Significant risk of developing asbestos-related diseases in Japan's industries: An analysis of workers' compensation

Our plain-English summary of Significant risk of developing asbestos-related diseases in Japan's industries: An analysis of workers' compensation, by L.H. Indriyati, M. Eitoku, N. Awn J-P, et al (AIMS Public Health, 2025).

The study

• Authors: L.H. Indriyati, M. Eitoku, N. Awn J-P, T. Tamura, N. Suganuma
• Journal: AIMS Public Health
• Published: 2025;12(4):1055-1068
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Asbestos has been used in various industries, and prolonged exposure can increase the risk of asbestos-related disease (ARD). Although the use of asbestos has been prohibited in Japan since 2012, it was imported well into the 2000s. This study aimed to identify industries in Japan whose workers are at heightened risk of developing ARD.

Methods: This study was based on a comprehensive analysis of fiscal year data from the Survey of Claims and Decisions on Benefits for Asbestos-Related Health Damage and calendar year data from the Status of Pneumoconiosis Health Management Implementation in Japan. Occupations associated with asbestos exposure risk were identified using the Japan Standard Industrial Classification (Rev. 14, 2023). The incidence rate ratio (IRR) was estimated using Poisson regression analysis.

Results: This study includes 8,971,500 person-years from 2006 to 2022. Construction workers showed the strongest positive associations with all ARDs. Within the manufacturing sector, shipyard workers were particularly vulnerable to ARDs, although a notable exception to this was the positive correlation with asbestosis among workers in the ceramic industry (IRR 1.56; 95% CI 1.12-2.17). Mesothelioma is the most prevalent ARD over the past 17 years.

Conclusions: This study suggests that, despite asbestos being banned in Japan for the past 13 years, cases of ARDs continue to occur in various industries, with construction and shipyard workers being at highest risk. Consequently, individuals with prior asbestos exposure require continuous monitoring to avoid potential adverse health consequences.

© 2025 the Author(s), licensee AIMS Press.

In plain English

This study used Japanese government records to compare how often workers in different industries received workers' compensation for asbestos-related diseases from 2006 to 2022. The diseases were lung cancer, mesothelioma, asbestosis, benign asbestos pleural effusion and diffuse pleural thickening. The number of asbestos-exposed workers is unknown, so the authors used dust-exposed workers in pneumoconiosis check-up records as the population at risk, totalling 8,971,500 person-years. Each industry was compared with an "other industry" group. Construction workers had the highest incidence rate ratios for every disease, for example 8.05 (95% CI 7.34 to 8.84) for lung cancer and 6.23 (5.79 to 6.70) for mesothelioma. Manufacturing as a whole had lower rates than the comparison group. Within manufacturing, shipbuilding and repairing workers had a ratio of 1.57 (1.41 to 1.76) for lung cancer. Ceramic industry workers had a ratio of 1.56 (1.12 to 2.17) for asbestosis. Mesothelioma made up most cases. The authors noted they lacked data on age, sex, smoking, exposure levels and when exposure began. The authors concluded that these diseases continue to occur, with construction and shipyard workers most at risk.

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: Analysis of national government compensation and health check-up statistics, with incidence rate ratios estimated by Poisson regression
• Who was studied: Dust-exposed workers recorded in Japan's Status of Pneumoconiosis Health Management Implementation, used as the population at risk because the number of asbestos-exposed workers is unknown. The authors presumed this group includes asbestos-exposed workers. The data covered 8,971,500 person-years from 2006 to 2022. Cases were newly compensated workers' compensation cases.
• Exposure: Occupational asbestos exposure, assessed only as the industry of employment. Industries at risk were identified from compensation documents and grouped as construction, mining, manufacturing (with sub-sectors such as chemical, ceramic, steel, shipbuilding and repairing) and other industry. No fiber types or doses were analyzed.
• Main results:
  • Construction workers, compared with other industry: asbestosis IRR 8.36 (95% CI 6.32–11.07); lung cancer IRR 8.05 (95% CI 7.34–8.84)
  • Construction workers: mesothelioma IRR 6.23 (5.79–6.70), based on 5133 events over 474,508 person-years
  • Construction workers: benign asbestos pleural effusion IRR 5.28 (3.79–7.36); diffuse pleural thickening IRR 7.58 (5.73–10.03)
  • Manufacturing overall had IRRs below 1 compared with other industry, for example lung cancer 0.33 (0.30–0.36) and mesothelioma 0.27 (0.25–0.29)
  • Shipbuilding and repairing workers: lung cancer IRR 1.57 (1.41–1.76); mesothelioma 1.10 (1.00–1.21); benign asbestos pleural effusion 1.72 (1.17–2.52); diffuse pleural thickening 1.46 (1.03–2.06); asbestosis 1.14 (0.78–1.65), an interval that includes 1
  • Ceramic industry workers: asbestosis IRR 1.56 (95% CI 1.12–2.17), based on 99 events
  • Mining workers had very low IRRs, for example lung cancer 0.05 (0.02–0.10) and mesothelioma 0.06 (0.04–0.11)
  • Mesothelioma accounted for the majority of all compensated cases. Construction workers had the highest annual mesothelioma incidence rate in every year, peaking in 2006 (IR 250) and then ranging from 80 to 250.
• The authors' conclusion: The authors concluded that asbestos-related diseases continue to occur in workers from various industries despite the ban, with construction and shipyard workers most at risk. They also concluded that previously exposed workers should be continuously monitored.
• Limitations the authors state:
  • No data on each worker's age, sex, smoking or alcohol use
  • No workplace exposure measurements
  • The time of first exposure is unknown, so latency could not be examined, nor whether cases were exposed before or after asbestos restrictions
  • Long-latency diseases such as mesothelioma would be counted in the population at risk only if former workers kept attending check-ups
  • The data do not show whether workers changed occupations
  • Cases may be underreported if employees declined medical examinations; the authors judged this impact negligible

Topics

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Asbestos Exposure, Incidence, Mesothelioma.

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