Preliminary Results from ATSDR's Pilot Mesothelioma Surveillance

Background:

The association of mesothelioma with past direct or indirect exposure to asbestos is commonly recognized. However, about 20% to 30% of mesothelioma cases have no known history of asbestos exposure. Identification and assessment of exposure in mesothelioma cases is critical in order to develop preventive public health strategies.

Objective:

To evaluate the history of asbestos exposure in incident cases with pleural and non-pleural mesothelioma.

Methods:

Incident cases were 160 New York and New Jersey residents with histologically confirmed malignant mesothelioma at different tumor locations. ATSDR's classification of occupational and non-occupational asbestos-associated activities was used to design a telephone questionnaire.

Results:

The frequency of pleural cases was 5 times higher than non-pleural. Overall, 90% of males and 28% of females reported at least one asbestos-associated activity in their lifetime (n=120). Ninety-one percent of these activities were job-related. Among those who reported asbestos-associated activity, pleural cases were 3.8 times more likely than non-pleural (p<0.05). Among pleural cases with asbestos-associated activities, male cases were 2.5 times more likely than female (p<0.05). Seventy two percent of all pleural cases reported more than one asbestos-associated activity (n=86). Among female non-pleural cases, none reported any asbestos-associated activity.

Conclusions:

Pleural mesothelioma is strongly associated with occupational exposure to asbestos. Mesothelioma involving other locations is less frequently associated with asbestos exposure. Among female cases diagnosed with non-pleural mesothelioma, none reported any asbestos-associated activity. Further studies of the relationship between non-pleural mesothelioma and asbestos exposure are required.