Years of potential life lost before age 65 years attributable to asbestos-associated respiratory diseases in the United States, 1999-2008

Background: Although asbestos use has been restricted in recent decades, asbestos-associated deaths continue to occur in the United States. We computed years of potential life lost before age 65 (YPLL65) to evaluate premature mortality and loss of potentially productive years of life attributed to asbestos-associated respiratory diseases. Methods: We used the 1999–2008 National Center for Health Statistics mortality data for decedents aged 25–64 years. We identified decedents with asbestosis, malignant mesothelioma (MM), and lung cancer listed as underlying cause of death—with lung cancer decedents restricted to those with asbestosis as a contributing cause of death. We calculated YPLL65 using age at death. We calculated a year-to-year YPLL65 difference for each disease and performed a Wilcoxon signed rank test on the differences to assess the significance of time-trends. Results: During 1999–2008, 5,808 deaths were attributed to these diseases accounting for 42,557 YPLL65 (mean per decedent 7.3 years); 30,120 (mean: 6.7) for male and 37,912 (mean: 7.1) for white decedents. By state, YPLL65 was highest among California (4,863) decedents. A total of 40,071 (mean: 7.6 years) YPLL65 were attributed to MM, 1,627 (mean: 4.7) to asbestosis, and 859 (mean: 4.3) to lung cancer with asbestosis. No significant changes in the time-trends were observed. Conclusions: Asbestos-associated respiratory diseases are associated with a considerable loss of potentially productive years of life. The continuing occurrence of asbestos-associated respiratory diseases underscores the need for maintaining prevention efforts and for ongoing surveillance to monitor these diseases temporal trends.