Segura O, Burdorf A, Looman C
Department of Public Health, Erasmus University Rotterdam, Rotterdam, Netherlands.
Occup Environ Med. 2003 Jan;60(1):50-5. doi: 10.1136/oem.60.1.50.
To predict the expected number of pleural mesothelioma deaths in the Netherlands from 2000 to 2028 and to study the effect of main uncertainties in the modelling technique.
Through an age-period-cohort modelling technique, age specific mortality rates and cohort relative risks by year of birth were calculated from the mortality of pleural mesothelioma in 1969-98. Numbers of death for both sexes were predicted for 2000 to 2028, taking into account the most likely demographic development. In a sensitivity analysis the relative deviation of the future death toll and peak death number were studied under different birth cohort risk assumptions.
The age-cohort model on mortality 1969-98 among men showed the highest age specific death rates in the oldest age group (79 per 100 000 person-years in the age group 80-84 years) and the highest relative risks for the birth cohorts of 1938-42 and 1943-47. Among men a small period effect was observed. The age-cohort model was considered the best model for predicting future mortality. The most plausible scenario predicts an increase in pleural mesothelioma mortality up to 490 cases per year in men, with a total death toll close to 12 400 cases during 2000-28. However, using different assumptions this death toll could rise to nearly 15 000 in men (20% increase). Mortality among women remains low, with a total death toll of about 800 cases. It is predicted that the total death toll in the period 2000-28 is 44% lower than previous predictions using mortality data from 1969 to 1993.
Adding five recent years of observed mortality in an age-cohort model resulted in a 44% lower prediction of the future death toll of pleural mesothelioma. A statistically significant period effect was observed, possibly influenced by initial asbestos safety guidelines in the 1970s and introduction of the ICD-10 codification.
预测2000年至2028年荷兰胸膜间皮瘤死亡的预期数量，并研究建模技术中主要不确定性因素的影响。
通过年龄-时期-队列建模技术，根据1969 - 1998年胸膜间皮瘤死亡率计算特定年龄死亡率和按出生年份划分的队列相对风险。考虑到最可能的人口发展情况，预测了2000年至2028年两性的死亡人数。在敏感性分析中，研究了不同出生队列风险假设下未来死亡人数和死亡人数峰值的相对偏差。
1969 - 1998年男性死亡率的年龄-队列模型显示，最年长年龄组的特定年龄死亡率最高（80 - 84岁年龄组每10万人年中有79例），1938 - 1942年和1943 - 1947年出生队列的相对风险最高。在男性中观察到较小的时期效应。年龄-队列模型被认为是预测未来死亡率的最佳模型。最合理的情景预测男性胸膜间皮瘤死亡率将增至每年490例，2000 - 2028年期间总死亡人数接近12400例。然而，采用不同假设，男性的这一死亡人数可能增至近15000例（增加20%）。女性死亡率仍然较低，总死亡人数约为800例。预计2000 - 2028年期间的总死亡人数比之前使用1969年至1993年死亡率数据的预测低44%。
在年龄-队列模型中加入最近五年观察到的死亡率，使得胸膜间皮瘤未来死亡人数的预测降低了44%。观察到具有统计学意义的时期效应，这可能受到20世纪70年代初期石棉安全指南以及国际疾病分类第10版编码引入的影响。
