Mesothelioma mortality in Great Britain: how much longer will dockyards dominate?
File(s)
Author(s)
Reynolds, CJ
Minelli, C
Darnton, A
Cullinan, P
Type
Journal Article
Abstract
OBJECTIVES: We aimed to investigate whether there has been a geographic shift in the distribution of mesothelioma deaths in Great Britain given the decline of shipbuilding and progressive exposure regulation. METHODS: We calculated age-adjusted mesothelioma mortality rates and estimated rate ratios for areas with and without a dockyard. We compared spatial autocorrelation statistics (Moran's I) for age-adjusted rates at local authority district level for 2002-2008 and 2009-2015. We measured the mean distance of the deceased's postcode to the nearest dockyard at district level and calculated the association of average distance to dockyard and district mesothelioma mortality using simple linear regression for men, for 2002-2008 and 2009-2015. RESULTS: District age-adjusted male mortality rates fell during 2002-2015 for 80 of 348 districts (23%), rose for 267 (77%) and were unchanged for one district; having one or more dockyards in a district was associated with rates falling (OR=2.43, 95% CI 1.22 to 4.82, p=0.02). The mortality rate ratio for men in districts with a dockyard, compared with those without a dockyard was 1.41 (95% CI 1.35 to 1.48, p<0.05) for 2002-2008 and 1.18 (95% CI 1.13 to 1.23, p<0.05) for 2009-2015. Spatial autocorrelation (measured by Moran's I) decreased from 0.317 (95% CI 0.316 to 0.319, p=0.001) to 0.312 (95% CI 0.310 to 0.314, p=0.001) for men and the coefficient of the association between distance to dockyard and district level age-adjusted male mortality (per million population) from -0.16 (95% CI -0.21 to -0.10, p<0.01) to -0.13 (95% CI -0.18 to -0.07, p<0.01) for men, when comparing 2002-2008 with 2009-2015. CONCLUSION: For most districts age-adjusted mesothelioma mortality rates increased through 2002-2015 but the relative contribution from districts with a dockyard fell. Dockyards remain strongly spatially associated with mesothelioma mortality but the strength of this association appears to be falling and mesothelioma deaths are becoming more dispersed.
Date Issued
2019-11-14
Date Acceptance
2019-10-02
ISSN
1351-0711
Publisher
BMJ Publishing Group
Start Page
908
End Page
912
Journal / Book Title
Occupational and Environmental Medicine
Volume
76
Issue
12
Copyright Statement
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/31662422
oemed-2019-105878
Subjects
asbestos
epidemiology
mesothelioma
asbestos
epidemiology
mesothelioma
1103 Clinical Sciences
1117 Public Health and Health Services
1599 Other Commerce, Management, Tourism and Services
Environmental & Occupational Health
Publication Status
Published
Country
England
Date Publish Online
2019-10-29