Document XdbX1LMqdJE0KEnb1n9Kxx2R

Mesothelioma register J967-48 99 (0 subjects with pcs of asbestos vnown, 45 had e group of 12 mesothelioma' they had been en exposed to between these : mesothelioma o chrysotile. A -lined in seven is, but six of tos. It was not .- tale to which ional exposure i h the presence xstos fibres or or radiologinleston (1973) ist microscopy g for asbestos .ques does not (Rous and however, to : exposure uootheliomas . definitely not as'corTOborst found in the tries. Of those exposure (six ures. Of those .1 cases), two' J[ i j ! History and "ttrrlfoma Afof reported (1350 2 (WTO II (M50 Geographical distribution Tables 9a and 9b show the distribution and rate/ million per year of mesothelioma notifications and diagnoses in England and Wales and in Scotland. The Registrar General's standard regions are employed for England and Wales. Clydeside includes Dunbartonshire, Renfrewshire, Greenock, Glasgow, Hamilton, and Motherwell. The distributions are by no means related to population density. South western England, with a population of 3 652 thousands, had a total of 22 definite cases (a rate of 2-97 cases/million per year) yet Plymouth, with a population of 250000,* had 13 cases, all with histories of occupational exposure to asbestos. The remainder of the region, with nearly 3 million population, produced nine mesotheliomas of which only four had a history of occupational exposure to asbestos (a rate of 1-5 cases/million per year). 'Assuming that Plymouth hospitals serve a population of twice that number, the rate would be 26 cascs/mitlion per year. Merseyside, Oydeside, Tyneside, the South East Lancashire conurbation, and Greater London had an incidence of mesothelioma markedly greater than the national rate with deficits in the remainder of these regions. They have in common the presence of heavy asbestos-using industries. . The geographical distributions of cases, and of cases with occupational exposure, are shown in Figures 5 and 6. Discussion The recognition of diffuse mesothelioma depends on awareness and acceptance of the tumour as a pathological entity. The macroscopic appearance of a typical mesothelioma, resulting from its propensity to infiltrate serosal membranes, is best characterized by the well-developed pleural mesothelioma with permeation of visceral and parietal surfaces by a continuous layer of tumour. However, metastatic tumour in the pleura, usually from a primary adeno- TABLE 9 (a) Geographical Distribution of Numbers and Dates of Notifications and Confirmations of Meso thelioma 1967-68 Jtegton1' Greater London .......................... Rest of SE England SE Lancashire conurbation .. Merseyside conurbation . * .. Rest or NW England.......................... Tyneside................................................. Rest of N England .......................... W Yorkshire conurbation .. Rest of Yorks & Humberside N Wales ..................................... SE Wales................................................. B Anglia.. Oydeside' ..................................... Rest of Scotland .......................... SW England ..................................... E Midlands ..................................... W Midlands conurbation ................. Rest of W Midlands.......................... England, Wales & Scotland .. a. 1967 population (millions) 7-9 9-1 2-J 1*4 2-9 0-8 2-5 1*7 3*0 0-8 1-9 1-6 1-7 3*5 3-7 j-j 2-4 2-6 33*6 Notifications to Rejister 1967-68 No, Ratejmillion ni 40 21 33 13 14 13 17 3 3 14 6 43 18 30 9 11 11 412* 703 204 4-20 11-79 2-24 8-73 2 60 300 ____ 0*83 1-88 3-60 1-88 12-63 2-37 4-03 1-36 2-29 M2 3-14 `Standard ration! of Registrar General England & Wales, except Oydeside `Dunbartonshire, Renfrewshire. Greenock, Glasgow, Hamilton, Motherwell `One subject who died in Australia not included Definite mesotheliomas? 1967-68 No, Rate}million year 58 3-47 18 0-97 16 3-20 25 8-93 8 1*38 9 3-63 9 180 12 3-53 3 0*30 3 1*88 to 2-63 3 0-94 28 8-24 ( 0-86 22 2-97 3 0-43 6 8*25 6 1-15 245` 2-29