examined to check for contamination.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneal Mesothelioma, Asbestos Exposure, Chrysotile, Amphibole Group.

Related studies

• French mesothelioma register — J. Bignon, P. Sebastien, et al. (1979)
• Malignant Peritoneal Mesothelioma: Patterns of Care and Survival in the Netherlands: A Population-Based Study — N.L. de Boer, J.P. van Kooten, et al. (2019)
• Explaining differences in incidence rates of pleural mesothelioma between Sweden and the Netherlands — A. Burdorf, B. Järvholm, et al. (2005)
• Peritoneal metastases from small bowel cancer: Results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in The Netherlands — T.R. van Oudheusden, V.E. Lemmens, et al. (2015)
• Analysis of latency time and its determinants in asbestos related malignant mesothelioma cases of the Italian register — A. Marinaccio, A. Binazzi, et al. (2007)
• Factors influencing long-term survival in mesothelioma patients--results of the German mesothelioma register — V. Neumann, A. Rütten, et al. (2004)

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