1

Surveillance of Mesothelioma at NIOSH

WoRLD Surveillance Reporthttp://www2a.cdc.gov/drds/WorldReportData/

The findings and conclusions in this report are those of the author and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

Surveillance of Mesothelioma at NIOSH

• Trends in overall deaths from mesothelioma in the US from 1999-2008– by race and sex

• Geographic distribution of deaths 1999-2007• Age group distribution of deaths 1999-2008• Years of potential life lost (YPLL) 1999-2007• Industry & Occupation Proportionate Mortality

Ratios (PMR)• Anatomical site 1999-2008

2350

2400

2450

2500

2550

2600

2650

2700

2750

1999 2002 2005 2008

Mesothelioma Deaths 1999 – 2008 (ICD 10)

4.2 4.3 3.0 3.9 4.2 3.7 4.2 4.8 4.0 4.119.7 19.3 19.4 19.4 19.0 19.4 20.6 19.4 20.4 20.6

2704

24842509

2531

2573

2625

2657

2588

2606

2711

PctBlk♀

Year

Regression - F = 14.2; p < 0.01 (still rising)

Five States with Most Deaths from Mesothelioma

1 2 3 4 5 6 7 8 9100

120

140

160

180

200

220

240

260

280

300

CAPAFLNYTX

1999 2002 2004 2007Year

Number of Deaths by State, 1999-2007

2326

136246

1183

141

366127

59

44

672248

1540

248

11001575

504264

712

396109

105 66

53

152

191

223 128

387

405

153

388

277 332

514594

219 1146518

841

213

1343

VT- 50 NH- 125

MA- 719

MD- 462DC- 23

DE- 95NJ- 1030

RI- 118CT- 340

HI- 71

Number of Deaths by Age Groups 1999-2008

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

3098

9870

7487

3845

12273568223

0.09 0.3 1.4 4.7 14.8 28.8 38.0 11.9Percentages

Age Group

Num

ber o

f Dea

ths

Decrease in Numbers of Deaths in ages 45-74 Over Time

44

46

48

50

52

54

Perc

enta

ge o

f Mes

othe

liom

aD

eath

s in

the

age

grou

p 45

-74

1999 2002 2005 2008Year

Increase in Numbers of Deaths in ages >74 Over Time

42

44

46

48

50

52

54

Perc

enta

ge o

f Mes

othe

liom

aD

eath

s in

the

age

grou

p >7

4

1999 2002 2005 2008Year

Change in Mesothelioma Death Rates by Age Groups Over Time

42

44

46

48

50

52

54

Perc

enta

ge o

f Mes

othe

liom

aD

eath

s by

Age

Gro

ups

1999 2002 2005 2008Year

Ns=185, &25988

Years of Potential Life Lost (1999-2007)

• Based on 23,277 deaths

• YPLL range 13.5 – 14.1 per death

• Average YPLL 13.8 per death

• Total YPLL 321,845

• 1999 – 2007; Thus YPLL/year is 35,760

PMRs by Industry & Occupation

• Industry– Ship/Boat building and repair 6.0 (2.4-12.3)– Industrial chemicals 4.8 (2.9-7.5)– Petroleum refining 3.8 (1.2-8.9)– Electric light and power 3.1 (1.5-5.7)– Construction 1.6 (1.2-1.9)

• Occupation– Plumbers/pipe- & steam-fitters 4.8 (2.8-7.5)– Mechanical engineers 3.0 (1.1-6.6)– Electricians 2.4 (1.3-4.2)– Teachers (elementary school) 2.1 (1.1-3.6)

Anatomical Site (1999-2008)

• Data derived from death certificates

• Data by anatomical site– Pleura 8.1%– Peritoneum 3.7%– Other 13.6%– Unspecified 75.7%

• Data frequently missing (similarly occupation)– Case for electronic health records

Summary

• There were almost 26,000 MM deaths among U.S. residents aged >15 years old between 1999 and 2008 and ~350,000 PYLL.

• During the same period ~20% of deaths were among women and ~4% were Black.

• More than half of which were from 9 States: CA > PA > FL > NY > TX > IL > OH > NJ > MI

• Construction accounted for 15% of decedents

WoRLD Surveillance Report• Asbestosis• Coal workers’ pneumoconiosis• Silicosis• Byssinosis• Unspecified and other Pneumoconioses• All pneumoconioses• Malignant mesothelioma• Hypersensitivity pneumonitis• Asthma• Chronic obstructive pulmonary disease• Respiratory conditions due to toxic agents• Respiratory tuberculosis• Lung cancer• Other interstitial pulmonary diseases• Pneumonia and influenza• Various work-related respiratory conditions• Smoking prevalence by industry and occupation

Acknowledgement

Contributing Agencies• Bureau of Labor Statistics• Social Security Admin.• Dept. Labor• OSHA/MSHA• CDC• National Center for Health Stats• CWXSP – NIOSH

NIOSH Staff• Jacek Mazurek• Patti Schleiff• John Wood• Eileen Storey• Ki-moon Bang

• Anita Wolfe