Reid A, Berry G, Heyworth J, de Klerk N H, Musk A W
Occupational Respiratory Epidemiology, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
Occup Environ Med. 2009 Mar;66(3):169-74. doi: 10.1136/oem.2007.038315. Epub 2008 Sep 19.
Nearly 3000 women and girls were documented to have lived at the blue asbestos mining and milling town of Wittenoom in Western Australia between 1943 and 1992. Eight per cent of deaths among these women to the end of 2004 have been from malignant mesothelioma of the pleura.
To predict future mortality from mesothelioma to 2030 in this cohort.
Mesothelioma mortality rates incorporating parameters for cumulative exposure, a power of time since first exposure and annual rates of fibre clearance from the lung were calculated from maximum likelihood estimates. These rates plus age specific mortality rates for Western Australian females incorporating an excess lung cancer risk were then applied to all Wittenoom cohort women surviving to the end of 2004, in yearly increments, to predict the future numbers of cases of mesothelioma to 2030.
There were 40 deaths from mesothelioma among the Wittenoom women to the end of 2004. Using a range of models that incorporate time since first exposure, competing risks from other diseases, latency periods and clearance of mesothelioma from the lungs we predict 66 (lowest estimate) to 87 (highest estimate) deaths from mesothelioma until 2030. This represents one and a half to two and a half times the number of deaths that have already occurred to the end of 2004.
The high toll from mesothelioma in this cohort of women and girls will continue well into the future.
1943年至1992年间,近3000名妇女和女孩曾居住在西澳大利亚州开采和加工蓝石棉的小镇维特努姆。截至2004年底,这些女性中8%的死亡原因是胸膜恶性间皮瘤。
预测该队列中到2030年间间皮瘤的未来死亡率。
根据最大似然估计计算间皮瘤死亡率,该死亡率纳入了累积暴露参数、首次暴露后的时间幂以及肺部纤维清除年率。然后将这些死亡率以及纳入肺癌额外风险的西澳大利亚女性年龄别死亡率,逐年应用于所有存活至2004年底的维特努姆队列女性,以预测到2030年间皮瘤的未来病例数。
截至2004年底,维特努姆女性中有40例死于间皮瘤。使用一系列纳入首次暴露后时间、其他疾病的竞争风险、潜伏期以及肺部间皮瘤清除情况的模型,我们预测到2030年,间皮瘤死亡人数为66例(最低估计)至87例(最高估计)。这是截至2004年底已发生死亡人数的1.5至2.5倍。
这一女性和女孩队列中间皮瘤造成的高死亡率在未来很长一段时间内仍将持续。