Chang Kwok C, Leung Chi C, Tam Cheuk M, Yu Wai C, Hui David S, Lam Wah K
Tuberculosis & Chest Service, Department of Health, Hong Kong; Pneumoconiosis Medical Board, Hong Kong.
Respir Med. 2006 Jan;100(1):75-82. doi: 10.1016/j.rmed.2005.04.017. Epub 2005 Jun 6.
Malignant mesothelioma (mesothelioma) is rare. We conducted the first systematic study of the epidemiology of mesothelioma in Hong Kong from 1988 to May 2002 by reviewing medical records. Mesothelioma patients were identified from the database of 12 out of 20 hospitals that would have admitted mesothelioma patients territory-wide. These 12 hospitals served 73% of the total hospital bed-years of the 20 hospitals. We identified 67 mesothelioma patients. The estimated annual incidence was one per million, which was similar to the background incidence of one to two per million among Caucasians. Occupational history was available in 43 subjects. Three quarters of mesothelioma patients with available occupational history had occupational asbestos exposure. Restricting analysis to 48 patients with accessible medical records and using 67 occupational asbestosis patients for comparison, the epidemiology of mesothelioma in Hong Kong shares similarities with the literature: mean age of 63 years upon diagnosis, mean latency of 46 years, median survival of 9.5 months, male predominance, selective presentation among women, high prevalence among workers in ships and dockyards, predominantly epithelioid type, lower prevalence of asbestos bodies, and negative association with pleural plaques. Asbestos consumption in Hong Kong rose in the 1970s and peaked in early 1980s and late 1990s. Hong Kong may encounter an epidemic of mesothelioma in the 2010s if effective occupational asbestos control measures are not in place.
恶性间皮瘤(间皮瘤)较为罕见。我们通过查阅病历,对1988年至2002年5月香港间皮瘤的流行病学进行了首次系统研究。间皮瘤患者是从全港20家医院中的12家医院的数据库中识别出来的,这12家医院提供了20家医院总病床年数的73%。我们共识别出67例间皮瘤患者。估计年发病率为百万分之一,与白种人中每百万一至二例的背景发病率相似。43名患者有职业史。在有职业史的间皮瘤患者中,四分之三有职业性石棉接触史。将分析限定在48例有完整病历的患者,并以67例职业性石棉肺患者作为对照,香港间皮瘤的流行病学与文献报道相似:诊断时平均年龄63岁,平均潜伏期46年,中位生存期9.5个月,男性居多,女性有选择性表现,在船舶和造船厂工人中患病率高,主要为上皮样类型,石棉小体患病率低,与胸膜斑呈负相关。香港的石棉消费量在20世纪70年代上升,在80年代初和90年代末达到峰值。如果不采取有效的职业性石棉控制措施,香港可能在2010年代遭遇间皮瘤流行。