1945 - 2000年澳大利亚的恶性间皮瘤

Malignant mesothelioma in Australia, 1945-2000.

作者信息

Leigh James, Davidson Patricia, Hendrie Leigh, Berry Dale

机构信息

Center for Occupational and Environmental Health, Department of Public Health and Community Medicine, University of Sydney, Sydney, NSW, Australia.

出版信息

Am J Ind Med. 2002 Mar;41(3):188-201. doi: 10.1002/ajim.10047.

DOI:10.1002/ajim.10047

PMID:11920963

Abstract

BACKGROUND

Australia has maintained a total national malignant mesothelioma case register since 1980. There has been a marked increase in the incidence of mesothelioma in the last 20 years. Currently 450-600 cases are notified annually in a population of 20 million. While the history of the Wittenoom (Western Australia) crocidolite mine and its aftermath is well known, these cases comprise only 5% of the total. This study describes the incidence of mesothelioma in Australia from 1945 to 2000.

METHODS

Using register data, time trends in mesothelioma incidence were calculated. Analyses of incidence are reported by age, sex, anatomical site, and state of notification. Associations with occupational and environmental asbestos exposure histories are described. Lung fiber content measurements were made on a subset of cases.

RESULTS

Australia has had 6,329 cases of mesothelioma from 1 January 1945 to 31 December 2000. (A further 620 cases were notified in the period from 1 January 2001 to 31 October 2001.) Annual incidence rates for Australia per million population > or = 20 years (1997) were: male, 59.8; female, 10.9; total, 35.4. Incidence rates have been continually increasing and are the highest reported national rates in the world. While Western Australia has the highest rate (1997 total rate, 52.8), most cases arise from the two most populous eastern states, New South Wales and Victoria. In 88% (male 90%, female 61%) of cases, a history of asbestos exposure was obtained. Exposures occurred in a wide variety of occupational and environmental circumstances. In 80% of cases with no history of exposure, TEM lung asbestos fiber counts > 200,000 fibers > 2 microm length per gm dry lung were obtained, suggesting unrecognized exposure.

CONCLUSIONS

Australia's high incidence of mesothelioma is related to high past asbestos use, of all fiber types, in a wide variety of occupational and environmental settings. The number of cases in total is expected to be about 18,000 by 2020, with about 11,000 yet to appear.

摘要

背景

自1980年以来，澳大利亚一直设有全国性的恶性间皮瘤病例总登记册。在过去20年中，间皮瘤的发病率显著上升。目前，在2000万人口中，每年有450 - 600例病例被通报。虽然西澳大利亚州维特努姆的青石棉矿的历史及其后果广为人知，但这些病例仅占总数的5%。本研究描述了1945年至2000年澳大利亚间皮瘤的发病率。

方法

利用登记数据计算间皮瘤发病率的时间趋势。发病率分析按年龄、性别、解剖部位和通报州进行报告。描述了与职业和环境石棉接触史的关联。对一部分病例进行了肺纤维含量测量。

结果

从1945年1月1日至2000年12月31日，澳大利亚有6329例间皮瘤病例。（在2001年1月1日至2001年10月31日期间又通报了620例病例。）澳大利亚每百万20岁及以上人口（1997年）的年发病率为：男性59.8；女性10.9；总计35.4。发病率一直在持续上升，是世界上报导的最高国家发病率。虽然西澳大利亚州的发病率最高（1997年总发病率为52.8），但大多数病例来自人口最多的两个东部州，新南威尔士州和维多利亚州。在88%（男性90%，女性61%）的病例中，有石棉接触史。接触发生在各种各样的职业和环境情况下。在80%无接触史的病例中，透射电镜下肺石棉纤维计数每克干肺中长度大于2微米的纤维超过200,000根，提示存在未被认识的接触。