prediction of mesothelioma incidence from asbestos consumption, a comparative study
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Prediction of Mesothelioma Incidence from Asbestos Consumption, A Comparative Study. Domyung Paek Seoul National University. Korean Situation. Asbestos industry started operation from 1960’s. Yet mesothelioma incidence stays low around 1-2/million, with male to female ratio of 1.6. - PowerPoint PPT PresentationTRANSCRIPT
Prediction of Mesothelioma Incidence from Asbestos
Consumption, A Comparative Study
Domyung PaekSeoul National University
Korean Situation
• Asbestos industry started operation from 1960’s.
• Yet mesothelioma incidence stays low around 1-2/million, with male to female ratio of 1.6.
• Concerns over what to expect (any increase?), where to expect (asbestos industry locations?) and whom to expect (any specific job or task?)
Asbestos Mining and Import, Korea
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
0
20000
40000
60000
80000
100000
120000
Mining Import
Phases of Change
EXPANSIOEXPANSIONN
FALLFALLPLATEAPLATEAUU
Industrial Industrial Safety and Safety and Health Act of Health Act of Korea, 1981Korea, 1981
First First Mesothelioma Mesothelioma Case in Korea, Case in Korea, 19941994
0
1
2
3
4
5
6
7
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Asbestos- related Cancers in Korea
Lung Cancer, Comp Lung Cancer, Not-CompMesothelioma, Comp Mesothelioma, Not-Comp
Korean Situation
• However, with very scanty data about mesothelioma incidence, future prediction is in murky state.
• Need to predict future scenarios based on inter-country comparative study.
Asbestos and Mesothelioma
• Usually studied in occupational settings, especially of mining and manufacturing sectors.
• However, much bigger problems are found in end-user industries such as construction and ship-building
• Per-capita consumption of asbestos can be a fair indicator of asbestos exposure extent in end-user industries
Asbestos and Mesothelioma
• The relationship can be studies in two directions– Spatial variation• Between jobs or departments• Between companies or industries• Between different countries
– Temporal variation• Between different periods • Between countries of different phases
Asbestos and Mesothelioma
• An example of spatial variation study– Per-capita asbestos consumption versus
mesothelioma incidence of different countries
Ecological association between asbestos-related diseasesand historical asbestos consumption: an international
analysisRo-Ting Lin, Ken Takahashi, Antti Karjalainen, Tsutomu Hoshuyama, Donald Wilson, Takashi
Kameda, Chang-Chuan Chan, Chi-Pang Wen, Sugio Furuya, Toshiaki Higashi, Lung-Chang Chien, Megu Ohtaki
Lancet 2007; 369: 844–49
Asbestos and Mesothelioma
• How about temporal variation study?
• Usually future predictions based on age-cohort models without asbestos inputs
• As yet, no relationship study between changes of asbestos consumption and mesothelioma incidence
Temporal Variation Study
• Analysis of cumulative per-capita asbestos exposure over certain age period versus mesothelioma incidence after certain age of a given birth cohort– When and how long is the best age period
of asbestos exposure to explain the changing mesothelioma incidence of different birth cohorts?
– How strong is the dose-response of mesothelioma incidence for a given cumulative asbestos exposure?
Temporal Variation Study
• Studies from Japan and Netherlands
Temporal Variation Study
• Per-capita asbestos consumption– Imported asbestos/population size
• Mesothelioma incidence risk of different birth cohorts of 5-10 year periods from 1910-1960– Age/period/cohort model analysis of
mesothelioma incidence data of each country
Analysis
• Mesothelioma rate ratio for a specific cohort was calculated based on age-sex specific mesothelioma mortality in certain period, i.e. age-cohort.
• Exposure during specific age (period) based on per-capita asbestos consumption was regressed against mesothelioma rate ratio.
RR(cohort I) =
∑ ( Per-capita asbestos consumption(i period)
* (40- age(i period))2 )
Analysis of exposure age period
• Period of from 15 – 25 years old
Analysis of temporal change
• Exposures of relatively young age period (15-25 years old) showed the best fit of the data
• After the exposure, takes about 30 years to show the elevation of the risk
• After the exposure, takes about 50 years to reach the peak of the risk
Prediction of PeakSpurt of asbestos industry
Peak of asbestos industry
Spurt of meso incidence
Ban of asbestos use
Peak of meso incidence
Netherlan
ds
1950’s
1965’ 1990’ 1991 2017
Japan 1960’s
1975’ 2000’ 2005 2030
Korea 1970’s
1990’ 2010’ 2009 2045(?)