Asbestosis mortality in the USA: facts and predictions.
BACKGROUND
Mortality trends in the USA show that deaths from asbestosis are increasing, while deaths related to other pneumoconiosis are declining.


OBJECTIVE
To analyse the association between asbestos consumption and asbestosis mortality trends.


METHODS
In an epidemiological time series study, we used a modern computer-intensive local regression method to evaluate the relationship between asbestos consumption per capita (1900-2006) as the predictor variable and number of deaths from asbestosis (1968-2004). The predictor variable was progressively lagged by annual increments from 30 to 60 years and the goodness of fit assessed for each lag period. The model having the smallest Akaike's Information Criteria was used to derive extrapolated estimates of future mortality based on more recent asbestos consumption data.


RESULTS
Asbestos consumption per capita reached a peak in 1951 and gradually declined until 1973, when it started to drop rapidly. In 2006, it was 0.0075 kg/person/year. There were 25 564 deaths from asbestosis over the period 1968-2004. The best-fitting model (adjusted coefficient of determination (R(2)) = 99.7%) for 1968-2004 deaths from asbestosis used asbestos consumption per capita 48 years prior (1920-1956) and the log value of asbestos consumption per capita 43 years prior (1925-1961). This model predicts a total of 29 667 deaths (95% CI 19 629 to 39 705) to occur during 2005-2027 (an average of 1290 deaths per year).


CONCLUSIONS
This study demonstrates a clear association between asbestos consumption and deaths from asbestosis and indicates that asbestosis deaths are not expected to decrease sharply in the next 10-15 years.
Antao
V C dos Santos
VC
National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA. VAntao@cdc.gov
Pinheiro
G A
GA
Wassell
J T
JT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000600:supply & distribution* / Q000633:toxicity; D001195:Asbestosis / Q000401:mortality*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D011009:Pneumoconiosis / Q000401:mortality; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D001194:Asbestos