National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Lancet Public Health. 2017 Nov;2(11):e522-e528. doi: 10.1016/S2468-2667(17)30192-5. Epub 2017 Nov 2.
The health risks associated with living in houses insulated with asbestos are unknown. Loose-fill asbestos was used to insulate some houses in the Australian Capital Territory (ACT). We compared the incidence of mesothelioma and other cancers in residents of the ACT who did and did not live in these houses.
Our cohort study included all ACT residents identified using Medicare enrolment data. These data were linked to addresses of affected residential properties in the ACT to ascertain exposure. We followed up residents by linking data to the Australian Cancer Database and National Death Index. Outcomes were diagnosis of mesothelioma and selected other cancers. Effects were estimated for males and females separately using standardised incidence ratios (SIRs), adjusting for age and calendar time of diagnosis.
Between Nov 1, 1983, and Dec 31, 2013, 1 035 578 ACT residents were identified from the Medicare database. Of these, 17 248 (2%) had lived in an affected property, including seven (2%) of 285 people diagnosed with mesothelioma. The adjusted incidence of mesothelioma in males who had lived at an affected property was 2·5 times that of unexposed males (SIR 2·54, 95% CI 1·02-5·24). No mesotheliomas were reported among females who had lived at an affected property. Among individuals who had lived at an affected property, there was an elevated incidence of colorectal cancer in women (SIR 1·73, 95% CI 1·29-2·26) and prostate cancer in men (1·29, 1·07-1·54); colorectal cancer was increased, although not significantly, in males (SIR 1·32, 95% CI 0·99-1·72), with no significant increase in the other cancers studied.
Residential asbestos insulation is likely to be unsafe. Our findings have important health, social, financial, and legal implications for governments and communities in which asbestos has been used to insulate houses.
ACT Government.
居住在使用石棉隔热的房屋中与健康风险相关，这一点尚不清楚。松散填充的石棉曾被用于澳大利亚首都领地（ACT）的一些房屋隔热。我们比较了居住在这些房屋中和未居住在这些房屋中的 ACT 居民中间皮瘤和其他癌症的发病率。
我们的队列研究包括使用医疗保险登记数据确定的所有 ACT 居民。这些数据与 ACT 中受影响的住宅物业的地址相关联，以确定暴露情况。我们通过将数据与澳大利亚癌症数据库和国家死亡指数相链接，对居民进行随访。结果是诊断为间皮瘤和其他选定的癌症。使用标准化发病率比（SIR），分别对男性和女性进行调整，以调整诊断时的年龄和日历时间。
1983 年 11 月 1 日至 2013 年 12 月 31 日，从医疗保险数据库中确定了 1035578 名 ACT 居民。其中，2%（17248 人）居住在受影响的房产中，包括 285 名间皮瘤患者中的 7 名（2%）。居住在受影响物业的男性间皮瘤的调整发病率是未暴露男性的 2.5 倍（SIR 2.54，95%CI 1.02-5.24）。居住在受影响物业的女性中没有报告间皮瘤。在居住在受影响物业的个体中，女性的结直肠癌发病率升高（SIR 1.73，95%CI 1.29-2.26），男性的前列腺癌发病率升高（1.29，1.07-1.54）；尽管不显著，但男性的结直肠癌发病率也有所升高（SIR 1.32，95%CI 0.99-1.72），研究中其他癌症没有显著增加。
住宅石棉隔热可能不安全。我们的研究结果对使用石棉隔热房屋的政府和社区具有重要的健康、社会、经济和法律意义。
ACT 政府。
