Document 6MQ8JD6wZxGMjRqgDnqVn0x1

NATIONAL OCCUPATIONAL HEALTH AND SAFETY COMMISSION THE INCIDENCE OF MESOTHELIOMA IN AUSTRALIA 1994 to 1996 AUSTRALIAN MESOTHELIOMA REGISTER REPORT, 1999 Australian Mesothelioma Register Location: National Occupational Health and Safety Commission 92 Parramatta Road, Camperdown NSW 2050 Postal Address: GPO Box 58, Sydney 2001  Commonwealth of Australia 1999 ISBN 0-642-41491 2 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from AusInfo. Requests and inquiries concerning reproduction and rights should be addressed to the Manager, Legislative Services, AusInfo, GPO Box 84, Canberra, ACT 2601. CONTENTS Introduction Asbestos production and use in Australia The Australian Mesothelioma program and register Statistics Figure 1 Incident cases of malignant mesothelioma in Australia 1945-1996. Figure 2 Age specific incidence rates of malignant mesothelioma in Australian men, 1986-1996. Figure 3 Age specific incidence rates of malignant mesothelioma in Australian women, 1986-1996. Table 1 Male cases of mesothelioma in Australia, 1994, by age and State Table 2 Female cases of mesothelioma in Australia, 1994, by age and State Table 3 Age specific incidence rates for mesothelioma per million males in Australia, 1994, by age and State Table 4 Age specific incidence rates for mesothelioma per million females in Australia, 1994, by age and State Figure 4 Incidence of mesothelioma in Australia, 1994, by age and sex Table 5 Male cases of mesothelioma in Australia, 1995, by age and State Table 6 Female cases of mesothelioma in Australia, 1995, by age and State Table 7 Age specific incidence rates for mesothelioma per million males in Australia, 1995, by age and State Table 8 Age specific incidence rates for mesothelioma per million females in Australia, 1995, by age and State Figure 5 Incidence of mesothelioma in Australia, 1995, by age and sex 1 1 2 3 4 5 6 7 7 8 8 9 10 10 11 11 12 iii Table 9 Table 10 Table 11 Table 12 Figure 6 Figure 7 Figure 8 Figure 9 Appendix A Appendix B List of Publications Male cases of mesothelioma in Australia, 1996, by age and State Female cases of mesothelioma in Australia, 1996, by age and State Age specific incidence rates for mesothelioma per million males in Australia, 1996, by age and State Age specific incidence rates for mesothelioma per million females in Australia, 1996, by age and State Incidence of mesothelioma in Australia, 1996, by age and sex Cases of mesothelioma in Australia, 1994-96, by site of primary lesion Trends in Australian incidence of mesothelioma per million persons, by State, 1982-96 Trends in Australian incidence of mesothelioma per million persons, by sex, 1982-96 Circumstances of exposure, 1 Jan 1986-31 Oct 1998 Australian Mesothelioma Register Notification Form 13 13 14 14 15 16 17 18 19 23 25 iv INTRODUCTION This document is the eleventh report of the Australian Mesothelioma Register, produced by the Research and Epidemiology Units of the National Occupational Health and Safety Commission NOHSC). Malignant mesothelioma is a cancer of the outer covering of the lung (the pleura) or the abdominal cavity (the peritoneum). Formerly rare, it is increasing in incidence throughout the industrial world and is very frequently associated with past exposure to asbestos. It is usually fatal and has no direct relation to smoking. Australia has a very high and increasing incidence rate (Takahashi et al, 1999). ASBESTOS PRODUCTION AND USE IN AUSTRALIA In Australia, more chrysotile than amphibole asbestos was mined until 1939. With the commencement of mining at Wittenoom, Western Australia in 1937, crocidolite dominated production, until final closure in 1966. New South Wales, the first State to mine asbestos, also produced the largest tonnages of chrysotile (until 1983) as well as smaller quantities of amphibole (until 1949). With the closing of the crocidolite mine at Wittenoom, Australian asbestos production and exports declined. Imports of chrysotile also started to decline. The main sources of raw asbestos imports were Canada (chrysotile) and South Africa (crocidolite and amosite). Consumption peaked in about 1975 at 70,000 tonnes/year. In addition to imports of asbestos fibre, Australia also imported many manufactured asbestos products, including asbestos cement articles, asbestos yarn, cord and fabric, asbestos joint and millboard, asbestos friction materials and gaskets. The main sources of supply were the United Kingdom, USA, Federal Republic of Germany and Japan. In Australia over 60% of all production and 90% of all consumption of asbestos fibre was used by the asbestos cement manufacturing industry. From about 1940 to the late 1960s all three types of asbestos were used in this industry. The use of crocidolite began being phased out from 1967. Amosite was used until the mid 1980s. Much of this industry output remains in service today in the form of "fibro" houses and water and sewerage piping. By 1954 Australia was number four in the Western world in gross consumption of asbestos cement products, after USA, UK and France, and clearly first on a per capita basis. After World War II to 1954, 70,000 asbestos cement houses were built in the State of New South Wales alone (52% of all houses built). In Australia as a whole, until the 1960s, 25% of all new housing was clad in asbestos cement. Exposures in the past were very high in some industries and jobs - (eg, 25 million particles per cubic foot (150 fibres/ml) in asbestos pulverisors and disintegrators in the asbestos cement industry; up to 600 fibres/ml in baggers at Wittenoom). Australia still imports about 2,000 tonnes a year of chrysotile fibre and some asbestos products a year, mainly friction material and gaskets. Handling of asbestos in place and removal operations are subject to a National Code of Practice. A series of regulations adopted in the late 1970s and early 1980s by the various States now impose exposure limits of 0.1 fibre/ml for crocidolite, amosite and mixtures and 0.1-1.0 fibre/ml for chrysotile (TWA 8 hr membrane filter method light microscopy, WHO fibres). In October 1999 NOHSC agreed to support 1 the phase-out of chrysotile use, subject to an impact analysis, and the chrysotile exposure limit is now under review. The first reported case of mesothelioma, from Wittenoom, was in 1962 (McNulty, 1962). Retrospective search identified 658 cases (535 male, 123 female) occurring in Australia from 1945-1979 (Musk et al, 1989). THE AUSTRALIAN MESOTHELIOMA PROGRAM AND REGISTER The Australian Mesothelioma Surveillance Program (Ferguson et al, 1987) began on 1 January 1980. Formal voluntary notification of cases was actively sought from a network of respiratory physicians, pathologists, general and thoracic surgeons, medical superintendents, medical records administrators, State and Territory departments of occupational health, cancer registries, compensation authorities or any other source. A full occupational and environmental history was obtained for each case, either from the patient or next-of-kin. The history taking was non directive but included specific questions on asbestos exposure at the end. Occupational and environmental exposure was based on the opinions of two experienced hygienists, who were not independent nor blinded as to disease status. The diagnosing pathologist was requested to provide slides and/or tissue specimens. These were circulated among a pathology expert panel for confirmation of diagnosis. Post-mortem examination was actively sought in every case in order to confirm diagnosis and to obtain lung tissue free of tumour for lung fibre content analysis. From 1 January 1986, a less detailed notification system has operated, with a short questionnaire history, which is followed up by mail. In the case of all WA and most of the NSW notifications (comprising 60% of the total Australian notifications), detailed occupational and environmental exposure histories from interview are available from the WA Mesothelioma Register and the NSW Dust Diseases Board. Only histologically confirmed cases are accepted but there is no pathology panel diagnosis confirmation. This is now known as the Australian Mesothelioma Register but is a continuation of the Program. Cross checks with State cancer registries are regularly carried out. Annual incidence reports are published (NIOHS (AGPS) 1989-98). Recent reviews are available (Leigh, 1994, Leigh et al 1998, 1999). This report includes data on cases notified to the register and diagnosed in 1994, 1995 and 1996. Full reconciliation with all State cancer registries has been carried out. Full analysis of incidence in 1997, 1998, 1999 awaits reconciliation checks with State cancer registries. However, notifications for 1997, 1998, 1999 were 318, 405, 546 respectively (to 31 December 1999). We are grateful to the continued cooperation of the notification network. 2 STATISTICS Incidence in a calendar year is defined as the number of new cases of mesothelioma first occurring* in an Australian State or Territory in that year. Age specific incidence rates are computed from population tables published by the Australian Bureau of Statistics for the estimated resident mid year populations for 1994, 1995 and 1996 (estimates based on Census 30 June, 1996). Standardised incidence rates (SI) were calculated using the 'World Standard Population' 20 years of age or greater1. The cumulative incidence rate (CR) is obtained by summing the annual incidence rates (assumed constant in each 5 year group). It can be shown, for rare diseases like mesothelioma, that the cumulative incidence rate approximates the cumulative risk, or probability, of developing the disease in a lifetime2. This can be expressed as a percentage. Thus the figure 0.48 in Table 3 for NSW (males) under CR indicates a 0.48% or 0.0048 lifetime (20-75) risk of developing mesothelioma. Therefore, the chance of developing mesothelioma between the ages 20-75 is approximately 1 in 209. * "First occurrence" is the earliest known date of diagnosis (presumptive or confirmed). Cases where a presumptive diagnosis had been rejected before the date of this report (August 13, 1999) have been excluded. 1. Waterhouse, J., Muir, C., Shanmugaratnam, K., & Powell, J., eds, Cancer Incidence in Five Continents Volume IV, Lyon (IARC Scientific Publications No 42, 1982) pp 671- 674. 2. Breslow, N. & Day, N., Statistical Methods in Cancer Research Volume I, Lyon (IARC Scientific Publications No 32, 1980) pp 51-52. 3 Figure 1 Incident cases of malignant mesothelioma in Australia, 1945 - 1996 Year of diagnosis 4 Figure 2 Age-specific incidence rates of malignant mesothelioma in Australian men, 1986-1996 5 Figure 3 Age-specific incidence rates of malignant mesothelioma in Australian women, 1986-1996 6 Table 1 TABULATION OF MALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1994 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 1 0000000 1 000000000 000000000 00 1 0 1 0002 2 2 6 0 2 0 0 0 12 5 2 4 3 3 0 0 1 18 8 5 6 1 4 0 0 0 24 18 6 9 2 9 1 0 1 46 14 7 10 4 8 2 0 1 46 36 8 10 7 6 1 0 0 68 30 9 4 5 5 1 0 0 54 19 5 5 5 7 2 0 0 43 19 2 3 3 4 0 0 0 31 8 3 2 2 1 0 0 0 16 ALL AGES 160 49 60 32 50 7 0 3 361 Table 2 TABULATION OF FEMALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1994 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 000000000 000000000 1 0000000 1 000000000 000200002 01001 1003 2 2002 0006 200000002 1 12000004 1 300 1 0005 1 2 1310008 300000003 2 200 1 0005 1 0000000 1 ALL AGES 14 11 3 5 6 1 0 0 40 7 Table 3 TABULATION OF AGE SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION MALES IN AUSTRALIA, 1994 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 4.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.2 0.0 14.5 0.0 0.0 0.0 2.9 9.1 12.3 50.6 0.0 30.2 0.0 0.0 0.0 18.2 24.0 13.2 35.6 59.7 49.5 0.0 0.0 86.8 29.2 49.2 42.4 69.9 26.1 88.4 0.0 0.0 0.0 50.6 131.7 60.0 130.4 61.0 246.3 95.7 0.0 176.5 116.8 112.2 76.4 165.5 128.2 254.3 205.9 0.0 236.9 129.5 305.4 93.8 177.3 227.3 213.5 109.8 0.0 0.0 204.6 319.2 134.2 88.1 200.5 230.2 137.3 0.0 0.0 204.7 323.7 121.5 176.0 320.0 541.6 426.5 0.0 0.0 263.4 552.8 77.1 180.2 317.5 480.5 0.0 0.0 0.0 314.6 449.5 211.2 214.5 401.9 202.4 0.0 0.0 0.0 300.3 ALL AGES SI CR LIFETIME RISK. 1 in: 75.0 63.9 0.48 209 31.1 28.8 0.22 463 54.1 53.0 0.36 276 61.5 50.1 0.35 285 84.3 83.2 0.56 177 43.3 37.3 0.27 364 0.0 0.0 0.00 - 29.2 36.2 0.25 400 57.7 52.4 0.38 264 Table 4 TABULATION OF AGE SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION FEMALES IN AUSTRALIA, 1994 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0.0 0.0 4.0 0.0 0.0 0.0 12.8 14.9 7.9 7.9 8.8 36.4 33.5 22.4 0.0 0.0 0.0 0.0 0.0 6.7 17.5 0.0 10.8 32.5 24.2 0.0 45.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 33.6 0.0 19.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 36.8 0.0 0.0 0.0 0.0 0.0 98.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 17.7 47.7 0.0 0.0 34.4 39.3 0.0 72.2 0.0 0.0 0.0 0.0 0.0 0.0 64.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.0 0.0 0.0 3.0 0.0 5.0 0.0 13.2 0.0 5.2 0.0 11.2 0.0 14.1 0.0 25.2 0.0 13.2 0.0 29.9 0.0 7.8 ALL AGES SI CR LIFETIME RISK. 1 in: 6.3 4.7 0.03 3554 6.7 5.6 0.05 2184 2.7 2.9 0.03 3777 9.2 7.0 0.07 1474 10.0 9.4 0.07 1437 5.9 6.4 0.03 0.0 0.0 0.00 0.0 0.0 0.00 6.2 5.2 0.04 2551 8 Figure 4 Crude incidence of mesothelioma per million persons, Australia 1994 by age and sex 9 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 Age in years 85+ *-- Males --|-- Females Table 5 TABULATION OF MALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1995 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0 1 000000 1 000000000 0000 1 000 1 000000000 1 000 1 0002 4 1 1020008 4 5 3 2 2 0 0 0 16 9 15 8 2 7 0 0 0 41 19 6 6 5 8 0 0 1 45 25 15 7 4 11 1 0 0 63 30 16 11 8 11 0 0 0 76 20 7 9 3 4 1 0 0 44 11 7 5 3 6 0 0 0 32 6 3 1 0 2 0 0 0 12 ALL AGES 129 76 51 27 55 2 0 1 341 Table 6 TABULATION OF FEMALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1995 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 000000000 000000000 000000000 000000000 000000000 1 00 200003 2 1 1010005 1 12 12 1008 4 4 1 1 0 0 0 0 10 3300 1 0007 6 1 2 0 0 1 0 0 10 6 6 1 0 0 1 0 0 14 02101 1005 000000000 ALL AGES 23 18 8 4 5 4 0 0 62 10 Table 7 TABULATION OF AGE SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION MALES IN AUSTRALIA, 1995 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0.0 5.5 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 14.0 0.0 0.0 0.0 1.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.5 0.0 0.0 0.0 14.9 0.0 0.0 0.0 3.0 18.7 6.4 8.6 0.0 31.8 0.0 0.0 0.0 12.6 23.6 40.9 32.8 50.0 42.1 0.0 0.0 0.0 32.2 63.9 146.4 110.2 60.0 184.7 0.0 0.0 0.0 100.8 153.6 66.2 98.5 164.1 251.9 0.0 0.0 224.8 127.3 211.2 174.5 122.2 129.6 383.7 109.6 0.0 0.0 188.0 311.8 233.2 236.7 314.2 492.7 0.0 0.0 0.0 281.5 330.1 163.7 302.4 186.1 296.0 208.2 0.0 0.0 259.6 306.7 262.1 286.5 302.0 688.5 0.0 0.0 0.0 311.9 315.1 197.8 100.1 0.0 384.0 0.0 0.0 0.0 211.4 ALL AGES SI CR LIFETIME RISK. 1 in: 59.7 50.4 0.39 254 47.9 42.0 0.34 297 44.7 39.8 0.30 328 51.7 41.7 0.36 279 90.7 88.2 0.71 141 12.3 9.0 0.05 1824 0.0 0.0 0.00 - 9.6 15.0 0.11 890 53.7 47.2 0.37 267 Table 8 TABULATION OF AGE SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION FEMALES IN AUSTRALIA, 1995 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0.0 0.0 0.0 0.0 0.0 4.8 12.3 7.3 31.8 23.7 51.7 71.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.4 9.9 43.2 32.6 11.9 100.2 44.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 11.6 29.2 16.6 0.0 37.6 25.7 35.7 0.0 0.0 0.0 0.0 0.0 0.0 39.0 0.0 29.6 31.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 22.7 55.4 0.0 33.8 0.0 0.0 69.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 93.1 0.0 0.0 111.6 148.9 204.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 ALL AGES SI CR LIFETIME RISK. 1 in: 10.3 8.2 0.07 1519 10.8 8.3 0.05 1889 6.9 6.0 0.05 2104 7.3 8.0 0.05 1990 8.2 7.9 0.06 1788 23.4 14.1 0.10 0.0 0.0 0.00 0.0 0.0 0.00 AUST 0.0 0.0 0.0 0.0 0.0 4.9 10.5 20.2 28.0 19.8 31.0 60.0 29.0 0.0 9.4 7.8 0.06 1749 11 Figure 5 Crude incidence of mesothelioma per million persons, Australia 1995 by age and sex 12 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 Age in years 85+ Males Females Table 9 TABULATION OF MALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1996 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0 1 000000 1 1 10000002 000000000 00000001 1 1 0 1 000002 6 1 1 1 3 0 0 0 12 13 6 1 2 3 0 0 0 25 13 8 4 3 6 0 1 0 35 23 13 5 6 14 2 0 1 64 25 12 8 4 9 0 0 1 59 24 20 9 5 7 1 0 0 66 23 16 7 1 10 1 0 0 58 10 8 5 1 8 2 0 1 35 4 6 3 1 3 1 0 0 18 ALL AGES 143 92 44 24 63 7 1 4 378 Table 10 TABULATION OF FEMALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1996 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 000000000 000000000 000000000 0 1 000000 1 0000 1 000 1 0 200 1 0003 1 0002 0003 1 12000004 4 1 1010007 0 1 1000002 7 1 1 1 0 1 0 0 11 4 3 3 0 1 0 0 0 11 3300 1 0007 0 200 1 0003 ALL AGES 20 15 8 1 8 1 0 0 53 13 Table 11 TABULATION OF AGE SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION MALES IN AUSTRALIA, 1996 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0.0 4.2 0.0 0.0 4.4 27.3 73.7 90.0 186.2 210.0 244.7 359.0 269.8 197.8 5.7 5.6 0.0 0.0 0.0 6.3 47.3 76.1 143.9 138.9 284.8 353.9 291.4 374.3 0.0 0.0 0.0 0.0 8.1 8.2 10.4 52.5 80.7 137.8 188.6 220.7 275.3 281.4 0.0 0.0 0.0 0.0 0.0 18.9 48.2 88.1 198.9 131.2 193.6 58.6 98.3 177.4 0.0 0.0 0.0 0.0 0.0 45.7 60.5 152.2 439.2 307.4 304.1 695.4 901.5 547.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 211.8 0.0 133.3 200.1 668.9 609.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 305.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 80.1 0.0 0.0 0.0 0.0 220.8 271.9 0.0 0.0 1096.5 0.0 1.4 2.8 0.0 1.4 3.0 18.3 48.3 83.4 180.9 174.9 239.0 323.0 330.7 298.5 ALL AGES SI CR LIFETIME RISK. 1 in: 65.2 56.8 0.42 238 57.3 48.6 0.35 282 37.6 32.9 0.24 411 45.7 41.3 0.34 295 101.6 98.2 0.65 153 43.0 32.6 0.17 579 15.9 20.3 0.15 - 37.9 45.5 0.29 349 58.6 51.8 0.38 265 Table 12 TABULATION OF AGE SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION FEMALES IN AUSTRALIA, 1996 BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0.0 0.0 0.0 0.0 0.0 0.0 5.9 7.1 31.9 0.0 59.7 45.7 47.9 0.0 0.0 0.0 0.0 5.5 0.0 12.5 0.0 9.6 10.8 10.9 11.7 47.9 64.8 52.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 27.9 16.6 16.8 18.5 73.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 32.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 14.6 16.1 43.6 0.0 31.6 0.0 0.0 52.0 67.5 82.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 111.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 ALL AGES SI CR LIFETIME RISK. 1 in: 8.8 6.2 0.05 1912 8.9 5.9 0.03 3277 6.7 5.6 0.04 2506 1.8 1.1 0.02 6206 12.8 10.9 0.05 1889 5.8 3.7 0.06 0.0 0.0 0.00 0.0 0.0 0.00 AUST 0.0 0.0 0.0 1.4 1.5 4.7 6.0 9.8 19.6 5.6 33.6 45.1 39.6 21.2 7.9 5.9 0.04 2431 14 Figure 6 Crude incidence of mesothelioma per million persons, Australia 1996 by age and sex 15 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 Age in years *-- Males --|-- Females 85+ Figure 7 Cases of mesothelioma in Australia, 1994-96, by site of primary lesion 400 300 No. of cases 200 100 0 Pleura Peritoneum Other Unknown 16 Figure 8 Trends in Australian incidence of mesothelioma per million persons by state, 1982-96 Year of Diagnosis Standardised to World Popn > 20 years 17 Figure 9 Trends in Australian incidence of mesothelioma per million persons by sex, 1982-96 Incidence per Standardised to World Popn > 20 years 18 ASBESTOS EXPOSURES AS DOCUMENTED IN THE AUSTRALIAN MESOTHELIOMA REGISTER FROM 1 JANUARY 1986 TO 31 OCTOBER 1998 CIRCUMSTANCES OF EXPOSURE NO. EXPOSED (WITH NO OTHER EXPOSURE) (Single) ACOUSTIC ENGINEER AIRCONDITIONING AIRCRAFT ARMED FORCES /WARTIME ARMED FORCES /PEACETIME ASBESTOS BAGGING (NOT WITTENOOM) ASBESTOS BAGS - HANDLED WHICH HAD CONTAINED ASBESTOS CLOTHING WORN ASBESTOS COVERS FOR COOKING ASBESTOS DWELLING/FENCE BUILT/RENOVATED ASBESTOS DWELLING - LIVED IN ASBESTOS PRODUCTS FACTORY LIVED NEAR ASBESTOS PRODUCTS FACTORY - WORKED NEAR ASBESTOS MINE - WORKED/LIVED NEAR (NOT WITTENOOM) ASBESTOS PRODUCT HANDLED IN THE WORKPLACE ASBESTOS PRODUCT MANUFACTURER - WORKED ASBESTOS PRODUCT PART OF WORKPLACE OR SURROUNDS ASBESTOS TAILINGS - PLAYED ON AS A CHILD ASBESTOS /OR PRODUCTS WORKER - LIVED WITH/WASHED CLOTHES BAKERY (OVENS) BOILERMAKER/CLEANER/ATTENDANT /INSTALLER/WELDER BRAKE LININGS - MADE/ REPAIRED BREWERY 1 10 13 27 9 3 8 7 1 66 27 8 2 12 43 99 15 4 38 3 77 58 1 NO. EXPOSED (WITH OTHER EXPOSURES) (Multiple) 8 8 - 1 6 6 2 - 1 6 33 6 - 3 40 12 - TOTAL EXPOSURES 1 18 13 35 9 3 8 8 1 72 33 10 2 13 49 132 21 4 41 3 117 70 1 19 CIRCUMSTANCES OF EXPOSURE BRICKLAYER BRICKWORKS BUILDER/ BUILDER'S LABOURER CARPENTER/JOINER CEMENT FACTORY WORKER CHEMICAL ENGINEER CONCRETING CONSTRUCTION WORKER CIVIL ENGINEER DEMOLITION DESIGN ENGINEER DIESEL ENGINEER DOCKYARD WORKER ELECTRICAL ENGINEER ELECTRICAL FITTER ELECTRICAL MECHANIC ELECTRICIAN ELECTROPLATER ENGINEER FIREPROOFING FIREDOORS FIREFIGHTER FITTER/TURNER FOUNDRY FURNACE GLASSWORKS/GLAZIERS INDUSTRIAL CHEMIST INDUSTRIAL ENGINEER INSTRUMENT TECHNICIAN INSULATION JEWELLER LABORATORY TECHNICIAN LABOURER LAGGER LAGGING IN WORKPLACE LAUNDRY/DRYCLEANERS NO. EXPOSED (WITH NO OTHER EXPOSURE) (Single) NO. EXPOSED (WITH OTHER EXPOSURES) (Multiple) TOTAL EXPOSURES 13 1 14 8 3 11 150 27 177 187 33 220 12 - 12 1 -1 5 -5 15 1 16 1 -1 5 27 1 12 - 11 22 16 38 5 16 15 4 19 3 -3 39 6 45 - 11 24 - 24 4 -4 3 -3 4 37 51 16 67 3 14 6 -6 4 -4 4 -4 2 -2 1 -1 8 19 1 -1 3 -3 25 4 29 26 13 39 24 2 26 14 2 16 20 CIRCUMSTANCES OF EXPOSURE LINESMAN LOCKSMITH MACHINE FITTER MACHINE INSPECTOR MACHINE OPERATOR MACHINIST MAINTENANCE CARPENTER MAINTENANCE ELECTRICIAN MAINTENANCE ENGINEER MAINTENANCE FITTER MAINTENANCE MECHANIC MAINTENANCE WORKER MARINE ENGINEER MECHANICAL ENGINEER MECHANICAL FITTER METAL FABRICATION METAL TRADES METALLURGY NAVY OIL REFINERY PAINTER/DECORATOR PANELBEATER PAPERMILL PATTERNMAKER PIPES - HANDLED/CUT/STORED/DRILLED PLASTERER PLUMBING POWER STATION WORKER PRESSURE PAK MANUFACTURER PRINTING RADIOGRAPHER RAILWAYS RENOVATIONS/MAINTENANCE/LAGGING IN WORKPLACE ROOFING NO. EXPOSED (WITH NO OTHER EXPOSURE) (Single) NO. EXPOSED (WITH OTHER EXPOSURES) (Multiple) TOTAL EXPOSURES 88 1 -1 3 14 2 -2 1 -1 3 -3 3 -3 2 -2 3 -3 13 3 16 3 -3 14 2 16 7 7 14 3 -3 3 25 2 -2 2 -2 1 -1 100 43 143 1 -1 49 5 54 9 -9 3 14 6 28 18 2 20 16 6 22 62 13 75 76 39 115 1 -1 9 -9 1 -1 89 36 125 20 2 22 10 3 13 21 CIRCUMSTANCES OF EXPOSURE SHEETMETAL SHIPS - BUILDING/REPAIRING/ON SHOP FITTER SITE VISITS/INSPECTIONS SMELTING STEELWORKS STOREMAN STOVES SUGAR MILL TANNERY TELEPHONE TECHNICIAN TILER TOOLMAKER TRADES ASSISTANT TRANSPORTING ASBESTOS TRANSPORTING ASBESTOS PRODUCT TYRE FACTORY WATERSIDE WORKER WEIGHING TRUCKS WELDER WHITEWASH -GREECE/CYPRUS WINE MAKING (FILTERS) WITTENOOM WOOD MACHINIST Asbestos exposure single multiple No apparent asbestos exposure No response to questionnaire Total cases from 1/1/86 - 31/10/98 Proportion of respondents with asbestos exposure NO. EXPOSED (WITH NO OTHER EXPOSURE) (Single) NO. EXPOSED (WITH OTHER EXPOSURES) (Multiple) TOTAL EXPOSURES 11 9 20 79 53 132 1 -1 7 29 1 -1 13 2 15 13 - 13 2 -2 6 4 10 1 -1 7 29 5 -5 4 15 10 - 10 13 4 17 12 1 13 10 4 14 70 8 78 1 -1 21 5 26 2 13 1 -1 189 25 214 1 -1 2,245 340 443 717 3,745 2,585 3,028 = 85% 22 NATIONAL OCCUPATIONAL HEALTH & SAFETY COMMISSION AUSTRALIAN MESOTHELIOMA REGISTER NOTIFICATION Please direct all correspondence to: The Registrar Australian Mesothelioma Register National Occupational Health and Safety Commission GPO Box 58 Sydney NSW 2001 Telephone: (02) 9577 9304 Patient details - please supply ALL available information SURNAME:.......................................................................... FIRST NAMES:............................................................. ADDRESS:........................................................................................................................................................................ STATE:.......................... POSTCODE:............................ GENDER: M / F DATE OF BIRTH: / / IF DECEASED, DATE OF DEATH: / / PLACE OF DEATH: DATE OF INITIAL DIAGNOSIS: Month ................ Year: .................. HISTOLOGICAL: YES / NO HOSPITAL DIAGNOSED:.................................................................. PRIMARY SITE: .......................................... CLINICIAN'S NAME:......................................................... NAME OF LOCAL GP:....................................................... ADDRESS:......................................................................... ADDRESS:.......................................................................... Please describe briefly main occupation(s) of patient's worklife. OCCUPATION INDUSTRY YEAR 1 ........................................................................... 1................................................................................ 19 - 19 2 ........................................................................... 2............................................................................... 19 - 19 3 ........................................................................... 3............................................................................... 19 - 19 KNOWN ASBESTOS EXPOSURE: YES / NO If "YES" please indicate circumstances and duration: ................................................................................................... Details of person completing this form. NAME:....................................................................................................... SIGNATURE:............................................ ADDRESS:............................................................................................... DATE:........................................................ Please circle the appropriate category: CLINICIAN PATHOLOGIST CANCER REGISTRY MEDICAL RECORDS ADMIN DUST DISEASES BOARD OTHER: ................................................... Office Use Only Date Received: REGISTRATION NO: 23 24 LIST OF PUBLICATIONS FROM THE MESOTHELIOMA PROGRAM AND REGISTER Armstrong B.K., Musk A.W., Baker J.E., Hunt J.M., Newall C.C., Henzell H.R., Blunsdon B.S., Clarke-Hundley M.D. (1984). Epidemiology of malignant mesothelioma in Western Australia. Med. J. Aust. 141:86-88. Baker G., Driscoll T., Daniel S., Thompson R., Lee J, Constance T., Ferguson D., Leigh J. (1991). Clinical features of mesothelioma associated with tumor cell histology. Proceedings of the Thoracic Society of Australia and New Zealand, p 33. Berry G., Ferguson D.A., Fung C., Grimwood A., Major G. (1987). Mesothelioma as a result of occupational exposure to asbestos in Australia. XXII International Congress on Occupational Health, Sydney, Australia, 1987, p 57. Berry G. (1991). Prediction of mesothelioma, lung cancer, and asbestosis in former Wittenoom asbestos workers. Br. J. Ind. Med. 48:793-802. de Klerk N.H., Armstrong B.K., Musk A.W., Hobbs M.S.T. (1989). Predictions of future cases of asbestos-related disease among former miners and millers of crocidolite in Western Australia. Med. J. Aust. 151:616-620. Driscoll T., Leigh J., Thompson R. (1993). Asbestos and non-asbestos factors in the aetiology of malignant mesothelioma: a case-referent study. Proceedings of the 8th International Conference on Occupational Lung Diseases (Prague), 1:319-323. Driscoll T., Baker G., Daniel S., Thompson R., Lee J., Ferguson D.A., Leigh J. (1993). Clinical features of malignant mesothelioma in Australia. Aust. NZ J. Med. 23:19-25. Ferguson D.A. (1990). Low-level asbestos - the priorities are wrong (Letter). Med. J. Aust. 152:617-618. Ferguson D.A. (1989). Malignant mesothelioma - the rising epidemic (Letter). Med. J. Aust.150:233-235. Ferguson D.A., Berry G., Grimwood A. (1987). The incidence of mesothelioma in Australia. XXII International Congress on Occupational Health, Sydney, Australia, 1987, p 56. Ferguson D.A., Berry G., Jelihovsky T., Andreas S.B., Rogers A.J., Fung S.C., Grimwood A., Thompson R. (1987). The Australian Mesothelioma Surveillance Program 1979-1985. Med. J. Aust. 147:166-172. Henderson D.W., Shilkin K.B., Langlois S. Le P., Whitaker D. (eds.) (1992). Malignant mesothelioma. Hemisphere, New York. 25 Henderson D.W., Roggli V.L, Shilkin K.B, Hammar S.P and Leigh J. Is Asbestosis an Obligate Precursor for Asbestos-Induced Lung Cancer? Fiber Burden and the Changing Balance ofEvidence:A Preliminary Discussion Document In: Peters GA, Peters BJ (eds^. Sourcebook on Asbestos Diseases Vol 11 Charlottesville:Michie (1995) pp 97-170. Henderson D.W., de Klerk N.H., Hammar S.P., Hillerdal G., Huuskonen M., Leigh J., Pott F., Roggli V.L., Shilkin K.B., Tossavainen A. (1997). Asbestos and Lung Cancer:is it attributable to asbestosis or to asbestos fibre burden? In: (B Corrin ed) Pathology of Lung Tumors.London:Churchill Livingston (1997) pp 83-118. Henderson D.W. and Leigh, J. (2000). Asbestos and Lung Cancer: A selective update to the Helsinki Criteria for individual attribution. Scand J Work Env Health (in press). Leigh J., Rogers A.J., Berry G., Ferguson D.A., Mulder H.B., Ackad M. (1990). Relationship between lung asbestos fibre type and concentration and relative risk of mesothelioma. XXIII International Congress on Occupational Health, Montreal, Canada, p 160. Leigh J., Corvalan C.F., Grimwood A., Berry G., Ferguson D.A., Thompson R (1991). The incidence of malignant mesothelioma in Australia 1982-1988. Am. J. Ind. Med. 20:643-655. Leigh J., Driscoll T., Baker G., Corvalan C. (1991). The Australian Mesothelioma Program Recent research results. J Occup Health Safety-Aust NZ, 7:365-371. Leigh J., Rogers A.J., Ferguson D.A., Mulder H.B., Ackad M., Thompson R. (1991). Lung asbestos fiber content and mesothelioma cell type, site, and survival. Cancer 68:135-141. Leigh J. (1991). The Australian Mesothelioma Program and Register. Proc. Worksafe Australia Asbestos Symposium, pp 9-17. Leigh J. (1992). Review of "Malignant mesothelioma". Henderson et al. (eds). Hemisphere, New York. Cancer Forum 16:176-177. Leigh J., Corvalan C.F., Copland P.I. (1993). The incidence of malignant mesothelioma in Australia 1982-92. Proceedings of the 8th International Conference on Occupational Lung Diseases (Prague), 1: 314-318. Leigh J., Corvalan C., Copland P. (1993). Malignant mesothelioma incidence in Australia 1982-1992. Proceedings of the 5th International Congress on Applied Mineralogy (Perth), pp 28-30. Leigh J., Hull B., Ruck L., Mandryk J., Rogers A.J. (1993). Lung asbestos fibre content by type and length and mesothelioma site and cell type. Proceedings of the 8th International Conference on Occupational Lung Diseases (Prague), 1:351-356. 26 Leigh J. (1994). The Australian Mesothelioma Program 1979-1994. In: Peters G.A., and Peters, B.J. (eds), The Current Status of the Asbestos Public Health Problem (Vol. 9, Sourcebook on Asbestos Diseases). N.H. Butterworth, pp 1-74. Leigh J. (1995). Mesotheibma: is asbestos the onycause?(letter). Med. J. Aust. 163: 105-106. Leigh J. and Davidson P (1995/ Malignant Mesothelioma in Australia 1982-1995. Proceedings of the 5th International Symposium of the ISSA Research Section (Bonn), pp 429-437. Leigh J. (1995). Malignant Mesothelioma in Australia 1982-1995. Epidemiology 6: S73. Leigh J. (1995). Malignant Mesothelioma in Australia 1982-1995. European Respiratory Journal 8 (Supp.19): 437. Leigh J, Davidson P, Hull B.P. (1996). Malignant mesothelioma in Australia 1945-1995. Epidemiology 7: S80. Leigh J. (1996/ Predicting future numbers of cases of asbestos related disease in Australia. Proc Worksafe National Scientific Symposium Asbestos Related Diseases . Setting the National Research Agenda Sydney, June 1996. Leigh J, Davidson P, Hull B. (1996). Malignant mesothelioma in Australia 1945 1995. Proc 30th Ann Meeting Int Ass Cancer Registries (Edinburgh). Leigh J, Berry G, de Klerk, NH, Henderson, DW. Asbestos-Related Lung Cancer. Apportionment of Causation and Damages to Asbestos and Tobacco Smoke. In: Peters GA, Peters BJ (eds). Sourcebook on Asbestos Diseases Vol 13 Charlottesville:Michie (1996) pp 141-166. Leigh J, Davidson P, Hull B. (1997/ Malignant mesothelioma in Australia 1945 1995. Proc Inhaled Particles VIII Ann Occ Hyg 41(Supp 1): 161-167. Leigh J, Davidson P, Hull B. (1998/ Malignant mesothelioma in Australia 1945 1997. Excerpta Medica ICS 1153 Adv. Prev. Occ. Resp. Dis. 299-302. Leigh J. (1997). MaiignantMesotheibma inAustraib 1945-1995. RACP Fellowship Affairs 16 (4): 29-32. Leigh J. (1997). Malignant Mesothelioma in Australia 1945-1995. Environmental Management and Health 8:177-178. Leigh J., Musk A.W., Robinson B.W.S. Mesothelioma in Australia. In: Mesothelioma (Robinson B.W.S. ed) Harwood Academic Chur Switzerland (1999). Leigh J. (1999). The end game for asbestos? RACP Fellowship Affairs 18 (3): 35-37. 27 Leigh J. (1999). Malignant mesothelioma in Australia 1945-1999. Proc 21st Annual Conference of International Association of Cancer Registries (Lisbon) absts p 48. Leigh J. (1999). Malignant mesothelioma in Australia 1945-1999. Proc 5th Meeting Int Mesothelioma Interest Group (Grantham, UK) absts p 41. Leigh J. (2000). Malignant Mesothelioma in Australia 1945-1999. Aust. NZ J. Med. (in press). McNulty, J. C. (1962). Maiignantpleuralmesotheibma in an asbestos worker. Med. J. Aust. 2:953-954. Musk A.W., Dolin P.J., Armstrong B.K., Ford J.M., de Klerk N.H., Hobbs M.S. (1989). The incidence of malignant mesothelioma in Australia 1947-1980. Med. J. Aust. 150:242-246. Musk A.W., de Klerk N.H., Eccles J.L., et al. (1992). Wittenoom, Western Australia: A modern industrial disaster. Am. J. Ind. Med. 21:735-747. National Institute of Occupational Health and Safety - Epidemiology and Surveillance Unit. Mesothelioma Reports 1989, 1990, 1991, 1992, 1993, 1994, 1995, 1996, 1997, 1998, 1999 (Annual series). Canberra, AGPS. Rogers A.J., Leigh J., Berry G., Ferguson D.A., Mulder H.B., Ackad M., Morgan G.G. (1994). Dose-response relationship between airborne and lung asbestos fibre type, length and concentration and the relative risk of mesothelioma. Inhaled particles VII. Ann. Occup. Hyg., 38 (Supp 1): 631-638. Rogers A.J. (1984). Determination of mineral fibre in human tissue by light microscopy and transmission electron microscopy. Ann. Occup. Hyg. 28:1-12. Rogers A.J., Leigh J., Berry G., Ferguson D.A., Mulder H.B., Ackad M. (1991). Relationship between lung asbestos fiber type and concentration and relative risk of mesothelioma - A casecontrol study. Cancer 67:1912-1920. Rogers A.J. (1992). Predictions of mesothelioma in former Wittenoom asbestos workers (Letter). Br. J. Ind. Med. 49:451-452. Rogers A.J., Yeung P., Johnson A., Leigh J., Davidson, P. (1997). Trends in occupational groups and industries associated with Australian mesothelioma cases 1979-1995. Proc Inhaled Particles VIII Ann Occ Hyg 41(Supp 1)123-128. Rossiter C.E. (1987). Asbestos blues (Letter). Med. J. Aust. 147:162. Takahashi, K., Huuskonen, M. S., Tossavainen, A., Higashi, T., Okubo, T. and Rantanen, J. (1999). Ecological Relationship between Mesothelioma Incidence/Mortality and Asbestos Consumption in Ten Western Countries and Japan, J. Occup. Health 41: 8-11. 28