Upcoming epidemic of asbestos-related malignant pleural mesothelioma in Taiwan: A prediction of incidence in the next 30 years

J Formos Med Assoc. 2019 Jan;118(1 Pt 3):463-470. doi: 10.1016/j.jfma.2018.07.013. Epub 2018 Jul 31.

Abstract

Background/purpose: Globally, asbestos-related diseases (ARDs) keep rising over the coming decades. The epidemic of ARDs will be a burden on public health. We aimed to predict the malignant pleural mesothelioma (MPM) incidence in the next 30 years for Taiwan based on historical asbestos consumption.

Methods: We collected annual data on local asbestos consumption during 1939-2015 and sex-specific incidence of pleural cancer as a proxy for MPM during 1979-2013. We applied Poisson log-linear models to predict future MPM numbers under the assumption that latency periods between asbestos exposure and MPM incidence were between 25 and 45 years.

Results: Asbestos consumption reached a peak in the 1980s, with a total of 668 thousand metric tons during 1939-2015. The observed number of MPM incidence increased by 9- and 6-fold in males and females during 1979-2013, with a cumulative number of 907. Given a latency period of 31 years, MPM incidences were expected to peak around 2012-2016 for males and 2016-2020 for females. In 2017-2046, the predicted total number of new MPM might reach 659 cases (95% confidence interval = 579-749); and the male to female ratios ranged from 1.8 to 2.8.

Conclusion: The MPM epidemic in Taiwan will likely peak in 2012-2020 as a result of local asbestos consumption. Approximately 659 new MPM cases in the next 30 years warrant an urgent need to implement a total asbestos ban and put more resources on a comprehensive surveillance, diagnosis, and follow-up health care system for ARDs.

Keywords: Asbestos; Mesothelioma; Pleural cancer.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Asbestos / adverse effects*
  • Child
  • Child, Preschool
  • Environmental Exposure / adverse effects*
  • Female
  • Forecasting*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Lung Neoplasms / chemically induced
  • Lung Neoplasms / epidemiology*
  • Male
  • Mesothelioma / chemically induced
  • Mesothelioma / epidemiology*
  • Mesothelioma, Malignant
  • Middle Aged
  • Pleural Neoplasms / chemically induced
  • Pleural Neoplasms / epidemiology*
  • Regression Analysis
  • Sex Distribution
  • Taiwan / epidemiology
  • Young Adult

Substances

  • Asbestos