Pleural mesothelioma in New Caledonia: associations with environmental risk factors

Abstract

Background: High incidences of malignant mesothelioma (MM) have been observed in New Caledonia. Previous work has shown an association between MM and soil containing serpentinite.

Objectives: We studied the spatial and temporal variation of MM and its association with environmental factors.

Methods: We investigated the 109 MM cases recorded in the Cancer Registry of New Caledonia between 1984 and 2008 and performed spatial, temporal, and space-time cluster analyses. We conducted an ecological analysis involving 100 tribes over a large area including those with the highest incidence rates. Associations with environmental factors were assessed using logistic and Poisson regression analyses.

Results: The highest incidence was observed in the Houaïlou area with a world age-standardized rate of 128.7 per 100,000 person-years [95% confidence interval (CI), 70.41-137.84]. A significant spatial cluster grouped 18 tribes (31 observed cases vs. 8 expected cases; p = 0.001), but no significant temporal clusters were identified. The ecological analyses identified serpentinite on roads as the greatest environmental risk factor (odds ratio = 495.0; 95% CI, 46.2-4679.7; multivariate incidence rate ratio = 13.0; 95% CI, 10.2-16.6). The risk increased with serpentinite surface, proximity to serpentinite quarries and distance to the peridotite massif. The association with serpentines was stronger than with amphiboles. Living on a slope and close to dense vegetation appeared protective. The use of whitewash, previously suggested to be a risk factor, was not associated with MM incidence.

Conclusions: Presence of serpentinite on roads is a major environmental risk factor for mesothelioma in New Caledonia.

Figure 1

Map of New Caledonia, asbestos-bearing geological units, main roads, standardized incidence of MM by commune (residence 30 years before diagnosis), 1984–2008, and study area.

Figure 2

Map of the study area, MM incidence by tribe (residence 30 years before diagnosis), 1984–2008, and results of the spatial analysis. Abbreviations: obs, observed; exp, expected.