title: Predicted mortality from malignant mesothelioma among women exposed to blue asbestos at Wittenoom, Western Australia.
abstract: BACKGROUND
  Nearly 3000 women and girls were documented to have lived at the blue asbestos mining and milling town of Wittenoom in Western Australia between 1943 and 1992. Eight per cent of deaths among these women to the end of 2004 have been from malignant mesothelioma of the pleura.
  
  
  OBJECTIVE
  To predict future mortality from mesothelioma to 2030 in this cohort.
  
  
  METHODS
  Mesothelioma mortality rates incorporating parameters for cumulative exposure, a power of time since first exposure and annual rates of fibre clearance from the lung were calculated from maximum likelihood estimates. These rates plus age specific mortality rates for Western Australian females incorporating an excess lung cancer risk were then applied to all Wittenoom cohort women surviving to the end of 2004, in yearly increments, to predict the future numbers of cases of mesothelioma to 2030.
  
  
  RESULTS
  There were 40 deaths from mesothelioma among the Wittenoom women to the end of 2004. Using a range of models that incorporate time since first exposure, competing risks from other diseases, latency periods and clearance of mesothelioma from the lungs we predict 66 (lowest estimate) to 87 (highest estimate) deaths from mesothelioma until 2030. This represents one and a half to two and a half times the number of deaths that have already occurred to the end of 2004.
  
  
  CONCLUSIONS
  The high toll from mesothelioma in this cohort of women and girls will continue well into the future.
authors.affiliation: Occupational Respiratory Epidemiology, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. alison.reid@uwa.edu.au
authors.forename: A
authors.initials: A
authors.lastname: Reid
authors.forename: G
authors.initials: G
authors.lastname: Berry
authors.forename: J
authors.initials: J
authors.lastname: Heyworth
authors.forename: N H
authors.initials: NH
authors.lastname: de Klerk
authors.forename: A W
authors.initials: AW
authors.lastname: Musk
mesh_terms: D000328:Adult; D000368:Aged; D000397:Air Pollution / Q000009:adverse effects*; D017638:Asbestos, Crocidolite / Q000633:toxicity*; D002273:Carcinogens / Q000633:toxicity*; D015331:Cohort Studies; D004784:Environmental Monitoring; D005260:Female; D005544:Forecasting; D006801:Humans; D016013:Likelihood Functions; D008175:Lung Neoplasms / Q000401:mortality; D008654:Mesothelioma / Q000209:etiology / Q000401:mortality*; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure; D010997:Pleural Neoplasms / Q000209:etiology / Q000401:mortality*; D018570:Risk Assessment / Q000379:methods; D014904:Western Australia
chemical_list: D002273:Carcinogens; D017638:Asbestos, Crocidolite