Asbestosis mortality in the USA: facts and predictions.
dos Santos Antão-VC; Pinheiro-GA; Wassell-JT
Occup Environ Med 2009 May; 66(5):335-338
OBJECTIVES: Mortality trends in the U.S. show that asbestosis deaths are increasing, while deaths related to other pneumoconiosis are declining. To analyze the association between asbestos consumption and asbestosis mortality trends. METHODS: In an epidemiologic time series study, we used a modern computer intensive local regression method to evaluate the relationship between asbestos consumption per capita (1900-2006) as the predictor variable and number of asbestosis deaths (1968-2004). The predictor variable was progressively lagged by annual increments from 30 to 60 years and the goodness-of-fit assessed for each lag period. The model having the smallest Akaike's Information Criteria (AIC) was used to derive extrapolated estimates of future mortality based on more recent asbestos consumption data. RESULTS: Asbestos consumption per capita reached a peak in 1951 and gradually declined until 1973, when it started to drop rapidly. In 2006, it was 0.0075 kg/person/year. There were 25,564 asbestosis deaths over the period 1968-2004. The best fitting model (Adjusted R2 = 99.7%) for 1968-2004 asbestosis deaths used asbestos consumption per capita 48 years prior (1920-1956) and the log value of asbestos consumption per capita 43 years prior (1925-1961). This model predicts a total of 29,667 deaths (95% CI 19,629, 39,705) to occur during 2005-2027 (an average of 1,290 deaths per year). CONCLUSIONS: This study demonstrates a clear association between asbestos consumption and asbestosis deaths and indicates that asbestosis deaths are not expected to decrease sharply in the next 10-15 years.
Respiratory-system-disorders; Pulmonary-system-disorders; Asbestos-workers; Asbestos-industry; Asbestosis; Epidemiology; Statistical-analysis; Surveillance;
Author Keywords: asbestos consumption; asbestosis; mortality; generalized additive model
Vinicius Cavalcanti dos Santos Antao, 4770 Burford Highway NE, MS f-57, Atlanta, Georgia 30305, USA
Occupational and Environmental Medicine