Environmental Health最新文献

Background: Asbestos is a well-established occupational carcinogen, with strong evidence linking its exposure to lung cancer. Despite increasing awareness of its health risks, asbestos continues to be used in many countries. We aimed to evaluate the global burden of lung cancer attributable to occupational asbestos exposure and to analyze its epidemiological patterns across time and by regions, sex, and age.

Methods: We utilized lung cancer data from the Global Burden of Disease (GBD) 2021 database, including information on new cases, deaths, and disability-adjusted life-years (DALYs), along with their age-standardized rates by gender and age groups. Temporal trends were examined using Joinpoint regression models with 95% confidence intervals (CIs). The timeline data on global asbestos bans were retrieved from the International Ban Asbestos Secretariat.

Results: We observed, approximately 25 years after the complete ban on asbestos use, a declining trend for lung cancer incidence, as well as for mortality and DALYs due to asbestos exposure. In 2021, occupational asbestos exposure accounted for 9.4% of global lung cancer deaths and 7.2% of DALYs. Between 1990 and 2021, the number of asbestos-related lung cancer deaths increased from 0.13 million to 0.19 million, while DALYs rose from 2.58 million to 3.34 million. The highest deaths and DALYs were observed in regions with high Socio-demographic Index (SDI), though the most rapid increases occurred in lower SDI regions. Over time, lung cancer burden shifted towards older populations, especially those aged over 70.

Conclusions: We found, for the first time, that a complete ban on asbestos with a lag time of 25 years could effectively reduce lung cancer incidence along with asbestos-related deaths and DALYs. These findings underscore the urgent need for a complete ban on asbestos (especially chrysotile).

Background: In Italy, the area of Casale Monferrato in the Piedmont Region has experienced a high burden of malignant mesothelioma (MM) due to environmental contamination from Eternit, the country's largest asbestos-cement plant, which operated from 1907 to 1986. The severity of the health impact led to the area's designation as a Site of National Interest (SIN) for environmental and health concerns. Despite the 1992 asbestos ban, the MM epidemic persists, driven by the disease's long latency. Using data from the Piedmont Malignant Mesothelioma Registry (RMM), we describe MM trends in Casale Monferrato's SIN from 1990 to 2021 and project future incidence through 2042 using Age-Period-Cohort (APC) models.

Methods: Incidence rates (1990-2021) were estimated as smooth functions of age and calendar time using APC models with restricted cubic splines. Projections through 2042 were made using three approaches: (1) spline-unrestricted, (2) spline-restricted, and (3) constraint-based approach. Performance was evaluated by predicting 2010-2021 rates using data up to 2010 and comparing predicted to observed cases. Sensitivity to the number and position of spline knots was assessed.

Results: Between 1990 and 2021, 1,282 pleural MM cases (731 men, 551 women) aged 35-96 were recorded in the Casale Monferrato SIN. Occupational exposure was reported in 61% of men and 21% of women. Non-occupational exposures, including environmental and familial exposures, were common in women (58%) than in men (22%). Incidence increased with age up to 85-90 years, and with birth cohort up to 1945 (154 and 105 per 100,000 in men and women, respectively), then declined. Rates increased over time by period until the mid-2010s and began to decrease thereafter. All approaches projected a slow but steady decline, with case numbers by 2035 returning to early 1990s levels. By 2042, incidence is estimated at 31 per 100,000 in men (8 cases) and 34 per 100,000 in women (9 cases).

Conclusions: The three approaches yielded consistent results, predicting extinction of the MM epidemic curve around mid-century. However, the health burden will persist over the next two decades, highlighting the need for sustained environmental health surveillance.