Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil.
Programa de Saúde Ambiental e de Saúde do Trabalhador, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, Brazil.
Int J Environ Res Public Health. 2022 Mar 19;19(6):3656. doi: 10.3390/ijerph19063656.
The aim of this study is to compare the mortality rates for typical asbestos-related diseases (ARD-T: mesothelioma, asbestosis, and pleural plaques) and for lung and ovarian cancer in Brazilian municipalities where asbestos mines and asbestos-cement plants had been operating (areas with high asbestos consumption, H-ASB) compared with in other municipalities. The death records for adults aged 30+ years were retrieved from multiple health information systems. In the 2000-2017 time period, age-standardized mortality rates (standard: Brazil 2010) and standardized rate ratios (SRR; H-ASB vs. others) were estimated. The SRRs for ARD-T were 2.56 for men (257 deaths in H-ASB municipalities) and 1.19 for women (136 deaths). For lung cancer, the SRRs were 1.33 for men (32,604 deaths) and 1.19 for women (20,735 deaths). The SRR for ovarian cancer was 1.34 (8446 deaths). Except for ARD-T and lung cancer in women, the SRRs were higher in municipalities that began using asbestos before 1970 than in municipalities that began utilizing asbestos from 1970 onwards. In conclusion, the mortality rates for ARD-T, and lung and ovarian cancer in municipalities with a history of asbestos mining and asbestos-cement production exceed those of the whole country. Caution is needed when interpreting the results of this ecological study. Analytical studies are necessary to document the impact of asbestos exposure on health, particularly in the future given the long latency of asbestos-related cancers.
本研究旨在比较巴西境内存在石棉矿和石棉水泥厂（高消耗石棉地区，H-ASB）与其他地区的典型石棉相关疾病（ARD-T：间皮瘤、石棉肺和胸膜斑）和肺癌、卵巢癌死亡率。从多个卫生信息系统中检索到 30 岁以上成年人的死亡记录。在 2000-2017 年期间，估计了年龄标准化死亡率（标准：2010 年巴西）和标准化率比（H-ASB 与其他地区相比，SRR）。男性 ARD-T 的 SRR 为 2.56（H-ASB 市 257 例死亡），女性为 1.19（H-ASB 市 136 例死亡）。对于肺癌，男性的 SRR 为 1.33（32604 例死亡），女性为 1.19（20735 例死亡）。卵巢癌的 SRR 为 1.34（8446 例死亡）。除女性的 ARD-T 和肺癌外，H-ASB 市开始使用石棉的时间早于 1970 年的 SRR 高于从 1970 年开始使用石棉的市。总之，有石棉矿和石棉水泥生产历史的市的 ARD-T、肺癌和卵巢癌死亡率高于全国水平。在解释这项生态研究结果时应谨慎。需要进行分析性研究来记录接触石棉对健康的影响，特别是在未来，考虑到与石棉有关的癌症潜伏期较长。
