Mortality, morbidity, and asbestosis in New Zealand: the hidden legacy of asbestos exposure.
OBJECTIVE
To examine the morbidity and mortality patterns of patients with asbestosis in New Zealand to determine (more fully) the overall health impact of past exposure to asbestos.


METHODS
Individual mortality, cancer and hospital records for all New Zealand men diagnosed with asbestosis between 1974-2001 were examined. Mortality data were analysed for time trends, cause of death, and occupation. Trends for patients diagnosed with asbestosis were compared with those diagnosed with lung cancer. Hospital discharge data for men with asbestosis were examined to determine reasons for hospitalisation, resource utility, and recent hospitalisation trends.


RESULTS
Death rates for New Zealand males dying with asbestosis increased between 1974-1999. Only 17% of deaths of males dying with asbestosis were directly attributed to this cause; the remainder were attributed to other non-malignant and malignant respiratory disease. Deaths from asbestos-related lung disease were grossly underestimated. Death certificates of men dying with asbestosis were found in all major occupational groups. Trends in hospital discharges may provide additional information for the overall modelling of the current epidemic of asbestos related disease.


CONCLUSIONS
The number of men dying with asbestosis in NZ has increased in line with mesothelioma. There is some indication that asbestosis prevalence may have peaked for the most serious cases of asbestosis. Some level of asbestos exposure, as indicated by asbestosis, may be present in all major occupational groups.
Smartt
Pamela
P
New Zealand Health Technology Assessment (NZHTA), Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand. pamela.smartt@chmeds.ac.nz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001195:Asbestosis / Q000191:economics / Q000453:epidemiology / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D017721:Hospital Costs; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008654:Mesothelioma / Q000401:mortality; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality / Q000639:trends; D009520:New Zealand / Q000453:epidemiology; D009790:Occupations; D012140:Respiratory Tract Diseases / Q000191:economics / Q000401:mortality