CONTINUING INCREASE IN MESOTHELIOMA MORTALITY IN BRITAIN
CONTINUING INCREASE IN MESOTHELIOMA MORTALITY IN BRITAIN
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DOI：
10.1016/s0140-6736(95)90462-x
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发表时间：
1995-03-04
期刊：
影响因子：
168.9
通讯作者：
JONES, JR
中科院分区：
文献类型：
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作者：
PETO, J;HODGSON, JT;JONES, JR
间皮瘤与石棉接触密切相关，间皮瘤死亡率可以作为人群过去接触石棉的指标。我们分析了自 1968 年以来的间皮瘤死亡率，以评估间皮瘤流行的现状，并预测其未来的发展趋势。我们发现，男性间皮瘤的发病率形成了由年龄和出生日期定义的清晰模式。随着年龄的增长，发病率急剧上升，在所有五年出生的队列中都呈现出非常相似的模式。按出生日期计算，从 1893 年中期到 1948 年中期，出生率有所上升，然后有所下降。相对于 1943-48 年队列，1948-53 年队列的风险为 0.79，1953-58 年队列的风险为 0.48。尽管出现了这些下降，但如果这些人群的发病率年龄分布遵循过去人群的模式，那么他们的预测终生间皮瘤风险将为 1.3%、1.0% 和 0.6%。综合所有队列的预测，预计 2020 年左右，每年男性间皮瘤死亡人数将达到峰值，死亡人数为 2700 至 3300 人。如果诊断趋势导致记录病例每 5 年增加 20%（这是一个极端但有争议的情况），并且如果这种趋势现在停止，那么每年男性死亡人数的峰值将减少到 1300 人，在 2010 年左右达到。对死亡证明上记录的职业的分析表明，建筑工人，特别是管道工和燃气安装工、木匠和电工是最大的高风险群体。这些数据表明，间皮瘤死亡人数将继续增加至少15 年，更有可能 25 年。对于受影响最严重的人群（20 世纪 40 年代出生的男性）来说，间皮瘤可能占所有死亡人数的 1% 左右。在建筑和建筑维护工作中接触石棉将占这些死亡的很大一部分，因此此类工人应意识到风险并采取适当的预防措施，这一点很重要。
Mesothelioma is closely related to exposure to asbestos, and mesothelioma mortality can be taken as an index of past exposure to asbestos in the population. We analysed mesothelioma mortality since 1968 to assess the current state of the mesothelioma epidemic, and to predict its future course.We found that rates of mesothelioma in men formed a clear pattern defined by age and date of birth. Rates rose steeply with age showing a very similar pattern in all five-year birth cohorts. By date of birth, rates increased from mid-1893 to mid-1948, and then fell. Relative to the 1943-48 cohort, the risk for the 1948-53 cohort is 0.79 and for the 1953-58 cohort 0.48. Despite these falls, if the age profile of rates for these cohorts follows the pattern of past cohorts, their predicted lifetime mesothelioma risks will be 1.3%, 1.0%, and 0.6%. Combining projections for all cohorts results in a peak of annual male mesothelioma deaths in about the year 2020 of between 2700 and 3300 deaths. If diagnostic trend is responsible for a 20% growth in recorded cases every 5 years-an extreme but arguable case-and if this trend has now ceased, the peak of annual male deaths will be reduced to 1300, reached around the year 2010. Analysis of occupations recorded on death certificates indicate that building workers, especially plumbers and gas fitters, carpenters and electricians are the largest high-risk group.These data indicate that mesothelioma deaths will continue to increase for at least 15 and more likely 25 years. For the worst affected cohorts-men born in the 1940s-mesothelioma may account for around 1% of all deaths. Asbestos exposure at work in construction and building maintenance will account for a large proportion of these deaths, and it is important that such workers should be aware of the risks and take appropriate precautions.