Prediction of Mesothelioma Incidence from Asbestos Consumption, A Comparative Study

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Prediction of Mesothelioma Incidence from
Asbestos Consumption, A Comparative Study

• Domyung Paek
• Seoul National University

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Korean Situation

• Asbestos industry started operation from 1960s.
• Yet mesothelioma incidence stays low around
  1-2/million, with male to female ratio of 1.6.
• Concerns over what to expect (any increase?),
  where to expect (asbestos industry locations?)
  and whom to expect (any specific job or task?)

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Phases of Change
EXPANSION
FALL
PLATEAU
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Korean Situation

• However, with very scanty data about mesothelioma
  incidence, future prediction is in murky state.
• Need to predict future scenarios based on
  inter-country comparative study.

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Asbestos and Mesothelioma

• Usually studied in occupational settings,
  especially of mining and manufacturing sectors.
• However, much bigger problems are found in
  end-user industries such as construction and
  ship-building
• Per-capita consumption of asbestos can be a fair
  indicator of asbestos exposure extent in end-user
  industries

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Asbestos and Mesothelioma

• The relationship can be studies in two directions
• Spatial variation
• Between jobs or departments
• Between companies or industries
• Between different countries
• Temporal variation
• Between different periods
• Between countries of different phases

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Asbestos and Mesothelioma

• An example of spatial variation study
• Per-capita asbestos consumption versus
  mesothelioma incidence of different countries

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Ecological association between asbestos-related
diseasesand historical asbestos consumption an
international analysisRo-Ting Lin, Ken
Takahashi, Antti Karjalainen, Tsutomu Hoshuyama,
Donald Wilson, Takashi Kameda, Chang-Chuan Chan,
Chi-Pang Wen, Sugio Furuya, Toshiaki Higashi,
Lung-Chang Chien, Megu Ohtaki
Lancet 2007 369 84449
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Asbestos and Mesothelioma

• How about temporal variation study?
• Usually future predictions based on age-cohort
  models without asbestos inputs
• As yet, no relationship study between changes of
  asbestos consumption and mesothelioma incidence

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Temporal Variation Study

• Analysis of cumulative per-capita asbestos
  exposure over certain age period versus
  mesothelioma incidence after certain age of a
  given birth cohort
• When and how long is the best age period of
  asbestos exposure to explain the changing
  mesothelioma incidence of different birth
  cohorts?
• How strong is the dose-response of mesothelioma
  incidence for a given cumulative asbestos
  exposure?

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Temporal Variation Study

• Studies from Japan and Netherlands

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Temporal Variation Study

• Per-capita asbestos consumption
• Imported asbestos/population size
• Mesothelioma incidence risk of different birth
  cohorts of 5-10 year periods from 1910-1960
• Age/period/cohort model analysis of mesothelioma
  incidence data of each country

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Analysis

• Mesothelioma rate ratio for a specific cohort was
  calculated based on age-sex specific mesothelioma
  mortality in certain period, i.e. age-cohort.
• Exposure during specific age (period) based on
  per-capita asbestos consumption was regressed
  against mesothelioma rate ratio.
• RR(cohort I)
• ? ( Per-capita asbestos consumption(i
  period)
• (40- age(i
  period))2 )

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Analysis of exposure age period

• Period of from 15 25 years old

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Analysis of temporal change

• Exposures of relatively young age period (15-25
  years old) showed the best fit of the data
• After the exposure, takes about 30 years to show
  the elevation of the risk
• After the exposure, takes about 50 years to reach
  the peak of the risk

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Prediction of Peak