Consequences of asbestos use in Great Britain - BOHS

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Consequences of asbestos use in Great Britain - BOHS

Consequences of asbestos

use in Great Britain

Andy Darnton

HSE Epidemiology Unit


Tonnes

Thousands

UK asbestos imports by main fibre type

200

180

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Exposure (1000s)

Deaths

Asbestos exposure, actual and predicted mesothelioma deaths

among men in GB

200

2500

2000

1500

100

Fitted exposure

index

Observed deaths

Predicted deaths

(95% prediction

1000

500

0

interval)

1940 1960 1980 2000 2020

0


Female

Cumulative mesothelioma death rate to age 85

120

Australia

100

UK

Slovenia

80

Finland

Netherlands

60

40

20

Chile

Austria

Lith

Hungary

Rom

Czech Spain

Israel

Japan

SloArgentina

Serb Mexico

Portugal

Poland

France Denmark

Germany

Sweden

USA

Canada

Norway

Croatia

New Zealand

Australasia

W Europe

USA

Japan

E Europe

C&S America

Background

0

0 100 200 300 400 500 600 700 800

Male


British Asbestos Survey: number of workers recruited

each year by main industry


British mesothelioma case-control study

• Confirms the substantial contribution of “end-user”

exposure in construction.

• LR among men born in 1940s who worked as a

carpenter for 10 years before age 30 is worse than 1

in 10 (ie >10%)

• 62% of female cases not attributable to identifiable

sources of exposure

• About 200 cases per year in women (and same in

men) currently unexplained

• Background risk in men and women who did not do

any work in high risk jobs is about 1 in 1250 (0.08%)


Tonnes

Thousands

Regulatory and epidemiological history

200

180

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Tonnes

Thousands

Regulatory history

200

Asbestos Regulations 1969;

180

Croc banned;

Asbestos survey established

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Tonnes

Thousands

Regulatory history

200

Asbestos Regulations 1969;

180

Croc banned;

Asbestos survey established

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Tonnes

Thousands

Amos

banned

Regulatory history

200

Asbestos Regulations 1969;

180

Croc banned;

Asbestos survey established

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Tonnes

Thousands

Amos

banned

ASLIC

Regulatory history

200

Asbestos Regulations 1969;

180

Croc banned;

Asbestos survey established

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Tonnes

Thousands

Amos

banned

ASLIC

CAWR

Regulatory history

200

Asbestos Regulations 1969;

180

Croc banned;

Asbestos survey established

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Tonnes

Thousands

Amos

banned

ASLIC

CAWR

DTM

Regulatory history

200

Asbestos Regulations 1969;

180

Croc banned;

Asbestos survey established

160

Chrys

140

Amosite

120

100

Croc

80

60

40

20

0

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000


Where are we now

• What are the risks arising from exposures

today

• What are the risks to building maintenance

workers

• What is the background rate due to

environmental exposures today


Use quantitative risk models to make an

assessment


Use quantitative risk models to make an

assessment

Crocidolite


Use quantitative risk models to make an

assessment

Crocidolite

Amosite


Use quantitative risk models to make an

assessment

Crocidolite

Chrysotile

Amosite


Lifetime risk per 100,000

Non-linear (black lines) and linear risk (red) models from

Hodgson and Darnton 2000

12000

10000

8000

6000

4000

2000

0

0 10 20 30 40 50 60 70 80 90 100

Cumulative exposure (f/ml.yr)


Lifetime risk per 100,000

Non-linear (black lines) and linear risk (red) models from

Hodgson and Darnton 2000

12000

10000

8000

6000

4000

2000

0

0 10 20 30 40 50 60 70 80 90 100

Cumulative exposure (f/ml.yr)


Lifetime risk per 100,000

Non-linear (black lines) and linear risk (red) models

from Hodgson and Darnton 2000 – extrapolation

10000

1000

700

565

100

91

70

25

10

16

7

1

0.01 0.1 1 10 100

Cumulative exposure (f/ml.yr)


Lifetime risk per 100,000

Non-linear (black lines) and linear risk (red) models

from Hodgson and Darnton 2000 – extrapolation

10000

1000

700

565

100

91

70

25

10

16

7

1

0.01 0.1 1 10 100

Cumulative exposure (f/ml.yr)


Better population based models

1000

100

10

1

0.1

male

female

male

female

25-34

35-44

45-54

55-64

65-74

25-34

35-44

45-54

55-64

65-74

0.01

1880 1900 1920 1940 1960 1980


Lung burden studies of younger more recent workers

• Interviewed mesothelioma cases: where possible lung tissue is obtained

from post-mortem samples for measurement of asbestos fibres by optical

and transmission electron microscopy.

• Occupational histories and lung samples from lung cancer patients, and

from younger men and women treated surgically for pneumothorax.

• Aim to relate lung burden to mesothelioma risk, and determine the

amount and type of asbestos in the lungs of those who began work since

the 1980s, particularly building workers but also those working in low risk

jobs.

• Estimate future risks from current and recent asbestos exposure.

• Provide direct evidence on the contribution of the expansion of amosite

use to the 50,000 or more mesotheliomas expected in the UK over the

next 40 years in men and women born before 1960.

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