Global burden of mesothelioma attributable to occupational asbestos exposure in 204 countries and territories: 1990-2019

Abstract

Malignant mesothelioma, a rare and aggressive cancer primarily caused by occupational asbestos exposure, has a poor prognosis. This study leverages the Global Burden of Disease (GBD) 2019 dataset to analyze the burden of mesothelioma linked to occupational asbestos exposure from 1990 to 2019. The analysis includes the number of mesothelioma deaths and disability-adjusted life years (DALYs) attributable to occupational asbestos exposure, focusing on trends in age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life-year rate (ASDR) by year, age, sex, country, region, and Socio-demographic Index (SDI). In 2019, 91.7% of mesothelioma deaths and 85.2% of DALYs were attributable to occupational asbestos exposure, resulting in 26,820 (95% UI 24,312-28,622) deaths and 569,429 (95% UI 509,956-617,484) DALYs. Despite a decline in ASMR and ASDR from 1990 to 2019, the absolute number of deaths and DALYs almost doubled. The United States reported the highest number of mesothelioma deaths, while China had the highest number of DALYs. Age-specific mortality rates and DALYs decreased in the 25-74 age group but increased in the 75+ age group. In conclusion, occupational asbestos exposure remains the primary cause of mesothelioma worldwide, with an increasing number of deaths and DALYs. The highest incidence rates are observed in high-income areas, and rates are rising in low-income areas. It is crucial to raise awareness about the hazards of asbestos to reduce the global burden of mesothelioma linked to occupational exposure.

Keywords: Global burden of disease (GBD); Mesothelioma; Occupational asbestos exposure.

Fig. 1

Proportion of mesothelioma deaths and DALYs attributable to occupational asbestos exposure globally and in 26 GBD regions in 1990 and 2019. DALYs, disability-adjusted life-years; GBD, Global Burden of Disease Study

Fig. 2

Number and rate of mesothelioma deaths (a) and DALYs (b) attributable to occupational asbestos exposure between 1990 and 2019 according to the SDI. The bars represent the number of mesothelioma deaths (a) and DALYs (b) attributable to occupational asbestos exposure colored by SDI level. The line represents the mean ASMR (a) and ASDR (b) (per 100,000) attributable to occupational asbestos exposure at the global level. The shaded area represents the 95% UI for the mean rate. ASMR, age-standardized mortality rate; DALYs, disability-adjusted life-years; ASDR, age-standardized DALY rate; SDI, socio-demographic index; UI, uncertainty interval

Fig. 3

The spatial distribution of the mesothelioma ASMR (a) and ASDR (b) attributable to occupational asbestos exposure in 2019, and the EAPC in mesothelioma ASMR (c) and ASDR (d) attributable to occupational asbestos exposure. ASMR, age-standardized mortality rate; ASDR, age-standardized DALY rate; EAPC, estimated annual percentage change

Fig. 4

Number and rate of mesothelioma deaths (a) and DALYs (b) attributable to occupational asbestos exposure by age group and SDI level in 2019. The bars represent the number of mesothelioma deaths (a) and DALYs (b) attributable to occupational asbestos exposure colored by SDI level. The line represents the mean ASMR (a) and ASDR (b) (per 100,000) attributable to occupational asbestos exposure at the global level. The shaded area represents the 95% UI for the mean rate. DALYs, disability-adjusted life-years; ASDR, agestandardized DALY rate; SDI, socio-demographic index; UI, uncertainty interval

Fig. 5

Annual percentage change in mortality (a) and DALYs (b) between 1990 and 2019 by age group and region. EAPC, estimated annual percentage change; SDI, socio-demographic index; DALYs, disability-adjusted lifeyears