Asbestosis Mortality Surveillance in the United States, 1970-2004

To describe the demographic, geographic, and occupational distribution of asbestosis mortality in the United States during 1970–2004, a total of 25,413 asbestosis deaths were identified from the National Center for Health Statistics (NCHS) multiple cause-of-death records. Mortality rates were age-adjusted to the 2000 U.S. standard population. Proportionate mortality ratios (PMRs) with corresponding confidence intervals (CIs) were calculated by industry and occupation for selected states for 1985–1999, adjusted for age, sex, and race. The overall age-adjusted asbestosis mortality rate was 4.1 per million population with the rate for males (10.4) nearly 35-fold higher than that for females (0.3). The age-adjusted mortality rate increased significantly (p<0.001) from 0.6 to 6.9 per million population from 1970 to 2000, and then declined to 6.3 in 2004. The geographic distribution of mortality rates is predominantly coastal. Industries with highest PMRs include ship and boat building and repairing (PMR=18.5, 95% CI=16.3–20.9), and miscellaneous nonmetallic mineral and stone products (PMR=15.9, 95% CI=13.0–19.5). Occupations with highest PMRs included insulation workers (PMR=109.2, 95% CI=93.8–127.2) and boilermakers (PMR=21.3, 95% CI=17.0–26.6). Although previous studies suggested a continuing increase in asbestosis-related mortality predicted on the basis of the temporal pattern of asbestos usage, disease latency, and survival considerations, we report a slight decline in mortality rates. The reason for the decline is unclear and might be attributable to a combination of factors (e.g., decline in asbestos exposure, change in the workforce pattern). More surveillance data are needed to confirm this trend.