Occupational Burden of Asbestos-Related Diseases in Korea, 1998–2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer

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Abstract

Background

Asbestos exposure causes asbestos-related diseases (ARDs) including asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer. Although Korea used substantial amounts of asbestos in the past, no study has focused on its occupational burden of disease (OBD). Therefore, this study aimed to determine the OBDs of ARDs in Korea.

Methods

The CARcinogen Exposure (CAREX) database was used to determine the proportion of exposed population. Relative risks for lung cancer, laryngeal cancer, and ovarian cancer were used to determine the population-attributable fraction. Data for deaths caused by ARDs during 1998–2013 were obtained from the World Health Organization mortality database. The potential years of life lost (PYLL) and annual average PYLL (APYLL) indicated OBDs.

Results

In Korea, the number of ARD-attributable deaths and PYLL due to all ARDs during 1998–2013 were 4,492 and 71,763.7, respectively. The number of attributable deaths and PYLL due to asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer were 37 and 554.2, 808 and 15,877.0, 3,256 and 47,375.9, 120 and 1,605.5, and 271 and 6,331.1, respectively; additionally, the APYLL were 15.0, 19.7, 14.6, 13.4, and 23.4, respectively, and the average age at death was 70.4, 62.6, 69.1, 69.9, and 61.8, respectively. Our study showed that although the use of asbestos has ceased in Korea, the incidence of ARDs tends to increase.

Conclusion

Therefore, efforts to reduce future OBDs of ARDs, including early detection and proper management of ARDs, are needed in Korea.

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Most cited references 20

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The global burden of disease due to occupational carcinogens.

Marilyn Fingerhut, Annette Prüss-Ustün, Kyle Steenland … (2005)

The worldwide mortality and morbidity from lung cancer, leukemia, and malignant mesothelioma arising from occupational exposures to carcinogens are described. Cases reported in the year 2000 that resulted from relevant past and current exposures are assessed. The proportions of workers exposed to the carcinogens of interest, and their levels of exposure, were estimated using workforce data and the CAREX (CARcinogen EXposure) database. These were combined with relative risk measures (for lung cancer and leukemia) or absolute risk measures (for malignant mesothelioma) to develop estimates of deaths, disability-adjusted life years (DALYs) and attributable fraction (for lung cancer and leukemia). There were an estimated 152,000 deaths (lung cancer: 102,000; leukemia: 7,000; and malignant mesothelioma: 43,000) and nearly 1.6 million DALYS (lung cancer: 969,000; leukemia: 101,000; and malignant mesothelioma: 564,000) due to exposure to occupational carcinogens. Occupational carcinogens are an important cause of death and disability worldwide. 2005 Wiley-Liss, Inc.

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Occupational exposure to carcinogens in the European Union.

D Mirabelli, B. Pannett, P Boffetta … (1999)

To construct a computer assisted information system for the estimation of the numbers of workers exposed to established and suspected human carcinogens in the member states of the European Union (EU). A database called CAREX (carcinogen exposure) was designed to provide selected exposure data and documented estimates of the number of workers exposed to carcinogens by country, carcinogen, and industry. CAREX includes data on agents evaluated by the International Agency for Research on Cancer (IARC) (all agents in groups 1 and 2A as of February 1995, and selected agents in group 2B) and on ionising radiation, displayed across the 55 industrial classes. The 1990-3 occupational exposure was estimated in two phases. Firstly, estimates were generated by the CAREX system on the basis of national labour force data and exposure prevalence estimates from two reference countries (Finland and the United States) which had the most comprehensive data available on exposures to these agents. For selected countries, these estimates were then refined by national experts in view of the perceived exposure patterns in their own countries compared with those of the reference countries. About 32 million workers (23% of those employed) in the EU were exposed to agents covered by CAREX. At least 22 million workers were exposed to IARC group 1 carcinogens. The exposed workers had altogether 42 million exposures (1.3 mean exposures for each exposed worker). The most common exposures were solar radiation (9.1 million workers exposed at least 75% of working time), environmental tobacco smoke (7.5 million workers exposed at least 75% of working time), crystalline silica (3.2 million exposed), diesel exhaust (3.0 million), radon (2.7 million), and wood dust (2.6 million). These preliminary estimates indicate that in the early 1990s, a substantial proportion of workers in the EU were exposed to carcinogens.

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Asbestos: use, bans and disease burden in Europe

Takashi Kameda, Ken Takahashi, Rokho Kim … (2014)

Abstract Objective To analyse national data on asbestos use and related diseases in the European Region of the World Health Organization (WHO). Methods For each of the 53 countries, per capita asbestos use (kg/capita/year) and age-adjusted mortality rates (deaths/million persons/year) due to mesothelioma and asbestosis were calculated using the databases of the United States Geological Survey and WHO, respectively. Countries were further categorized by ban status: early-ban (ban adopted by 2000, n = 17), late-ban (ban adopted 2001–2013, n = 17), and no-ban (n = 19). Findings Between 1920–2012, the highest per capita asbestos use was found in the no-ban group. After 2000, early-ban and late-ban groups reduced their asbestos use levels to less than or equal to 0.1 kg/capita/year, respectively, while the no-ban group maintained a very high use at 2.2 kg/capita/year. Between 1994 and 2010, the European Region registered 106 180 deaths from mesothelioma and asbestosis, accounting for 60% of such deaths worldwide. In the early-ban and late-ban groups, 16/17 and 15/17 countries, respectively, reported mesothelioma data to WHO, while only 6/19 countries in the no-ban group reported such data. The age-adjusted mortality rates for mesothelioma for the early-ban, late-ban and no-ban groups were 9.4, 3.7 and 3.2 deaths/million persons/year, respectively. Asbestosis rates for the groups were 0.8, 0.9 and 1.5 deaths/million persons/year, respectively. Conclusion Within the European Region, the early-ban countries reported most of the current asbestos-related deaths. However, this might shift to the no-ban countries, since the disease burden will likely increase in these countries due the heavy use of asbestos.

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Author and article information

Journal

Journal ID (nlm-ta): J Korean Med Sci

Journal ID (iso-abbrev): J. Korean Med. Sci

Journal ID (publisher-id): JKMS

Title: Journal of Korean Medical Science

Publisher: The Korean Academy of Medical Sciences

ISSN (Print): 1011-8934

ISSN (Electronic): 1598-6357

Publication date (Electronic): 19 July 2018

Publication date Collection: 27 August 2018

Volume: 33

Issue: 35

Electronic Location Identifier: e226

Affiliations

[1 ]Department of Preventive, Occupational and Environmental Medicine, School of Medicine, Pusan National University, Yangsan, Korea.

[2 ]Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

[3 ]Environmental Health Center, Pusan National University Yangsan Hospital, Yangsan, Korea.

[4 ]Busan Workers Health Center, Pusan National University, Busan, Korea.

[5 ]Department of Occupational and Environmental Medicine, GoodGangAn Hospital, Busan, Korea.

Author notes

Address for Correspondence: Young-Ki Kim, MD, PhD. Department of Occupational, Environmental Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Republic of Korea. mungis@ 123456pusan.ac.kr

Author information

Dong-Mug Kang https://orcid.org/0000-0002-0657-0181

Jong-Eun Kim https://orcid.org/0000-0001-7711-0353

Young-Ki Kim https://orcid.org/0000-0001-7368-4245

Hyun-Hee Lee https://orcid.org/0000-0003-1170-9261

Se-Yeong Kim https://orcid.org/0000-0002-1260-494X

Article

DOI: 10.3346/jkms.2018.33.e226

PMC ID: 6105774

PubMed ID: 30140191

SO-VID: 7534a3e0-f97e-4ae1-97f3-e58c2e8eaa69

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 19 April 2017

Date accepted : 27 December 2017

Funding

Funded by: Pusan National University, CrossRef http://dx.doi.org/10.13039/501100002543;

Occupational Burden of Asbestos-Related Diseases in Korea, 1998–2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer

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Background

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Most cited references 20

The global burden of disease due to occupational carcinogens.

Occupational exposure to carcinogens in the European Union.

Asbestos: use, bans and disease burden in Europe

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