Industry, occupation, and exposure history of mesothelioma patients in the U.S. National Mesothelioma Virtual Bank, 2006-2022

Yuhe Gao; Jacek M Mazurek; Yaming Li; David Blackley; David N Weissman; Shirley V Burton; Waqas Amin; Douglas Landsittel; Michael J Becich; Ye Ye

doi:10.1016/j.envres.2022.115085

Industry, occupation, and exposure history of mesothelioma patients in the U.S. National Mesothelioma Virtual Bank, 2006-2022

Environ Res. 2023 Aug 1:230:115085. doi: 10.1016/j.envres.2022.115085. Epub 2023 Mar 23.

Authors

Affiliations

¹ Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, USA.
² Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, USA.
³ Clinical and Translational Sciences Institute, School of Medicine, Indiana University, USA.
⁴ Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, USA.
⁵ Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, USA. Electronic address: yey5@pitt.edu.

Abstract

Background: Malignant mesothelioma is associated with environmental and occupational exposure to certain mineral fibers, especially asbestos. This study aims to examine work histories of mesothelioma patients and their survival time.

Method: Using the NIOSH Industry and Occupation Computerized Coding System, we mapped occupations and industries recorded for 748 of 1444 patients in the U.S. National Mesothelioma Virtual Bank (NMVB) during the period 2006-2022. Descriptive and survival analyses were conducted.

Results: Among the 1023 industries recorded for those having mesothelioma, the most frequent cases were found for those in manufacturing (n = 225, 22.0%), construction (138, 13.5%), and education services (66, 6.5%); among the 924 occupation records, the most frequent cases were found for those in construction and extraction (174, 18.8%), production (145, 15.7%), and management (84, 9.1%). Males (583) or persons aged >40 years (658) at the time of diagnosis tended to have worked in industries traditionally associated with mesothelioma (e.g., construction), while females (163) or persons aged 20-40 years (27) tended to have worked in industries not traditionally associated with mesothelioma (e.g., health care). Asbestos, unknown substances, and chemical solvents were the most frequently reported exposure, with females most often reporting an unknown substance. A multi-variable Cox Hazard Regression analysis showed that significant prognostic factors associated with decreased survival in mesothelioma cases are sex (male) and work experience in utility-related industry, while factor associated with increased survival are epithelial or epithelioid histological type, prior history of surgery and immunotherapy, and industry experience in accommodation and food services.

Conclusion: The NMVB has the potential of serving as a sentinel surveillance mechanism for identifying industries and occupations not traditionally associated with mesothelioma. Results indicate the importance of considering all potential sources of asbestos exposures including occupational, environmental, and extra-occupational exposures when evaluating mesothelioma patients and advising family members.

Keywords: Asbestos; Mesothelioma; Occupational exposure; Sex; Survival; Work history.

Publication types

Research Support, U.S. Gov't, P.H.S.
Research Support, N.I.H., Extramural

MeSH terms

Asbestos* / toxicity
Female
Humans
Industry
Male
Mesothelioma* / chemically induced
Mesothelioma* / epidemiology
Mesothelioma, Malignant* / chemically induced
Occupational Diseases* / epidemiology
Occupational Exposure* / adverse effects
Occupations

Substances

Asbestos

Abstract

Publication types

MeSH terms

Substances

Grants and funding