Safety and Health at Work

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency (산업안전보건연구원)
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Analysis of Mortality from Asbestos-Related Diseases in Brazil Using Multiple Health Information Systems, 1996-2017

  • Algranti, Eduardo (Directory of Applied Research, Fundacentro, Ministry of Labor and Social Welfare) ;
  • Santana, Vilma S. (Institute of Collective Health, Federal University of Bahia) ;
  • Campos, Felipe (Institute of Collective Health, Federal University of Bahia) ;
  • Salvi, Leonardo (Institute of Collective Health, Federal University of Bahia) ;
  • Saito, Cezar A. (Directory of Applied Research, Fundacentro, Ministry of Labor and Social Welfare) ;
  • Cavalcante, Franciana (Institute of Collective Health, Federal University of Bahia) ;
  • Correa-Filho, Heleno R. (Department of Collective Health, School of Health Sciences, University of Brasilia)
  • Received : 2021.12.28
  • Accepted : 2022.04.29
  • Published : 2022.09.30
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Abstract

Background: In Brazil, asbestos was intensively used from the 1960s until its ban in 2017. Mesothelioma, asbestosis, and pleural plaques are typical asbestos-related diseases (ARD-T). To create an ARD-T national database, death records from 1996-2017 were retrieved from several health information systems (HIS). Methods: All national HIS containing coded diagnoses (ICD-10) and death information were obtained. Linkage was performed to create a single database of ARD-T death records, either as underlying or contributory causes, in adults aged 30 years and older. Results: A total of 3,057 ARD-T death records were found, 2,405 (76.4%) of which being malignant mesotheliomas (MM). Pleural MM (n = 1,006; 41.8%) and unspecified MM (n = 792; 32.9%) prevailed. Male to female MM ratio (M:F) was 1.4:1, and higher ratios were found for non-malignant ARD-T: 3.5:1 for asbestosis and 2.4:1 for pleural plaques. Male crude annual mesothelioma mortality (CMmm ×1,000,000) was 0.98 in 1996 and 2.26 in 2017, a 131.1% increment, while for females it was 1.04 and 1.25, a 20.2% increase, correspondingly. The small number of deaths with asbestosis and pleural plaques records precluded conclusive interpretations. Conclusions: Even with the linkage of several HIS, ARD-T in death records remained in low numbers. MM mortality in men was higher and showed a rapid increase and, along with non-malignant ARD-T, higher M:F ratios suggested a predominant pattern of work-related exposure. The monitoring of workplace and environmental asbestos exposure needs to be improved, as well as the workers surveillance, following the recent Brazilian ban.

Keywords

Acknowledgement

To the National Institute of Cancer, which made available the SisRHC database.

References

  1. Wolff H, Vehmas T, Oksa P, Rantanen J, Vainio H. Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations. Scand J Work Environ Health 2015;41(1):5-15. https://doi.org/10.5271/sjweh.3462.
  2. LaDou J, Castleman B, Frank A, Gochfeld M, Greenberg M, Huff J, Joshi TK, Landrigan PJ, Lemen R, Myers J, Soffritti M, Soskolne CL, Takahashi K, Teitelbaum D, Terracini B, Watterson A. The case for a global ban on asbestos. Environ Health Perspect 2010 Jul;118(7):897-901. https://doi.org/10.1289/ehp.1002285. Epub 2010 Jun 8.
  3. International Ban Asbestos Secretariat. Current asbestos bans 2019 [accessed 2021 Nov 16]. Available online: http://www.ibasecretariat.org/alpha_ban_list.php.
  4. Alpert N, van Gerwen M, Taioli E. Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use. Transl Lung Cancer Res 2020 Feb;9(Suppl. 1):S28-38. https://doi.org/10.21037/tlcr.2019.11.11. PMID: 32206568; PMCID: PMC7082259.
  5. Jamrozik E, de Klerk N, Musk AW. Asbestos-related disease. Intern Med J 2011 May;41(5):372e80. https://doi.org/10.1111/j.1445-5994.2011.02451.x.
  6. Arachi D, Soeberg M, Chimed-Ochir O, Lin RT, Takahashi K. Trend in the global incidence of mesothelioma: is there any changing trend after asbestos regulation and ban?. In: Malignant pleural mesothelioma. Singapore: Springer; 2021. p. 3-13.
  7. GBD 2016 Occupational Carcinogens Collaborators. Global and regional burden of cancer in 2016 arising from occupational exposure to selected carcinogens: a systematic analysis for the Global Burden of Disease Study 2016 GBD 2016 Occupational Carcinogens Collaborators. Occup Environ Med 2020;77:151-9. https://doi.org/10.1136/oemed-2019-106012
  8. Gerwen Mv, Alpert N, Flores R, Taioli E. An overview of existing mesothelioma registries worldwide, and the need for a US Registry. Am J Ind Med 2019;1-6 doi.org/10.1002/ajim.23069.
  9. Marinaccio A, Binazzi A, Bonafede M, Di Marzio D, Scarselli A, Centres RO. Epidemiology of malignant mesothelioma in Italy: surveillance systems, territorial clusters and occupations involved. J Thorac Dis 2018;10(Suppl. 2): S221-7. https://doi.org/10.21037/jtd.2017.12.146.
  10. Mazureck JM, Syamlal G, Wood JM, Hendricks SA, Weston A. Malignant mesothelioma mortality - United States 1999-2015. Morbidity Mortality Weekly Rep MMWR 2017 March 3;66(9):214-9. https://doi.org/10.15585/mmwr.mm6608a3.
  11. Delgermaa V, Takahashi K, Park EK, Le GV, Hara T, Sorahan T. Global mesothelioma deaths reported to the world health organization between 1994 and 2008. Bull World Health Organ 2011;89(10):716e24. https://doi.org/10.2471/BLT.11.086678. 24A-724.
  12. Algranti E, Markowitz S. Asbestosis. In: Newman-Taylor A, Cullinan P, Blanc P, Pickering A, editors. Occupational lung disorder. Boca Raton, FL: CRC Press; 2017. p. 157-70.
  13. Miller A, Black CB, Loewen G, Noonan CW, McNew T, Whitehouse AC, Frank AL. Case-fatality study of workers and residents with radiographic asbestos disease in Libby, Montana. Am J Ind Med 2022 Mar;65(3):196-202. https://doi.org/10.1002/ajim.23320.
  14. Maxim D, Niebo R, Utell M. Are pleural plaques an appropriate endpoint for risk analyses? Inhal Toxicol 2015;27(7):321-34. https://doi.org/10.3109/08958378.2015.1051640.
  15. Pedra F, Silva PO, Mattos I, Castro H. Mortality by mesothelioma in Brazil, 1980-2010. Braz J Cancerology 2014;60(3):199-206.
  16. Algranti E, Saito CA, Carneiro AP, Moreira B, Mendonca EM, Bussacos MA. The next mesothelioma wave: mortality trends and forecast to 2030 in Brazil. Cancer Epidemiol 2015;39(5):687-92. https://doi.org/10.1016/j.canep.2015.08.007.
  17. Fernandes GA, Algranti E, Wunsch-Filho V, Silva LF, Toporcov TN. Causes of death in former asbestos-cement workers in the state of Sao Paulo, Brazil. Am J Ind Med 2021 Nov;64(11):952-9. https://doi.org/10.1002/ajim.23279.
  18. Saito CA, Bussacos MA, Salvi L, Mensi C, Consonni D, Fernandes FT, Campos F, Cavalcante F, Algranti E. Sex-specific mortality from asbestos-related diseases, lung and ovarian cancer in municipalities with high asbestos consumption, Brazil, 2000-2017. Int J Environ Res Public Health 2022;19:3656. https://doi.org/10.3390/ijerph19063656.
  19. Santana VS, Algranti E, Campos F, Cavalcante F, Salvi L. Underreporting of mesothelioma, asbestosis and pleural plaques deaths in Brazil. Occup Med 2021 Aug 20;71(4-5):223-30. https://doi.org/10.1093/occmed/kqab073.
  20. Santana VS, Algranti E, Campos F, Cavalcante F, Salvi L, Santos SA, et al. Recovering missing mesothelioma deaths in death certificates using hospital records. Am J Ind Med 2018;61(7):547-55. https://doi.org/10.1002/ajim.22846.
  21. Fernandes FT, Silva DRME, Campos F, Santana VS, Cuani L, Curado MP, Salvi L, Algranti E. Recovering records on cancer of the larynx from anonymous health information databases. Rev Bras Epidemiol 2021 Apr 2;24:e210011. https://doi.org/10.1590/1980-549720210011.
  22. Available from: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?popsvs/cnv/popbr.def, Accessed August 1,2021.
  23. Gibbons CL, Mangen MJ, Plass D, Havelaar AH, Brooke RJ, Kramarz P, Peterson KL, Stuurman AL, Cassini A, Fevre EM, Mirjam EE, Kretzschmar MEE. Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods. BMC Public Health 2014;14:147. https://doi.org/10.1186/1471-2458-14-147.
  24. GBD 2017. Risk, Factor, Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1923-94. https://doi.org/10.1016/S0140-6736(18)32225-6
  25. D'Acri V. Trabalho e saude na industria textil de amianto. Sao Paulo Em Perspectiva 2003;17(2):13-22. https://doi.org/10.1590/S0102-88392003000200003.
  26. Lacourt A, Gramond C, Rolland P, Ducamp S, Audignon S, Astoul P, et al. Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma. Thorax 2014;69(6):532-9. https://doi.org/10.1136/thoraxjnl-2013-203744
  27. Ferrante D, Mirabelli D, Tunesi S, Terracini B, Magnani C. Pleural mesothelioma and occupational and non-occupational asbestos exposure: a casecontrol study with quantitative risk assessment. Occup Environ Med 2016;73(3):147-53. https://doi.org/10.1136/oemed-2015-102803
  28. Slomovitz B, De Haydu C, Taub M, Coleman RL, Monk BJ. Asbestos and ovarian cancer: examining the historical evidence. Int JGynecol Cancer 2021;31(1):122-8. https://doi.org/10.1136/ijgc-2020-001672
  29. Kauppinen T, Uuksulainen S, Saalo A, Makinen I. Trends of occupational exposure to chemical agents in Finland in 1950-2020. Ann Occup Hyg 2013 Jun;57(5):593e609. https://doi.org/10.1093/annhyg/mes090. Epub 2012 Dec 10. PMID: 23230130.
  30. Girardi P, Merler E, Ferrante D, et al. Factors affecting asbestosis mortality among asbestos-cement workers in Italy. Ann Work Exposures Health 2020: 1-14. https://doi.org/10.1093/annweh/vxaa037.
  31. Silva DRME, Luizaga CTM, Toporcov TN, Algranti E. Agreement and validity of asbestos-related cancers in the hospital information system of the Brazilian Unified Health System. Rev Bras Epidemiol 2021 Aug 13;24:e210044. https://doi.org/10.1590/1980-549720210044. eCollection 2021.