Department of Occupational Medicine, Administration of Occupational Safety and Health, Reykjavik, Iceland.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland ; Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Fossvogur, 108 Reykjavik, Iceland.
J Occup Med Toxicol. 2016 Jul 26;11:37. doi: 10.1186/s12995-016-0127-4. eCollection 2016.
Malignant mesothelioma caused by asbestos exposure has a long latency period. A ban on asbestos use may not be apparent in decreased incidence in the population until after several decades. The aim was to evaluate changes in the incidence of malignant mesothelioma, and the possible impact of the asbestos ban implemented in Iceland in 1983.
This is a population study on aggregate level; the source of data was the Icelandic Cancer Registry, the National Cause-of-Death Registry, and the National Register. Volume of asbestos import was obtained from Customs Tariff. The import figures reflect fairly accurately the amount used, as there are no mines in the country.
Asbestos import peaked in 1980 at 15.0 kg/capita/year, diminishing to 0.3 kg/capita/year ten years after the ban in 1983, and to zero in the most recent years. Seventy-nine per cent of the cases of malignant mesothelioma were men, and 72 % were of pleural origin. Mesothelioma incidence increased steadily from 1965 to 2014, when it reached 21.4 per million among men, and 5.6 among women. Mortality in 2014 was 22.2 per million among men, and 4.8 among women.
Malignant mesothelioma incidence and mortality increased in the population during the period, despite the ban on asbestos use from 1983. This is in agreement with the long latency time for malignant mesothelioma. In line with the previously high per capita volume of asbestos import, many buildings, equipment, and structures contain asbestos, so there is an on-going risk of asbestos exposure during maintenance, renovations and replacements. It is thus difficult to predict when the incidence of malignant mesothelioma will decrease in the future. During the last ten-year period, the incidence in Iceland was higher than the recently reported incidence in neighbouring countries.
由于石棉暴露而导致的恶性间皮瘤潜伏期较长。在几十年后,禁止使用石棉可能不会明显体现在人群中发病率的降低上。本研究旨在评估恶性间皮瘤发病率的变化,以及冰岛 1983 年实施的石棉禁令可能产生的影响。
这是一项基于人群的研究;数据来源为冰岛癌症登记处、国家死因登记处和国家登记处。石棉进口量从关税中获得。这些进口数据反映了使用量,因为该国没有矿山。
1980 年石棉进口量达到顶峰,为 15.0 公斤/人/年,1983 年禁令实施十年后,进口量减少至 0.3 公斤/人/年,最近几年则降为零。79%的恶性间皮瘤病例为男性,72%为胸膜起源。1965 年至 2014 年期间,间皮瘤发病率稳步上升,男性发病率达到 21.4/百万人,女性发病率为 5.6/百万人。2014 年男性死亡率为 22.2/百万人,女性死亡率为 4.8/百万人。
尽管 1983 年已禁止使用石棉,但在此期间,人群中的恶性间皮瘤发病率和死亡率仍在上升。这与恶性间皮瘤潜伏期长的情况相符。根据之前人均石棉进口量较高的情况,许多建筑物、设备和结构都含有石棉,因此在进行维护、翻新和更换时,仍存在石棉暴露的持续风险。因此,很难预测未来恶性间皮瘤的发病率何时会下降。在过去的十年中,冰岛的发病率高于最近邻国报告的发病率。