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The burden of asbestos-related disease in BC Asbestos Measurements - - PowerPoint PPT Presentation
The burden of asbestos-related disease in BC Asbestos Measurements - - PowerPoint PPT Presentation
The burden of asbestos-related disease in BC Asbestos Measurements (2,175) by Sector: BC, 1981-2004 Manufacturing 660 (30%) Service Sector 806 (37%) Auto Repair 239 (11%) Education 206 (9%) Healthcare 86 (4%) Construction 285 (13%)
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Asbestos Measurements (2,175) by Sector: BC, 1981-2004
Manufacturing 660 (30%) Service Sector 806 (37%) Auto Repair 239 (11%) Education 206 (9%) Healthcare 86 (4%) Construction 285 (13%) Government 233 (11%) Transportation 89 (4%)
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Mean Concentration of Asbestos Fibres by Province and Year
0.5 1 1.5 2 80-84 85-89 90-94 95-02 [Asbestos fibres] (mean, f/cc) British Columbia Ontario
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Number of people exposed to asbestos by industry for British Columbia: 2006
Industrial group Number of workers Specialty trade contractors 13,000 Building construction 8,900 Ship and boat building 1,800 Automotive repair and maintenance 500 Pulp, paper & paperboard mills 400 Remediation & other waste management 300 Deep sea, coastal, great lakes water transport 200 Architectural, engineering & related services 200 Management, scientific & consulting services 100 All others 600 Total 26,000
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Recognition of Asbestos-related Disease
Health Effect Suspected Probable Established Asbestosis ~1900 ~1915 ~1930 Lung Cancer ~1930 ~1945 ~1955 Mesothelioma ~1940 ~1955 ~1965 Other Cancers ~1955 ~1970 ?
From: U.S. IOM Asbestos, Selected Cancers, 2006. Original sources: Becklake (1976), Liddell (1997), Ross & Nolan (2003)
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Mesothelioma Cases, 1970-2007
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20 40 60 80 100 120 140 160 180
2000 4000 6000 8000 10000 12000 14000 16000 18000 20000 Metric Tonnes YEAR
Domestic Consumption BC Mesothelioma ON Mesothelioma
Asbestos Use in Canada and New Cases of Mesothelioma in Ontario and British Columbia
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10
n=312
111
New cases, 1992-2007
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Asbestosis Incidence
Men, 1992-2006
Asbestosis incidence increased from 5.3 to 6.5 per 100,000.
*rate per 100,000
11
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Asbestosis Incidence
Women, 1992-2006
*rate per 100,000
12
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Asbestosis Incidence
Males, Census Division, 1995-2006
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Cohort Studies Results: Ratios by Industry
- 10.00
- 5.00
0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00
Ratio Excess Lung : Mesothelioma, geometric mean = 2.16 & arithmetic mean = 4.16
Railway Shipbuilding Mining Insulators Textile Cement Mix
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Case Control Results: Attributable Proportion of Lung Cancers due to Asbestos Exposure
500 1000 1500 2000 2500
- 15.00%
- 10.00%
- 5.00%
0.00% 5.00% 10.00% 15.00% 20.00% 25.00% Number of Cases in the Case Control Study Calculated PAR, lines at geometric mean = 6.7% and arithmetic mean = 7.3%
Funnel Plot: Number of Cases
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Excess Risk of Lung Cancer in BC
- Attributable risk of lung cancer from case-control
studies – Based on ~2900 new cases of lung cancer annually (mean of 2005-2007): 7.3 = 211, 8.7% = 250 asbestos-related lung cancers
- Ratio of lung cancer cases to mesotheliomas in
cohort studies – Based on 79 mesotheliomas per year (mean
- f 2005-2007): 2.16 = 170, 4.16 = 328
asbestos-related lung cancers
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Other Asbestos-related Cancers
(1) U.S. Institute of Medicine. Asbestos: Selected Cancers, 2006. (2) International Agency for Research on Cancer, Monograph 100 Working Group, 2009.
Cancer Site IOM, 2006 (1) IARC, 2009 (2) Larynx Sufficient Sufficient Pharynx Suggestive Limited Stomach Suggestive Limited Colorectal Suggestive Limited Esophagus Inadequate Inadequate Ovary Not reviewed Sufficient
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US IOM 2006 Review of Other Asbestos-related Cancers
Cancer Site Conclusion Cohort Overall Cohort High expo. Case-Control Overall Larynx Sufficient 1.4 (1.2-1.6) 2.6 (1.5-4.5) 1.4 (1.1-1.8) Pharynx Suggestive 1.4 (1.0-2.0) 0.9 (0.2-4.2) 1.5 (1.0-2.0) Stomach Suggestive 1.2 (1.1-1.3) 1.3 (1.0-1.8) 1.1 (0.8-1.6) Colorectal Suggestive 1.2 (1.0-1.3) 1.4 (1.1-1.7) 1.2 (0.9-1.7) Esophagus Inadequate 1.0 (0.8-1.3) 1.4 (0.8-2.6) 1.5 (0.9-2.5)
U.S. National Academy of Sciences. Asbestos: Selected Cancer, 2006.
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Stomach & Lung Cancer Correlation in Asbestos Cohorts
y = 0.4011x + 0.4125 R² = 0.6623
1 2 3 4 5 1 2 3 4 5 6 7 8
Stomach Cancer SMR Lung Cancer SMR
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Colorectal & Lung Cancer Correlation in Asbestos Cohorts
y = 0.2785x + 0.5419 R² = 0.5895
1 2 3 1 2 3 4 5 6 7 8
Colorectal Cancer SMRs
Lung Cancer SMRs
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Decades after major reductions in exposure, the burden is very high. Each year in BC there are: –60-80 new cases of mesothelioma –70-100 new cases of asbestosis –170-330 new cases of lung cancer –Smaller numbers of other cancers
Asbestos-Related Diseases in BC
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UBC Asbestos Research Team
Paul Demers1,3, Mieke Koehoorn1,2,3, Chris McLeod1,2, Anne-Marie Nicol1,3 Wenqi Gan1, Tracy Kirkham1, Kim McLeod1,2, Cheryl Peters1, Kristin Hodgins1, Caitlin Blewett1,3 Christie Hurrel1,2, Lillian Tamburic2, Fan Xu2, Jon Fan2
- 1. UBC School of Environmental Health
- 2. Centre for Health Services & Policy Research
- 3. School of Population & Public Health
Funded by: WorkSafe BC, Canadian Partnership Against Cancer, & Canadian Institutes for Health Research
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