1. www.swpho.nhs.uk The occupations of mesothelioma cases in the South West Region, Hampshire and the Isle of Wight A Evans*, A Pring, S McPhail and J Verne South West Public Health Observatory, *annika.evans@swpho.nhs.uk South West Cancer Intelligence Service Conclusions This study broadly supports the theory that development of mesothelioma in females is linked to the occupation of their father or spouse. Possible future analysis of the familial occupations of all cases with no known direct asbestos exposure may yield more conclusive results. 1 South West Cancer Intelligence Service, “Mesothelioma in the South West”. 2006. 2 Health and Safety Executive, “Mesothelioma Mortality in Great Britain: Estimating the Future Burden”. 2006. 3 Health and Safety Executive, http://www.hse.gov.uk/statistics/causdis/meso.htm. 4 National Statistics Online, “Employee Jobs by Industry”. http://www.statistics.gov.uk/StatBase. 5 South West Cancer Intelligence Service, “The incidence of mesothelioma on the South West region, Hampshire and the Isle of Wight”. 2006. 6Trade Union Congress, http://www.tuc.org.uk/h_and_s/tuc-12235- f0.cfm. 2006. Background Mesothelioma is a rare cancer that usually occurs in the outer lining of the lungs. Less commonly, it can occur in the mesothelial (lining) tissue of the digestive tract. Mesothelioma has a known link with asbestos exposure, accounting for 80% of cases 1. It can take between 15 and 60 years after exposure for the cancer to become apparent. Survival is often as little as two years following diagnosis 2. Workers in particular industries are more likely to suffer asbestos exposure, and hence are at higher risk of developing mesothelioma. The Health and Safety Executive (HSE) has identified plumbers, gas fitters, carpenters, electricians and metal plate workers including in shipyards as currently amongst the highest risk occupations 3. Methodology Death Certificates were used to obtain occupation data for individuals dying between 1999 and 2004. Classifications were made for the occupation of males, females and husbands and fathers of females. Occupations were classified into industries based on the ONS Standard Industrial Classification (2003). A category of ‘Dockyard’ was added, to establish the proportion of mesothelioma deaths that occurred within this setting. Data for females was much less complete than for males. Problems were also encountered with occupations did not have a clearly specified industry. Occupations of Mesothelioma Deaths Figure 2: Mesothelioma Occupations by Industry in the South West, 1999 - 2004 MalesFemales Female's Spouse / Father With Recorded Occupation99.6%59%86% Classifiable by Industry92%98%92% Figure 1: Percentage complete occupational records for mesothelioma deaths FemalesMales Husbands / Fathers Aims To investigate occupational patterns in male and female mesothelioma deaths in the South West. To explore possible links with female mesothelioma and the occupation of her father or spouse. Regional Occupations of All People 4 Figure 3: All Occupations by Industry in the South West, 1999 - 2004 Males Females Occupational Patterns The distribution of females dying from mesothelioma are similar to that of all females in the South West region, with very few working in occupations at known risk. The male mesothelioma distribution shows far more construction industry workers than the overall South West distribution. This is consistent with ‘at-risk’ occupations identified by the HSE. A notable portion of males with mesothelioma worked in dockyard settings. Whilst these cannot be directly identified in ONS data, research indicates that the 20th century dockyard workforce peaked at up to 2% of males in the South West. Husbands and fathers of females with mesothelioma show a similar occupational pattern to males dying from mesothelioma, with more construction industry workers and less financial and professional workers than the region as a whole. However, the split is not as pronounced as for occupations of male deaths. This could reflect some direct female asbestos exposure leading to mesothelioma irrespective of their husband’s or father’s occupation. In addition, occupations may reflect employment at death, rather than past occupations responsible for asbestos exposure. RfRf Male to Female Ratio 5 Mesothelioma is much more common in men than in women, consistent with exposure to asbestos dust in predominantly male professions. Overall, the male to female ratio is approximately 7:1. However, there are marked geographical variations. In Plymouth the ratio is 25:1, while in Bristol it is 3:1. This study showed male mesothelioma death employment in construction and dockyard industries at 58% in Plymouth and 47% in Bristol, suggesting more Plymouth workers in ‘at-risk’ industries. Female employment was less varied. Consultation with the Trades Union Congress reported that dockyards in Plymouth had a history of providing laundry services, so families were not exposed to workers’ clothes 6. This prompted investigation into the occupations of the husbands and spouses of females who have died from mesothelioma, as repeated indirect exposure to asbestos in work clothes increased risk.