Document oO5L0QNz9xdMvQROkdQknjYD

totogical and tumours have 'gists (Wagner, irihane, 1964; iwdifle, 1971) ICC panel to the Appendix, cd the reports Mined. Where pinions on a er material to >n was taicen. ught after the ' by the nonJc by these iwlng groups; ' pathologist, rial supported Jtomy, lapar the diagnosis summed and a diagnosis of 'uihologist to ponds to the ed by UICC tcre the ' ..-iterial, or psy material : alternative <t. thorax and is that given Where (he opsy report. rviewed, but interviewed ies were also r employers n was made ho may or m diagnosis it. The final Jical adviser m this took n received. defined as lull-time or -r asbestos- Mesothelioma register 1967-63 93 containing compounds, or where the subject worked in an atmosphere contaminated by asbes tos dust. 'Possible', where the job description was too imprecise to be certain, but there was a strong * suspicion of exposure to asbestos. 'None', where, after exhaustive enquiry, no occupational exposure could be presumed. 'Unknown', where adequate industrial details were not forthcoming. If possible the duration of exposure was recorded and the length of time before death that exposure ceased. The duration io intermittent exposures is presented as a cumulative figure. Domestic exposure Domestic exposure was considered as positive when a history that members of a subject's family had come home visibly contaminated by asbestos was obtained. Hobby exposure Hobby exposure was recorded In several house holders or smallholders who gave a history of sawing asbestos sheeting for the construction of outhouses, garages, and chicken houses. Neighbourhood exposure Neighbourhood exposure was recorded when sub jects lived within one mile of an asbestos factory or shipyard using asbestos but bad no occupational exposure. Other evidence of asbestos exposure Asbestos exposure was presumed In cases showing evidence of asbestosis (either on chest radiograph or at necropsy) and in those in whom asbestos bodies or fibres had been demonstrated by light microscopy in sputum, lung sections, or fluid expressed from the cut surface of the lung. The reported finding of pleural plaques at operation or necropsy, or evidence of plaques on the chest radiograph, was regarded as suggestive of asbestos exposure. Resells For the years 1967 and 1968, a total of 413 cases was reported to the mesothelioma register. Of these, 168 were first notified by death certificate as having died in those years and a further 166 were notified in life and died during this period. Seventy-nine subjects notified survived the period of study. Death certificates were the most important source of notification comprising 53-3% of all notifications in 1967 and 77;8% in 1968. In the absence of death certifications, further notifications were received from cancer bureaux, 45 (26-5%) in 1967 and 33 (13.-6 %) in 1968. Further groups of cases were reported exclusively by other sources (physicians, surgeons, and pathologists), 31 (18-2%) in 1967 and 18 (7-4%) in 1968. Three other cases otherwise unreported were reported in each year by the Pneumoconiosis Medical Panels. A total of 170 notifications were made in 1967 and 243 in 1968. Pathological diagnosis In Table 1 the notifications are shown categorized according to the criteria of diagnosis. The correla tion between histological diagnosis and the diagnosis given on the death certificate was weak. Of the 246 cases accepted as 'definite', only 186 were so des cribed on death certificates. On the other hand, of 76 cases `definitely not mesothelioma' death had been attributed to mesothelioma on the death TABLE I Notifications to Mesothelioma Rxooter analysed by Diagnostic Criteria and Site or Tumour UICC Panel Other pathologists Tout All CUBS Sue of tumour Pleura Peritoneum Pleura Peritoneum Pleurft Peritoneum Definite 111*1 mm iJ Ml m 2(6 10 244 Dtognostic catriory1 UndtcUed IwffieUnt muttrial u~\ m* 261 V2S 2j 40 6 46 ,21 |J OJ 44 1 45 Dtfinittly not mi 7jr30 421 H6 J 65 II 76 Total 167 28 1M 20 365 48 413 'See text for definition