Trend in the Global Incidence of Mesothelioma: Is There Any Changing Trend After Asbestos Regulation and Ban?

Abstract

Asking “does an asbestos ban lead to a decrease in malignant mesothelioma?” is not a simple question as it may seem. This is largely because the phrase “asbestos ban” refers to a wide range of national situations and processes. It also reflects that countries have varied widely in their speed of reducing asbestos consumption in relation to, or independent of, adopting a ban. Thus, it is analytically complex to address an asbestos ban in relation to mesothelioma incidence, and few such studies have been conducted. The first study to directly address this question compared national-level data of changes in pleural mesothelioma mortality rates versus changes in asbestos use across a range of countries; the authors found correlations between these changes and suggested that there may be an early effect. The second study, which was a birth cohort analysis conducted in Sweden, showed that a later birth cohort (one active in the workforce after the decrease in asbestos use) had a decreased risk of pleural mesothelioma relative to an earlier birth cohort, regardless of gender. These studies implicated a causal effect, wherein an asbestos ban leads to a decrease in mesothelioma incidence. Given the very long latency period for mesothelioma, it can be expected that a much clearer effect will soon become evident in countries that adopted an early ban on asbestos. Furthermore, given the ongoing use of asbestos by many industrializing countries, it is also pertinent to ask: “Did an increase in mesothelioma incidence lead to an asbestos ban in some countries?”.