High incidence of mesothelioma in an English city without heavy industrial use of asbestos.
BACKGROUND
Mesothelioma rates are increasing in the industrialized world, related to occupational asbestos exposure. The highest rates have been reported from areas with specific industries such as shipbuilding or mining. Lower rates have been reported from areas without such industries. We studied an area without heavy industry to examine if such a pattern occurred in England.


METHODS
We studied the population of Exeter Primary Care Trust, Devon, United Kingdom, with a population of 131,849. Exeter has no mining, shipbuilding or other heavy industry. All lung cancers and mesotheliomas were identified from the local cancer registry, supplemented by searches at all primary care practices. The cancer diagnoses were checked by inspection of histology or primary care records. Occupational data were extracted from the primary care records.


RESULTS
The searches revealed 291 lung cancers, 283 of which had either histological proof or strong clinical evidence for the diagnosis. Twenty-two (8 per cent) of these were pleural mesotheliomas, 17 of these occurring in men. The incidence rate of mesothelioma in men over 40 years was 12.1 per 100,000 per year (95 per cent confidence intervals 7.0-19.3), one of the highest reported rates in the world.


CONCLUSIONS
The mesothelioma epidemic will extend to areas without local heavy industrial exposure.
Hamilton
William T
WT
Division of Primary Health Care, University of Bristol. w.hamilton@bristol.ac.uk
Round
Alison P
AP
Sharp
Deborah J
DJ
Peters
Tim J
TJ
D000328:Adult; D000368:Aged; D001194:Asbestos / Q000633:toxicity; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007221:Industry; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012042:Registries
D001194:Asbestos