Asbestos: The Legacy

 

The devastating asbestos legacy in the UK is set to become ever more pervasive and be with us for many decades to come. The history of asbestos use in the UK is well documented and the consequences of this legacy are felt across all communities.

Dangerous work

Asbestos is still in place in many buildings, including factories, offices, hospitals and schools This results in continuing occupational exposure for construction, maintenance and demolition workers if adequate precautions are not taken to identify and deal with asbestos.

People using or living in buildings may be at risk if asbestos is poorly maintained.

 

3D - Question Mark (II)3D - Question Mark (II)Answers from the Health & Safety Executive:

Asbestos: Frequently Asked Questions (FAQ’S)

Health Risks; Employers & Employees; Control of Asbestos Regulations &  Members of the Public.

According to figures from the Health & Safety Executive (HSE) there are over 2500 people per year in the UK diagnosed with mesothelioma (the most serious form of asbestos related cancer) and at least a further 2500 cases of lung cancer which are also likely to be caused by asbestos exposure.

inwalls

 

Asbestos-related disease Statistics

 

Mesothelioma-tumours-270x300Mesothelioma

 

There were 2,542 mesothelioma deaths in Great Britain in 2015

Mesothelioma is a form of cancer that takes many years to develop following the inhalation of asbestos fibres, but is usually rapidly fatal following disease onset. Annual deaths in Britain increased steeply over the last 50 years, a consequence of mainly occupational asbestos exposures that occurred because of the widespread industrial use of asbestos during 1950-1980.

The latest information shows:

  • There were 2,542 mesothelioma deaths in Great Britain in 2015, a similar number to the previous three years.
  • The latest projections suggest that there will continue to be around 2,500 deaths per year for the rest of this current decade before annual numbers begin to decline.
  • The continuing increase in annual mesothelioma deaths in recent years has been driven mainly by deaths among those aged 70 and above.
  • In 2015 there were 2,135 male deaths and 407 female deaths, similar to the annual numbers in among males and females in the previous three years.
  • There were 2,130 new cases of mesothelioma assessed for Industrial Injuries Disablement Benefit (IIDB) in 2015 compared with 2,215 in 2014.
  • Men who worked in the building industry when asbestos was used extensively are now among those most at risk of mesothelioma.

Mesothelioma in Great Britain: annual deaths, IIDB cases and projected future deaths to 2030.

Mesothelioma in Great Britain: annual deaths, IIDB cases and projected future deaths to 2030

Contains public sector information published by the Health and Safety Executive and licensed under the Open Government Licence v3.0.

Asbestos-related lung cancer

Summary

 

  • The overall scale of asbestos-related lung cancer deaths has to be estimated rather than counted.
  • Research suggests there are currently about as many lung cancer deaths attributed to past asbestos exposure each year in Great Britain as there are mesothelioma deaths.
  • This implies there are currently in excess of 2,000 asbestos-related lung cancer deaths each year.
  • This estimate is uncertain, and since asbestos and smoking act together to increase the risk, it is affected by past smoking habits as well as asbestos exposure.

 

Background information

 

Asbestos is one of a large number of agents that can cause lung cancer, the most important of which is tobacco smoking.

Lung cancer usually has no specific clinical signs suggesting a particular cause and asbestos exposure and smoking act together to increase the risk. This – together with the fact that cases usually take many years to develop – makes it difficult to be sure about the cause of individual cases. As a consequence, data sources that rely on the counting of individual cases attributed to asbestos exposures, such as Industrial Injuries Disablement Benefit (IIDB) and the Health and Occupation Reporting (THOR) schemes, tend to underestimate the true scale of asbestos-related cases.

Epidemiological analyses that are representative of the British population suggest that there are likely to be about as many lung cancer cases attributed to past asbestos exposure each year in the population as a whole as there are mesotheliomas .  This implies there are currently in excess of 2000 asbestos-related lung cancer deaths each year.

This estimate is uncertain. Since asbestos and smoking act together to increase the risk of lung cancer, it is affected by past smoking habits as well as the extent of asbestos exposure. The ratio of lung cancers to mesotheliomas is expected to fall over time, a reflection of reductions in both asbestos exposure and the prevalence of smoking. Among more specific groups of workers heavily exposed to asbestos in the past there were typically a greater number of excess lung cancer cases than there were mesotheliomas.

Lung cancer is still typically fatal within a few years of diagnosis and so, as with the mesothelioma, the number of annual deaths is similar to the annual incidence of new cases.

In recent years there have been, on average, around 300 new cases of asbestos-related lung cancer each year within the IIDB scheme and less than 100 cases identified by chest physicians each year within the THOR scheme.

Estimates of the burden of lung cancer attributable to occupational exposures other than asbestos are available based on the Burden of Occupational Cancer research

References

  1. Darnton A, McElvenny D, Hodgson J (2005). Estimating the number of asbestos related lung cancer deaths in Great Britain from 1980-2000. Annals of Occupational Hygiene 50(1): 29-38.
  2. Gilham C, Rake C, Burdett G et al (2015). Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden. Occup Environ Med. 73(5):290-9.
  3. McCormack V, Peto J, Byrnes G et al (2012). Estimating the asbestos-related lung cancer burden from mesothelioma mortality. Br J Cancer. 106(3):575-84.

Contains public sector information published by the Health and Safety Executive and licensed under the Open Government Licence v3.0.

early-asbestosis-in-a-retired-pipe-fitterAsbestosis

 

Asbestosis deaths and Industrial Injuries Disablement Benefit (IIDB) cases continue to increase in Great Britain, a legacy of heavy exposures to asbestos in the past.

The latest information shows:

  • In 2014 there were 431 deaths where the death certificate mentioned asbestosis and not mesothelioma compared with 109 in 1978. (Asbestosis register)
  • In 2014 there were 198 deaths with asbestosis specifically recorded as the underlying cause of death compared with 36 in 1978. (Asbestosis register).
  • There were 1175 new cases assessed for Industrial Injuries Disablement Benefit (IIDB) in 2015 compared with 985 in 2014.
  • There has been a long-term upward trend in both deaths and IIDB cases, though with substantial fluctuations year-on-year in IIDB cases, particularly in recent years.
  • Increases in annual numbers of deaths have been driven mainly by cases above age 75 years.

Annual deaths where death certificates mentioned asbestosis but not mesothelioma, and IIDB cases 1978-2015

Asbestosis deaths and disablement benefit cases 1978-2011

Deaths from asbestosis (a form of pneumoconiosis caused by the inhalation of asbestos fibres) continue to increase in Great Britain, a legacy of heavy exposures to asbestos in the past.

The latest information shows:

  • In 2013 there were 516 deaths where asbestosis is likely to have contributed as a cause compared with 109 in 1978. (Asbestosis register).
  • There were 217 deaths in 2013 where asbestosis was specifically recorded as the underlying cause of death. (Asbestosis register).
  • There were 985 newly assessed cases for Industrial Injuries Disablement Benefit in 2014. (IIDB).
  • Annual numbers of newly assessed cases have fluctuated in recent years.

Asbestosis in Great Britain 2016

 

Non-malignant pleural disease

 

Non-malignant pleural disease is a non cancerous condition affecting the outer lining of the lung (the pleura). It includes two forms of disease: diffuse pleural thickening and the less serious pleural plaques. A substantial number of cases continue to occur each year in Great Britain, mainly due to workplace asbestos exposures many years ago.

The latest information shows:

  • There were 430 new cases of pleural thickening assessed for Industrial Injuries Disablement Benefit in 2015 (IIDB).
  • The annual number has been fairly constant over the last 10 years, with an average of around 430 new cases per year (IIDB).
  • An estimated 564 new cases of non-malignant pleural disease mainly caused by asbestos were reported by chest physicians in 2015. A substantial proportion of these were cases of pleural plaques (THOR).
  • Pleural plaques are usually symptomless and are often identified in the THOR scheme when individuals have chest x-rays for other conditions.
  • For these reasons, there are likely to be substantially more individuals in the population with pleural plaques than those identified by chest physicians.

Tables

  • IIDB05 Excel spreadsheet – Prescribed industrial diseases of the lungs and new cases of assessed disablement by disease
  • THORR01 Excel spreadsheet – Numbers by sex and diagnostic category, 1998 to latest year

Contains public sector information published by the Health and Safety Executive and licensed under the Open Government Licence v3.0.

Other Conditions

 

There is some evidence to suggest that asbestos can also cause laryngeal cancer and may be implicated in causing pharyngeal, stomach and colorectal cancer…and conceivably a wide range of others. Asbestos: Effects on health of exposure to asbestos. Richard Doll and Julian Peto. HSE. 1985.pdf

All types of asbestos cause lung cancer, mesothelioma, cancer of the larynx and ovary, and asbestosis. World Health Organisation. www.who.int/ipcs/assessment/public_health/asbestos/en/

Across Europe 10 asbestos-related cancers are recognised; in the UK only two, lung cancer and mesothelioma, are prescribed. And it seems IIAC is content to see workers with eight of the 10 asbestos related cancers continue to miss out. http://www.hazards.org/compensation/meantest

Each year around 13,000 deaths from occupational lung disease and cancer are estimated to have been caused by past exposure, primarily to chemicals and dusts, at work (this estimate includes mesothelioma deaths) http://www.hse.gov.uk/statistics/index.htm

Currently, the UK Government advisory body the Industrial Injuries Advisory Council (IIAC)  lists only the following ‘prescribed’ diseases for the purposes of claiming Industrial Injuries Disablement Benefit & State Compensation

List of prescribed diseases;

  • D1 – Asbestosis
  • D3 – Mesothelioma
  • D8 – Primary carcinoma of the lung where there is accompanying evidence of asbestosis
  • D8A– Primary carcinoma of the lung
  • D9 – Diffuse Pleural Thickening

Industrial Injuries Advisory Council (IIAC) and Asbestos – related Diseases Reports & Position Papers:

Asbestos in Schools:

HSE: Annual Workplace Fatalities UK (excluding disease) 2016

GOV.UK:  Publications: FOI 

Contains public sector information published by the Health and Safety Executive and licensed under the Open Government Licence v3.0.

Last updated: July 2017