1 SPONTANEOUS MESOTHELIOMA DATA: AN INTERPRETATION Robin Howie, Robin Howie Associates, Edinburgh.
2 SPONTANEOUS MESOTHELIOMA
3 MESOTHELIOMA DEATHS HSE (2003a) estimated there are about 26 spontaneous deaths per year in both males and females. Tan & Warren (2009) estimated there are around 23 male spontaneous deaths per year.
4 MESOTHELIOMA DEATHS The above estimates are based only on identifying residuals in analysis of the temporal pattern of mesothelioma deaths, i.e. the intercept on the Y axis. They are not based on medical evidence.
5 MESOTHELIOMA Parkes (1994) suggested that spontaneous mesothelioma may have a flat pattern v age, a more equal sex ratio, a younger average age and a longer survival period from first symptom to death.
7 MESOTHELIOMA DEATHS Male and female cumulative mesotheliomas up to the age band are similar at about 8 deaths. At higher ages both male and female deaths rise rapidly and the number of male and female deaths diverge.
8 MESOTHELIOMA DEATHS As the mean latent period for mesothelioma is about 40 years, mesotheliomas below age 30 are probably too early to have been caused by exposure to asbestos.
9 MESOTHELIOMA DEATHS 8 spontaneous mesothelioma deaths to age about 29 suggests, assuming a level occurrence with age, about 22 such deaths to age 80.
10 MESOTHELIOMA DEATHS From 1945 onwards the Registrar General for Scotland reported data for mortality and incidence of cancer of the pleura Until the1960s mortality was 1-2 deaths per gender per year and incidence was about twice mortality.
11 MESOTHELIOMA DEATHS Assuming Scotland accounted for about 10% of the GB population, GB mortality would have been per year. Higher incidence than mortality suggests that survival exceeded at least 1 year, as against a median of about 8 months for occupational mesotheliomas.
12 MESOTHELIOMA DEATHS The above suggests that spontaneous mesotheliomas do occur, and at a rate of about 25 deaths per year for each gender.
13 MESOTHELIOMA It is assumed herein that there are two main causes of malignant mesothelioma: those which are spontaneous and those caused by exposure to asbestos or other fibrous materials.
14 MESOTHELIOMA DEATHS What is the relevance of estimating spontaneous mesothelioma deaths?
15 MESOTHELIOMA DEATHS Spontaneous mesothelioma data are critical in interpreting occupational Proportional Mortality Ratios (PMR) for mesothelioma.
16 MESOTHELIOMA DEATHS Such data are also relevant in assessing the potential consequences of environmental exposures to asbestos.
17 PROPORTIONAL MORTALITY RATIOS
18 PMR PMR = 100 X observed deaths expected deaths
19 PMR The number of expected deaths in each occupation is currently determined by smearing the total number of occupational deaths up to age 74 from the disease of interest proportionally across all occupations.
20 PMR This means that the number of expected deaths in every occupation includes a proportion of the deaths in occupations with heavy exposures.
21 PMR In the HSE mesothelioma mortality reports 20 occupations generally account for about half both male and female occupational mesothelioma deaths.
22 PMR It also means that the number of expected deaths in occupations with heavy exposures is mainly defined by the deaths in the same occupations.
23 PMR i.e. in the calculation of PMR for such occupations the denominator contains a major input from the numerator!!
24 PMR Current PMR for all occupations are therefore underestimated.
25 PMR Rationally, the interest should be in comparing the number of deaths in each occupation with the number of deaths that would have been expected if there had been no exposure to the agent of concern.
26 PMR If we were studying whether giving birth affected life expectancy, we would compare the data for women who had given birth with data for those women who had not.
27 PMR For mesothelioma, the number of such deaths in each occupation should be compared with the number of spontaneous deaths expected in each occupation.
28 PMR All occupations should therefore have a PMR of 100 based on spontaneous deaths. Any occupation with a PMR significantly above 100 will therefore have had some level of exposure to asbestos.
29 ESOTHELIOMA DEATHS, Gender , ex 1981 Total, all ages in SC to age 74 at ages >74 Male 17,493 12,821 13,136 4,356 Female 2,791 1,004 1,
30 MESOTHELIOMA DEATHS, Gender , ex 1981 % of total in SC % to age 74 in SC % of total at ages >74 Male Female
31 EXPECTED SPONTANEOUS DEATHS , ex 1981 Gender Total expected % in SC Expected in all SC Male Female
32 Gender EXPECTED DEATHS , ex 1981 Expected, as presently calculated Expected based on spontaneous deaths only Male 12, Female 1,
33 MESOTHELIOMA DEATHS, MALES, , ex : Metal SC Observed Expected (PMR) plate workers 144: Plumbers, gas fitters (503) (413) 47: Farmers (25.8) 88: Other coal miners (24.1) corr. expected corr. PMR , ,
35 Comment 1 PMR as currently determined underestimate mesothelioma risk: very substantially so for occupations with heavy exposures to asbestos.
36 Comment 2 PMR as currently determined has no value as an absolute indicator of occupational disease and is relevant only for assessing the relative risk in different occupations: and then only for comparing occupations with similar training regimen and life expectancy patterns.
37 Comment 3 PMR as determined against spontaneous mesothelioma deaths provides an absolute indication of risk in each occupation.
38 IS THERE EVIDENCE OF ENVIRONMENTAL EXPOSURES CAUSING MESOTHELIOMA?
39 ENVIRONMENTAL MESOTHELIOMAS? If there is evidence of PMR based on spontaneous mesothelioma numbers being consistently higher than about, say 200, in occupations unlikely to have had significant exposure to asbestos, such excess could be due to environmental exposures to asbestos.
40 ENVIRONMENTAL MESOTHELIOMAS? If the expected in the , ex 1981 data set for females are corrected as above, the average corrected PMR for the 40, 30 and lowest ranked non-zero SC are 381, 331 and 256 respectively.
41 ENVIRONMENTAL MESOTHELIOMAS? These figures suggest that the mesothelioma rate due to environmental exposures to asbestos may be 3-4 times higher the spontaneous rate,
42 ENVIRONMENTAL MESOTHELIOMAS? i.e deaths per year in each gender.
EFFECT OF CHILDREN'S AGE AND LIFE EXPECTATION ON MESOTHELIOMA RISK 1 Robin Howie 2, Robin Howie Associates, Edinburgh It is generally accepted that the major risk from "low" level exposures to asbestos
Increasing mesothelioma amongst school staff and former pupils The 2003 to 2012 mesothelioma statistics for the Education Sector show an ever increasing rise in the number of school teachers dying from
Health and Safety Executive Mesothelioma mortality in Great Britain The revised risk and two-stage clonal expansion models Prepared by the Health and Safety Laboratory for the Health and Safety Executive
The Relationship Between Accident Report Lag and Claim Cost in Workers Compensation Insurance By Thomas Sheppard Actuarial Consultant NCCI In 2000, a study by The Hartford, using its own data, found that
December 7, 2006 Where Are Mesothelioma Claims Heading? Paul Hinton, Ron Miller, Faten Sabry, and Fred Dunbar NERA Economic Consulting i Table of Contents I. Introduction...1 II. III. Background...1 Evidence
Lung disease in Australia Leanne M Poulos Patricia K Correll Brett G Toelle Helen K Reddel Guy B Marks Woolcock Institute of Medical Research, University of Sydney, NSW Prepared for Lung Foundation Australia
Reported Road Casualties Great Britain: 2013 Annual Report Focus on pedal cyclists Key findings The key findings from this article include: Pedal cyclist deaths have seen a long-term fall, but have fluctuated
Worldwide mesothelioma mortality trends Harvard Symposium 24 th July 2009 Julian Peto London School of Hygiene and Tropical Medicine and Institute of Cancer Research Asbestos-related diseases Asbestosis
Projections of the Size and Composition of the U.S. Population: to Population Estimates and Projections Current Population Reports By Sandra L. Colby and Jennifer M. Ortman Issued March 15 P25-1143 INTRODUCTION
1 Risk Anal. 2004 Jun;24(3):547-52. Related Articles, Links Mesothelioma among brake mechanics: an expanded analysis of a casecontrol study. Hessel PA, Teta MJ, Goodman M, Lau E. Exponent, Wood Dale, IL
Asbestos and Mesothelioma a briefing document for the Metropolitan Police Prepared by Professor John Cherrie, Heriot Watt University, Edinburgh, UK. Introduction The purpose of this document is to provide
SOME ANALYSES OF CAR INSURANCE CLAIM-RATES BY J. M. MUNDEN London Editorial Comment We have printed the foregoing paper by Mr. Munden as submitted because we think that the detailed analysis will be of
Summary of Investigation into the Occurrence of Cancer Census Tract 2104 Zip Code 77009, Houston Harris County, Texas 1998 2007 May 11, 2010 Background: Concern about a possible excess of cancer prompted
australian mesothelioma registry 2nd Annual Report Mesothelioma in Australia 2012 The Australian Mesothelioma Registry is funded by Safe Work Australia and Comcare. Creative Commons ISBN 978-1-74361-136-4
Industrial Health 2012, 50, 197 204 Original Article Future Trends of Mesothelioma Mortality in Japan Based on a Risk Function Tomoya MYOJIN 1, Kenichi AZUMA 2 *, Jiro OKUMURA 2 and Iwao UCHIYAMA 3 1 Department
Update 1 st August 2011 INCREASED VULNERABILITY OF CHILDREN TO ASBESTOS The Precautionary Principle 1. For at least forty years warnings have been given to successive Governments that children are more
GermanY'S Population by 2060 Results of the 12th coordinated population projection Federal Statistisches Statistical Bundesamt Office GERMANY S POPULATION BY 2060 Results of the 12th coordinated population
$6%(67265(/$7('',6($6(6 7+(,1685$1&(&267 SUHSDUHGE\ 7LP$QGUHZVDQG*HRII$WNLQV,QWURGXFWLRQ The ideas for this paper evolved out of studies we were asked to undertake by a number of insurers involving estimation
Asbestos Risks of environmental and occupational exposure G e z o n d h e i d s r a a d H e a l t h C o u n c i l o f t h e N e t h e r l a n d s To the Minister of Housing, Spatial Planning and the Environment
MESOTHELIOMA IN AUSTRALIA INCIDENCE 1982 TO 28 MORTALITY 1997 TO 27 August 212 Safe Work Australia Mesothelioma in Australia Incidence 1982 to 28 Deaths 1997 to 27 August 212 Acknowledgement Data on the
December 2011 by Tanya Restrepo and Harry Shuford Workers Compensation and the Aging Workforce There is widespread concern about the potential adverse impact on workers compensation loss costs as the baby
Models Where the Fate of Every Individual is Known This class of models is important because they provide a theory for estimation of survival probability and other parameters from radio-tagged animals.
CANCER INCIDENCE RATES IN NORTHEASTERN MINNESOTA MCSS Epidemiology Report 99: September 999 Minnesota Cancer Surveillance System Chronic Disease And Environmental Epidemiology Section Minnesota Department
Why do men and women at ICRAF differ in their views about gender, their perceived relevance of gender, capacity to implement gender analysis, and their views towards gender in the organization? Results
Health and Safety Executive Occupational, domestic and environmental mesothelioma risks in Britain A case-control study Prepared by the Institute of Cancer Research and the London School of Hygiene and
MESOTHELIOMAS - ASBESTOS EXPOSURE AND LUNG BURDEN G. Berry Department of Public Health, University of Sydney, Australia A.J. Rogers National Occupational Health and Safety Commission, University of Sydney,