Document XOjz47dQbKqbQmk3Nngp18R14

COMMONWEALTH OF AUSTRALIA @>NOHSC National Occupat'.onal Health ft Safety Comrms&lon NATIONAL OCCUPATIONAL HEALTH AND SAFETY COMMISSION THE INCIDENCE OF MESOTHELIOMA IN AUSTRALIA 1997 to 1999 AUSTRALIAN MESOTHELIOMA REGISTER REPORT 2002 May 2002 Australian Mesothelioma Register Location: Level 6 Alan Woods Building, 25 Constitution Avenue CANBERRA ACT 2600 Postal Address: GPO Box 1577, Canberra ACT 2601 Copyright Commonwealth of Australia 2002 ISBN 0 642 70593 3 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, InfoAccess Network, GPO Box 1920, Canberra City, ACT 2601. The suggested citation is: The Incidence of Mesothelioma in Australia 1997 to 1999 AUSTRALIAN MESOTHELIOMA REGISTER REPORT 2002. National Occupational Health and Safety Commission: May 2002. n CONTENTS Executive Summary Introduction Asbestos production and use in Australia The Australian Mesothelioma program and register Statistics Figure 1 Incident cases of malignant mesothelioma in Australia 1945 - 1999. Figure 2 Age-specific incidence rates of malignant mesothelioma in Australian men, 1986 - 1999. Figure 3 Age-specific incidence rates of malignant mesothelioma in Australian women, 1986 - 1999. Table 1 Male cases of mesothelioma in Australia, 1997, by age and State Table 2 Female cases of mesothelioma in Australia, 1997, by age and State Table 3 Age-specific incidence rates for mesothelioma per million males in Australia, 1997, by age and State Table 4 Age-specific incidence rates for mesothelioma per million females in Australia, 1997, by age and State Figure 4 Crude incidence of mesothelioma in Australia, 1997, by age and sex Table 5 Male cases of mesothelioma in Australia, 1998, by age and State Table 6 Female cases of mesothelioma in Australia, 1998, by age and State Table 7 Age-specific incidence rates for mesothelioma per million males in Australia, 1998, by age and State Table 8 Age-specific incidence rates for mesothelioma per million females in Australia, 1998, by age and State Figure 5 Crude incidence of mesothelioma in Australia, 1998, by age and sex 1 2 2 3 4 5 6 7 8 8 9 9 10 11 11 12 12 13 iii Table 9 Table 10 Table 11 Table 12 Figure 6 Figure 7 Figure 8 Figure 9 Table 13 Table 14 Table 15 Table 16 Table 17 Table 18 Appendix A Male cases of mesothelioma in Australia, 1999, by age and State Female cases of mesothelioma in Australia, 1999, by age and State Age-specific incidence rates for mesothelioma per million males in Australia, 1999, by age and State Age-specific incidence rates for mesothelioma per million females in Australia, 1999, by age and State Crude incidence of mesothelioma in Australia, 1999, by age and sex Cases of mesothelioma in Australia, 1997 - 1999, by site of primary lesion Trends in Australian incidence of mesothelioma per million persons, by State, 1982 - 1999 Trends in Australian incidence of mesothelioma per million persons, by sex, 1982 - 1999 Number of mesothelioma cases associated with a past asbestos exposure and industry in Australia, 1997-1999 Number of work-related, mesothelioma cases and industry in Australia, 1997-1999 Number of mesothelioma cases classified by occupation and industry in Australia, 1997-1999 Number of mesothelioma cases associated with a past asbestos exposure and occupation in Australia, 1997-1999 Number of work-related, mesothelioma cases and occupation in Australia, 1997-1999 Number of work-related, mesothelioma cases associated with a past exposure to asbestos in Australia, 1997-1999 Asbestos exposures as documented in the Australian Mesothelioma Register, from 1 January 1986 to 31 December 2001 iv 14 14 15 15 16 17 18 19 20 20 21 22 22 23 24 Appendix B List of Publications Australian Mesothelioma Register Notification Form 29 30 v EXECUTIVE SUMMARY This publication is the fourteenth report of the Australian Mesothelioma Register (the Register), produced by the Epidemiology Unit of the National Occupational Health and Safety Commission (NOHSC). Mesothelioma is a fatal form of cancer usually with a very long period between exposure and diagnosis. Long-term data from the Register indicates that: (a) the incidence rates of malignant mesothelioma have been increasing in Australia since 1965. It is believed that these high rates of mesothelioma are related to the extensive use and production of asbestos in Australia in previous decades; (b) mesothelioma incidence rates are higher in males than females, possibly because of a higher exposure in male-dominated industries that produced or used asbestos (e.g. construction and manufacturing); (c) the 50-64, 65-79 and 80 plus age groups have the highest age-specific incidences of mesothelioma; (d) year-to-year fluctuations in age-specific mesothelioma incidence rates are lower in persons younger than 64 years than in older persons; and (e) most Australian mesothelioma cases are cancerous lesions of the pleura. Mesothelioma cases affecting the peritoneum and other sites are fewer. Based on the malignant mesothelioma cases recorded in 1997-99: (a) there is no indication of when the incidence rates of mesothelioma will start to decline in Australia; (b) incidence rates of malignant mesothelioma continue to be the highest in males, especially in SA and WA. The NT, the ACT and TAS have incidence rates below the national average while NSW, QLD and VIC have incidence rates approximating to the national average of 60 cases per million males; and (c) incidence rates of mesothelioma in SA are now higher than what they were previously, especially in males aged 75 years and above. SA now has the highest incidence rate for malignant mesothelioma cases for (92-118 per million males) in Australia, which is higher than the national average (60 cases per million males). It is not clear however, whether this indicates a genuine divergence from other jurisdictions or changes in the consistency of reporting in different jurisdictions. Since 1986 the Register has received 5,546 notifications of mesothelioma. About 88% of these cases were linked to a previous exposure to asbestos. Cases of mesothelioma reported to the Register in 1997 1999 were used to study occupational exposure to asbestos, given industry and occupation, with the view to improve efficiency in monitoring mesothelioma. The Australian and New Zealand Standard Industrial Classification (ANZSIC) (ABS 1993) and the Australian Standard Classification of Occupations (ASCO) (ABS 1997) coding systems were used to code for industry and occupation, respectively. About 50 cases from VIC were excluded from the study because of a lack of information on industry, occupation and other information necessary to determine work-relatedness and asbestos exposure. The study found that: (a) About 50% of the cases were uncodeable for industry and occupation; (b) Close to 45-49% of the cases were uncodeable for occupational asbestos exposure and work relatedness; (c) A third of the persons that were exposed to asbestos worked in the Construction industry and a quarter worked in the Manufacturin g industry; (d) Of the mesothelioma cases with a past asbestos exposure, close to 90% were work-related, about 2% were not work-related and the rest (9%) could not be classified; (e) Of the persons with work-related mesothelioma, one in three had worked in the Construction industry and one in five had worked in the Manufacturing industry. Workers in the Cultural and Recreational Services industry had the fewest cases of occupational mesothelioma; and (f) Most occupational asbestos exposures occurred among Tradespersons/Related workers, Labourers/Related workers or Intermediate Production/Transport workers. In general, Service workers (e.g. Advanced Clerical/Service workers and Elementary Clerical workers) had the fewest cases of occupational asbestos exposures. 1 INTRODUCTION This document is the fourteenth report of the Australian Mesothelioma Register, produced by the Epidemiology Unit of 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 the world's highest incidence rate (Takahashi et al, 1999, Tossavainen and Takahashi, 2000). 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 from 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 the 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 1,500 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). On 17 October 2001, NOHSC declared a prohibition on the use of chrysotile asbestos in Australia. The prohibition will take effect simultaneously under regulations in each Australian OHS jurisdiction by no later than 31 December 2003. 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). 2 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 or 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 - 2001). Recent reviews are available (Leigh, 1994, Leigh et al 1998, 2001). This report includes data on cases notified to the register and diagnosed in 1997, 1998 and 1999. Reconciliation with all State cancer registries has been carried out, but some initial under-reporting for 1999, 2000 and 2001 might be expected because of the relocation of the Register from Sydney to Canberra 2001 and recent changes in privacy legislation. Full analysis of incidence in 2000, 2001 and 2002 awaits reconciliation checks with State cancer registries. However, notifications for 2000, 2001 and 2002 (to 31 March 2002) were respectively 490, 685 and 82. NOHSC acknowledges the continued cooperation of the notification network. 3 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 1997, 1998 and 1999 (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 0.36 in table 3 for NSW (males) under CR indicates a 0.36% or 0.0036 lifetime (20-75) risk of developing mesothelioma. Therefore, the chance of developing mesothelioma between the ages 20-75 is approximately 1 in 275. * "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 (27 March 2002) 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. 4 Figure 1 Incident cases of malignant mesothelioma in Australia, 1945 - 1999 Year of diagnosis 5 Figure 2 Age-specific incidence rates of malignant mesothelioma in Australian men, 1986 - 1999 Year of diagnosis 6 Figure 3 Age-specific incidence rates of malignant mesothelioma in Australian women, 1986 - 1999 Year of diagnosis 7 Table 1 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 + All ages MALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1997, BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 0 00 00 0 0 00 0 00 00 0 0 00 0 00 00 0 0 00 1 0001 00 02 1 1 001 00 03 401 01 0 0 06 7 4 11 1 1 1 0 0 25 8 5 9 3 5 0 0 0 30 13 15 13 2 10 0 0 0 53 16 16 12 6 11 00 0 61 37 22 12 10 9 1 0 0 91 23 12 10 7 15 0 0 0 67 11 12 4 5 4 0 0 0 36 5 4 1 1 2 3 0 0 16 126 91 73 35 60 5 0 0 390 Table 2 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 + All ages FEMALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1997, BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 0 00 00 0 0 00 000 1 0 00 01 0 1 000 00 01 0 00 00 0 0 00 0 00 00 0 0 00 1 3 3 00 00 07 02 2 30 00 07 341 01 0 0 09 4 00 2 2 0 0 08 1 201 000 1 5 7 6 1 1 1 0 0 1 17 6 1 2 1 1 0 0 0 11 1 1 001 00 03 021 1 0001 5 23 22 10 10 6 0 0 3 74 8 Table 3 AGE-SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION MALES IN AUSTRALIA, 1997, BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25-29 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 30-34 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35-39 4.0 0.0 0.0 0.0 13.7 0.0 0.0 0.0 2.7 40-44 4.3 5.9 0.0 0.0 14.3 0.0 0.0 0.0 4.4 45-49 18.4 0.0 8.2 0.0 15.2 0.0 0.0 0.0 9.2 50-54 37.0 29.4 105.6 22.3 18.5 70.4 0.0 0.0 44.9 55-59 54.1 46.3 113.1 86.3 121.5 0.0 0.0 0.0 69.3 60-64 103.5 164.0 203.5 65.5 306.5 0.0 0.0 0.0 147.1 65-69 134.9 186.1 205.4 201.7 372.8 0.0 0.0 0.0 181.3 70-74 372.4 307.3 246.6 379.9 378.9 131.8 0.0 0.0 323.7 75-79 339.3 251.3 297.8 390.9 979.5 0.0 0.0 0.0 352.9 80-84 288.9 431.4 211.6 479.3 444.0 0.0 0.0 0.0 331.8 85 + 230.7 236.4 88.8 166.6 348.2 1 743.2 0.0 0.0 250.0 All ages SI CR Lifetime risk 1 in: 56.7 45.4 0.36 275 55.9 46.4 0.37 271 61.1 56.7 0.44 227 66.2 46.6 0.38 265 94.6 88.6 0.62 161 30.7 24.8 0.10 989 0.0 0.0 0.00 - 0.0 0.0 0.00 - 59.6 50.4 0.39 256 Table 4 AGE-SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION FEMALES IN AUSTRALIA, 1997, BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25-29 0.0 0.0 0.0 18.6 0.0 0.0 0.0 0.0 1.4 30-34 0.0 5.5 0.0 0.0 0.0 0.0 0.0 0.0 1.4 35-39 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 40-44 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 45-49 4.7 18.8 25.6 0.0 0.0 0.0 0.0 0.0 10.9 50-54 0.0 15.0 20.3 67.2 0.0 0.0 0.0 0.0 13.1 55-59 20.8 37.6 13.4 0.0 25.6 0.0 0.0 0.0 21.4 60-64 31.5 0.0 0.0 63.7 61.6 0.0 0.0 0.0 22.0 65-69 8.0 22.0 0.0 31.8 0.0 0.0 0.0 253.0 14.2 70-74 59.6 69.9 18.4 32.2 37.8 0.0 0.0 276.5 51.8 75-79 65.5 15.2 46.4 40.7 48.9 0.0 0.0 0.0 43.0 80-84 15.7 21.5 0.0 0.0 67.5 0.0 0.0 0.0 16.8 85 + 0.0 50.3 41.4 68.8 0.0 0.0 0.0 800.0 33.5 All ages SI CR Lifetime risk 1 in: 10.0 7.6 0.06 1605 12.8 10.5 0.08 1185 8.2 6.9 0.04 2579 18.0 16.2 0.11 936 9.4 8.5 0.06 1600 9 0.0 0.0 0.00 - 0.0 0.0 0.00 - 27.2 28.5 0.26 378 10.9 9.0 0.07 1468 Figure 4 Crude incidence of mesothelioma in Australia, 1997, Incidence per million by age and sex Males Age in years --I-- Females 10 Table 5 MALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1998, BY AGE AND STATE NSW VIC QLD SA WA TAS NT 20-24 0 0 0 0 0 0 0 25-29 0 0 0 0 0 0 0 30-34 0 0 0 0 0 0 0 35-39 1 0 1 0 1 0 0 40-44 2 1 0 1 0 0 0 45-49 2 5 1 0 0 0 0 50-54 8 16 2 3 2 0 0 55-59 15 6 10 5 7 0 0 60-64 9 7 15 14 12 1 0 65-69 29 15 9 2 13 2 0 70-74 19 21 7 6 10 2 0 75-79 19 14 13 7 6 0 0 80-84 14 10 6 3 4 0 0 85 + 641 8200 All ages 124 99 65 49 57 5 0 ACT AUST 00 00 00 03 04 08 0 31 0 43 0 58 1 71 0 65 0 59 0 37 0 21 1 400 Table 6 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 + All ages FEMALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1998, BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 000000 000 000000 000 000000 000 000000 000 1 00000 001 1 3 021 0 007 1 00201 004 2 1 0000 003 4 1 201 1 009 2 4 01 20 009 1 2 1 1 1 0 006 5 1 1 1 1 0 009 2 1 1 020 006 1 1 0000 002 20 14 5 7 8 2 0 0 56 11 Table 7 AGE-SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION MALES IN AUSTRALIA, 1998, 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 + All ages SI CR Lifetime risk 1 in: 0.0 0.0 0.0 3.9 8.5 9.1 39.9 98.8 71.6 246.9 188.7 266.0 360.6 260.6 0.0 0.0 0.0 0.0 5.8 31.5 111.4 54.2 76.5 175.9 287.3 277.0 358.2 221.0 0.0 0.0 0.0 7.4 0.0 8.1 18.0 121.0 234.8 154.0 141.0 368.6 307.5 82.3 0.0 0.0 0.0 0.0 18.1 0.0 63.8 139.1 458.5 68.4 225.0 371.3 284.7 1237.4 0.0 0.0 0.0 13.4 0.0 0.0 34.5 164.1 367.8 439.7 412.2 363.7 447.4 333.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 104.3 222.8 259.6 0.0 0.0 0.0 55.2 45.1 0.33 300 60.0 49.5 0.37 269 53.5 48.6 0.34 292 92.1 76.8 0.49 206 88.1 88.0 0.72 140 30.7 26.7 0.29 341 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.0 0.0 0.0 5.7 0.0 0.0 1 2.2 0.0 0.0 52.4 0.0 0.0 96.4 0.0 0.0 161.0 0.0 263.8 212.4 0.0 0.0 227.3 0.0 0.0 294.2 0.0 0.0 336.1 0.0 0.0 307.5 0.0 0.0 0.00 - 9.4 13.2 0.13 758 60.4 52.2 0.39 259 Table 8 AGE-SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION FEMALES IN AUSTRALIA, 1998, 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 + All ages SI CR Lifetime risk 1 in: 0.0 0.0 0.0 0.0 4.2 4.6 5.2 13.5 31.0 16.2 8.5 52.4 31.1 18.3 0.0 0.0 0.0 0.0 0.0 18.6 0.0 9.2 10.5 44.4 23.2 14.4 21.6 24.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 31.3 0.0 18.1 22.2 33.1 0.0 0.0 0.0 0.0 0.0 0.0 37.7 42.3 0.0 0.0 32.4 32.5 38.9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15.5 0.0 0.0 29.9 66.4 37.2 46.3 136.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 68.6 0.0 100.2 0.0 0.0 0.0 0.0 0.0 8.6 6.7 0.04 2402 8.1 6.8 0.05 1889 4.0 3.3 0.02 12.5 10.6 0.07 4045 1380 12.3 10.0 0.07 1343 11.6 12.4 0.08 1185 12 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 0.00 - 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.0 10.8 0.0 7.0 0.0 7.0 0.0 24.3 0.0 25.8 0.0 18.2 0.0 33.6 0.0 33.3 0.0 12.8 0.0 0.0 0.00 8.2 6.7 0.05 - 2117 Figure 5 Crude incidence of mesothelioma in Australia, 1998, Incidence per million by age and sex Age in years *-- Males --I-- Females 13 Table 9 MALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1999, BY AGE AND STATE NSW VIC QLD SA WA TAS NT 20-24 0 1 0 0 0 0 0 25-29 0 0 0 0 0 0 0 30-34 0 0 0 0 1 0 0 35-39 1 1 0 0 0 0 0 40-44 0 1 1 1 2 0 0 45-49 2 1 2 0 0 0 0 50-54 4 8 3 2 7 0 0 55-59 5 6962 1 0 60-64 9 11 10 11 60 0 65-69 20 11 10 11 10 0 0 70-74 19 13 5 10 9 1 0 75-79 22 9 8 12 8 0 0 80-84 12 6 4 6 9 1 0 85 + 6274200 All ages 100 70 59 63 56 3 0 ACT AUST 01 00 01 02 05 05 3 27 0 29 0 47 2 64 2 59 1 60 0 38 0 21 8 359 Table 10 FEMALE CASES OF MESOTHELIOMA IN AUSTRALIA, 1999, BY AGE AND STATE NSW VIC QLD SA WA TAS NT ACT AUST 20-24 0 0 0 0 0 0 0 0 0 25-29 0 0 0 0 0 0 0 0 0 30-34 1 0 0 0 0 0 0 0 1 35-39 0 1 0 0 0 0 0 0 1 40-44 0 0 0 0 0 0 0 0 0 45-49 2 1 0 0 0 0 0 0 3 50-54 0 2 2 2 0 0 0 0 6 55-59 3 3 0 3 1 0 0 0 10 60-64 1 3 1 2 0 0 0 0 7 65-69 1 0 0 1 0 0 0 0 2 70-74 5 5 1 1 3 0 0 0 15 75-79 5 5 3 0 3 0 0 0 16 80-84 1 1 3 2 0 0 0 0 7 85 + 1 1 1 000 003 All ages 20 22 11 11 7 0 0 0 71 14 Table 11 AGE-SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION MALES IN AUSTRALIA, 1999, 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 + All ages SI CR Lifetime risk 1 in: 0.0 0.0 0.0 3.9 0.0 9.0 19.4 31.5 68.9 172.0 186.5 292.3 304.3 244.4 5.7 0.0 0.0 5.4 5.7 6.2 53.9 52.3 116.0 129.3 175.7 166.9 214.7 103.2 0.0 0.0 0.0 0.0 7.7 16.1 25.9 103.0 144.8 170.8 98.5 215.1 201.6 543.6 0.0 0.0 0.0 0.0 18.0 0.0 41.0 161.4 352.0 381.4 372.8 601.4 568.2 577.6 0.0 0.0 14.1 0.0 27.8 0.0 115.5 44.6 169.7 337.4 363.7 452.4 1010.3 312.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 82.7 0.0 0.0 128.5 0.0 323.4 0.0 43.9 33.9 0.25 41.7 36.0 0.28 47.6 42.7 0.28 117.6 90.5 0.66 84.7 75.7 0.54 18.4 12.5 0.11 407 363 353 151 186 947 0.0 0.0 1.4 0.0 0.0 0.0 0.0 0.0 1.4 0.0 0.0 2.7 0.0 0.0 7.1 0.0 0.0 7.5 0.0 282.1 44.1 0.0 0.0 62.2 0.0 0.0 124.1 0.0 514.9 192.4 0.0 644.3 203.4 0.0 442.5 282.4 0.0 0.0 342.1 0.0 0.0 288.1 0.0 0.0 0.00 73.9 78.1 0.72 53.3 44.5 0.32 139 309 Table 12 AGE-SPECIFIC INCIDENCE RATES FOR MESOTHELIOMA PER MILLION FEMALES IN AUSTRALIA, 1999, 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 + All ages SI CR Lifetime risk 1 in: 0.0 0.0 4.2 0.0 0.0 9.1 0.0 19.5 7.6 8.2 42.7 49.8 15.6 17.3 0.0 0.0 0.0 5.3 0.0 6.1 13.5 26.5 31.0 0.0 58.3 68.1 21.9 23.0 0.0 0.0 0.0 0.0 0.0 0.0 18.1 0.0 15.0 0.0 17.9 63.9 98.6 36.7 0.0 0.0 0.0 0.0 0.0 0.0 40.8 80.7 61.6 32.7 32.7 0.0 117.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 23.8 0.0 0.0 110.4 131.4 0.0 0.0 8.5 6.1 0.05 12.5 9.6 0.07 8.7 5.3 0.03 19.6 16.6 0.12 10.6 7.5 0.07 2191 1421 3919 805 1490 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 0.00 - 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 0.00 - 0.0 0.0 0.0 0.0 0.0 1.4 0.0 1.3 0.0 0.0 0.0 4.5 0.0 10.1 0.0 22.2 0.0 18.5 0.0 5.8 0.0 45.5 0.0 56.8 0.0 39.2 0.0 18.2 0.0 0.0 0.00 10.2 7.5 0.05 - 1829 15 Figure 6 Crude incidence of mesothelioma in Australia, 1999, Males --I-- Females 16 Figure 7 Cases of mesothelioma in Australia, 1997 - 1999, by site of primary lesion No. of cases Site of lesion 17 Figure 8 Trends in Australian incidence of mesothelioma per million persons by State, 1982 - 1999 Incidence per million Standardised to World Population 20 years of age or greater 18 Figure 9 Trends in Australian incidence of mesothelioma per million persons by sex, 1982 - 1999 Incidence per million Standardised to World Population 20 years of age or greater 19 Table 13 NUMBER OF MESOTHELIOMA CASES ASSOCIATED WITH A PAST ASBESTOS EXPOSURE AND INDUSTRY IN AUSTRALIA, 1997-1999 Industry Asbestos exposure Uncodeable Construction Manufacturing Government Administration/Defence Communication/Finance/Insurance Transport/Storage Mining Retail Trade Electricity/Gas/Water Agriculture/Forestry/Fishing Cultural/Recreational Services Total Yes 73 161 141 52 26 38 22 17 18 11 8 567 Possibly 43 12 13 4 11 5 2 3 0 3 1 97 No Unknown 11 547 7 15 55 46 79 11 21 32 00 20 00 42 586 Total 673 195 164 66 53 45 27 25 18 16 9 1292 Table 14 NUMBER OF WORK-RELATED, MESOTHELIOMA CASES AND INDUSTRY IN AUSTRALIA, 1997 -1999 Industry Work-related Yes No Unknown Uncodeable 20 24 630 Construction 194 0 1 Manufacturing 164 0 0 Government Administration/Defence 64 1 1 Communication/Finance/Insurance 53 0 0 Transport/Storage 45 0 0 Mining 27 0 0 Retail Trade 25 0 0 Electricity/Gas/Water 18 0 0 Agriculture/Forestry/Fishing 16 0 0 Cultural/Recreational Services 80 1 Total 634 25 633 Total 673 195 164 66 53 45 27 25 18 16 9 1292 20 Table 15 NUMBER OF MESOTHELIOMA CASES CLASSIFIED BY OCCUPATION AND INDUSTRY IN AUSTRALIA, 1997- 1999 Industry Uncodeable Uncodeable Construction Manufacturing Government Administration/ Defence Communication/ Finance/Insurance Transport/Storage Mining Retail Trade Electricity/Gas/ Water Agriculture/Forestry/ Fishing Cultural/Recreational Services Total 655 1 3 4 0 0 0 0 1 1 0 665 Managers/ Administrators 1 21 4 Professionals 5 4 10 Associate Professionals 1 2 0 Occupation Tradespersons / Related workers Advanced Clerical/ Service workers 40 142 0 86 1 Intermediate Clerical/ Sales/ Service workers 0 1 3 3 14 17 18 0 5 5 10 6 54 12 0 20 51 0 0 10 00 1 0 0 6 12 0 2 0 2 0 12 0 0 8 00 00 0 0 11 20 1 42 49 33 286 6 25 Intermediate Production/ Transport workers 2 8 18 3 1 12 19 2 2 1 1 69 Elementary Clerical/ Labourers/ Sales/ Related Total Service workers workers 0 6 673 3 13 195 0 39 164 0 2 66 6 4 53 1 24 45 0 6 27 2 1 25 0 1 18 0 6 16 2 19 14 103 1292 21 Table 16 Occupation NUMBER OF MESOTHELIOMA CASES ASSOCIATED WITH A PAST ASBESTOS EXPOSURE AND OCCUPATION IN AUSTRALIA, 1997-1999 Asbestos exposure Yes Possibly No Unknown Uncodeable Tradespersons/Related workers 71 40 11 543 241 21 8 16 Labourers/Related workers Intermediate Production/Transport workers 88 61 10 4 3 2 2 2 Professionals 35 5 4 5 Managers/Administrators 25 6 3 8 Associate Professionals 25 3 1 4 Intermediate Clerical/Sales/Service workers 12 5 5 3 Elementary Clerical/Sales/Service workers 7 3 2 2 Advanced Clerical/Service workers 203 1 Total 567 97 42 586 Total 665 286 103 69 49 42 33 25 14 6 1292 Table 17 Occupation NUMBER OF WORK-RELATED, MESOTHELIOMA CASES AND OCCUPATION IN AUSTRALIA, 1997-1999 Work-related Yes No Unknown Uncodeable 8 25 632 Tradespersons/Related workers 286 0 0 Labourers/Related workers 103 0 0 Intermediate Production/Transport workers 69 0 0 Professionals 49 0 0 Managers/Administrators 42 0 0 Associate Professionals 33 0 0 Intermediate Clerical/Sales/Service workers Elementary Clerical/Sales/Service 25 0 0 workers 13 0 1 Advanced Clerical/Service workers 6 0 0 Total 634 25 633 Total 665 286 103 69 49 42 33 25 14 6 1292 22 Table 18 NUMBER OF WORK-RELATED, MESOTHELIOMA CASES ASSOCIATED _______________ WITH A PAST EXPOSURE TO ASBESTOS IN AUSTRALIA, 1997-1999 Asbestos exposure Unknown Work-related Yes No Unknown Yes Possibly No 536 52 37 8 43 7 503 12 57 3 31 3 Total 633 634 25 Total 586 567 97 42 1292 23 APPENDIX A ASBESTOS EXPOSURES AS DOCUMENTED IN THE AUSTRALIAN MESOTHELIOMA REGISTER FROM 1 JANUARY 1986 TO 31 DECEMBER 2001 Circumstances of exposure Single exposure Acoustic engineer Air-conditioning Aircraft Armed forces / wartime Armed forces / peacetime Asbestos bagging (not Wittenoom) Asbestos bags - handled which had contained asbestos 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 Bricklayer Brickworks Builder / builder's labourer Carpenter / joiner Cement factory worker 1 13 11 29 7 8 8 9 3 71 29 11 11 13 45 107 50 10 47 3 86 59 1 15 8 197 234 20 With other exposure 0 14 5 19 3 4 0 4 0 14 9 2 0 7 9 39 13 4 6 0 62 19 0 5 3 43 49 2 Total exposures 1 27 16 48 10 12 8 13 3 85 38 13 11 20 54 146 63 14 53 3 148 78 1 20 11 240 283 22 24 Circumstances of exposure Chemical engineer Civil engineer Coal miner Concreting Construction worker Demolition Design engineer Diesel engineer Dockyard worker Electrical engineer Electrical fitter Electrical mechanic Electrician Electroplater Engineer Fireproofing Fire doors Fire fighter Fitter / turner Flour miller Foundry Furnace Glassworks / glaziers Industrial chemist Industrial engineer Instrument technician Insulation Jeweller Knitting mill worker Laboratory technician Labourer Lagger Lagging in workplace Laundry / drycleaners Linesman Locksmith APPENDIX A continued Single exposure 1 7 1 7 15 5 2 0 41 7 15 3 59 0 30 5 5 6 56 1 6 6 6 5 2 1 19 7 1 8 33 31 24 14 9 1 With other exposure 0 0 0 3 2 2 1 1 23 8 4 0 17 1 1 0 0 3 23 0 2 0 0 0 0 0 4 2 0 3 17 16 5 5 4 0 Total exposures 1 7 1 10 17 7 3 1 64 15 19 3 76 1 31 5 5 9 79 1 8 6 6 5 2 1 23 9 1 11 50 47 29 19 13 1 25 APPENDIX A continued Circumstances of exposure Single exposure 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 Moulder Navy Oil refinery Painter / decorator Panel beater Paper mill Patternmaker Pipes - handled / cut / stored / drilled Plasterer Plumbing Power station worker Pressure pack manufacturer Printing Radiographer Railways Renovations / maintenance / lagging in workplace Roofing Rubber manufacturing 3 2 1 4 3 2 4 13 3 12 11 7 8 3 3 1 4 162 7 40 9 3 6 25 18 60 88 1 10 2 102 21 17 0 With other exposure 1 0 5 0 1 1 1 5 2 3 8 0 5 0 1 0 1 66 3 8 2 2 3 6 7 28 52 0 3 0 50 5 4 1 Total exposures 4 2 6 4 4 3 5 18 5 15 19 7 13 3 4 1 5 228 10 48 11 5 9 31 25 88 140 1 13 2 152 26 21 1 26 APPENDIX A continued Circumstances of exposure Sheet metal 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 Truck driver - general Tyre factory Waterside worker Weighing trucks Welder Whitewash - Greece / Cyprus Wine making (filters) Wittenoom Wood machinist Wood chipper Single exposure 14 76 2 8 1 13 18 2 6 2 6 13 4 17 14 17 1 10 96 1 23 4 1 194 4 1 With other exposure 12 59 0 7 0 8 0 0 4 0 3 1 2 3 6 3 0 4 13 0 9 1 0 60 0 0 Total exposures 26 135 2 15 1 21 18 2 10 2 9 14 6 20 20 20 1 14 109 1 32 5 1 254 4 1 27 SUMMARY OF ASBESTOS EXPOSURES Asbestos exposure single multiple possible No apparent asbestos exposure No response to questionnaire Total cases from 1/1/86 - 31/12/2001 2,800 400 281 475 1,590 5,546 Respondents with asbestos exposure Total respondents Percentage respondents with asbestos exposure 3,481 5,546 88% 28 APPENDIX B NATIONAL OCCUPATIONAL HEALTH AND SAFETY COMMISSION AUSTRALIAN MESOTHELIOMA REGISTER NOTIFICATION Please direct all correspondence to: The Registrar Australian Mesothelioma Register, National Occupational Health and Safety Commission, GPO Box 1577 Canberra ACT 2600 Telephone: (02) 6279 1005 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 YEAR INDUSTRY 1........................................................ 1......................................... 2........................................................ 2......................................... 3....................................................... 3......................................... KNOWN ASBESTOS EXPOSURE: YES / NO If "YES" please indicate circumstances and duration: 19 - 19 19 - 19 19 - 19 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: 29 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. (1991). Prediction of mesothelioma, lung cancer, and asbestosis in former Wittenoom asbestos workers. Br. J. Ind. Med. 48:793-802. 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. 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., 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. 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. Ferguson D.A. (1989). Malignant mesothelioma - the rising epidemic (Letter). Med. J. Aust.150:233- 235. Ferguson D.A. (1990). Low-level asbestos - the priorities are wrong (Letter). Med. J. Aust. 152:617-618. 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., 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 pp 83-118. 30 Henderson D.W., Leigh, J. (2000). Asbestos and Lung Cancer: A selective update to the Helsinki Criteria for individual attribution. In: People and Work Research Reports. FIOH.Helsinki 36:3-18. Henderson D.W., Roggli V.L, Shilkin K.B, Hammar S.P and Leigh J. (1995) Is Asbestosis an Obligate Precursor for Asbestos-Induced Lung Cancer? Fiber Burden and the Changing Balance of Evidence:A Preliminary Discussion Document In: Peters G.A., Peters B.J. (eds). Sourcebook on Asbestos Diseases Vol 11 Charlottesville:Michie pp 97-170. Henderson D.W., Shilkin K.B., Langlois S. Le P., Whitaker D. (eds). (1992). Malignant mesothelioma. Hemisphere, New York. Kjellstrom T., Smartt P. (2000). Increased mesothelioma incidence in New Zealand in the asbestos-cancer epidemic has started. NZ. Med. J. 113:485-490. 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. (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). 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. (1995). Mesothelioma: is asbestos the only cause? (letter). Med. J. Aust. 163: 105 106. 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. (1997). Malignant Mesothelioma in Australia 1945-1995. Environmental Management and Health 8:177-178. Leigh J. (1997). Malignant Mesothelioma in Australia 1945-1995. RACP Fellowship Affairs 16 (4): 29-32. Leigh J. (1999). Malignant mesothelioma in Australia 1945-1999. Proc 21st Annual Conference of International Association of Cancer Registries (Lisbon) Absts. p 48. 31 Leigh J. (1999). Malignant mesothelioma in Australia 1945-1999. Proc 5th Meeting Int Mesothelioma Interest Group (Grantham, UK) Absts. p 41. Leigh J. (1999). The end game for asbestos? RACP Fellowship Affairs 18 (3): 35-37. Leigh J. (2000). Malignant Mesothelioma in Australia 1945-2000. Europ. Resp. J. 16 (Supp. 31): 350. Leigh J. (2000). Malignant Mesothelioma in Australia 1945-2000. Respirology 5 (Supp.) :A59. Leigh J. (2001). Asbestos-related diseases: International estimates of future liability. Proc. Int. Cong. Work Injuries Prev., Rehab., Compensation (Workcongress5) Adelaide Absts. p 102. Leigh J. (2001). Global future liability for asbestos-related disease. Proc. RACP Annual Scientific Meeting. Sydney Absts. p 63. Leigh J. (2001). Malignant mesothelioma in Australia (1945-2000). Int. J. Occ. Env. Health 7(3) Supp :S34. Leigh J., Berry G., de Klerk, N.H., Henderson, D.W. (1996). Asbestos-Related Lung Cancer. Apportionment of Causation and Damages to Asbestos and Tobacco Smoke. In: Peters G.A., Peters B.J. (eds). Sourcebook on Asbestos Diseases Vol 13 Charlottesville:Michie pp 141 -166. Leigh J., Corvalan C., Copland P.I. (1993). Malignant mesothelioma incidence in Australia 1982-1992. Proceedings of the 5th International Congress on Applied Mineralogy (Perth), pp 28-30. 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.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., 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., Davidson P., Hendrie L., Berry D. (2002). Malignant Mesothelioma in Australia (1945-2000). Am. J. Ind. Med. 41:188-201. Leigh J., Davidson P., Hendrie L., Berry D. (2001). Malignant Mesothelioma in Australia (1945-2000). J. Occ. Health and Safety (ANZ) 17:453-470. Leigh J., Davidson P., Hull B.P. (1996). Malignant mesothelioma in Australia 1945-1995. Epidemiology 7: S80. 32 Leigh J., Davidson P, Hull B.P. (1996). Malignant mesothelioma in Australia 1945 1995. Proc. 30th Ann. Meeting Int. Ass. Cancer Registries (Edinburgh). Leigh J., Davidson P., Hull B.P. (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.P. (1998). Malignant mesothelioma in Australia 1945 1997. Excerpta Medica ICS 1153 Adv. Prev. Occ. Resp. Dis. 299-302. 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., 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. Leigh J., Robinson B.W.S. (2001). The History of Mesothelioma in Australia 1945-2000. In: Mesothelioma (Robinson B.W.S., Chahinian P. eds) London: Taylor and Francis pp 55-87. 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., 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. McNulty, J. C. (1962). Malignant pleural mesothelioma in an asbestos worker. Med. J. Aust. 2:953-954. 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. 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. National Institute of Occupational Health and Safety - Epidemiology and Surveillance Unit. Mesothelioma Reports 1989, 1990, 1991, 1992, 1993, 1994, 1995, 1996, 1997, 1998, 1999, 2000, 2001 (Annual series). Canberra, AGPS. 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. (1992). Predictions of mesothelioma in former Wittenoom asbestos workers (Letter). Br. J. Ind. Med. 49:451-452. 33 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 case-control study. Cancer 67:1912-1920. 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., 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. Tossavainen A., Takahashi K. (2000). Epidemiological trends for asbestos-related cancers, In: People and Work Research Reports. FIOH.Helsinki 36: 26-30. World Trade Organisation. (2000). European Communities - Measures affecting asbestos and asbestos-containing products. Report of the panel. WT/DS135/R 15 September 2000. Yeung P., Rogers A. (2001). An Occupation-Industry Matrix Analysis of Mesothelioma Cases in Australia 1980-1985. App. Occ. Env. Hyg. 16:40-44. 34