Population‐Based Cohort Study on Health Effects of Asbestos Exposure in Japan

Abstract

Occupational asbestos exposure occurs in many workplaces and is a well‐known cause of mesothelioma and lung cancer. However, the association between non‐occupational asbestos exposure and those diseases is not clearly described. The aim of this study was to investigate cause‐specific mortality among the residents of Amagasaki, a city in Japan with many asbestos factories, and evaluate the potential excess mortality due to established and suspected asbestos‐related diseases. The study population consisted of 143,929 residents in Amagasaki City before 1975 until 2002, aged ≥40 years on January 1, 2002. Follow‐up was conducted from 2002 to 2015. Standardized mortality ratio (SMR) with its 95% confidence interval (CI) was calculated by sex, using the mortality rate of the Japanese population as reference. A total of 38,546 deaths (including 303 from mesothelioma and 2,683 from lung cancer) were observed. The SMRs in long‐term residents' cohort were as follows: death due to all causes, 1.12 (95% CI, 1.10–1.13) in men and 1.07 (95% CI, 1.06–1.09) in women; lung cancer, 1.28 (95% CI, 1.23–1.34) in men and 1.23 (95% CI, 1.14–1.32) in women; mesothelioma, 6.75 (95% CI, 5.83–7.78) in men and 14.99 (95% CI, 12.34–18.06) in women. These SMRs were significantly higher than expected. The increased SMR of mesothelioma suggests the impact of occupational asbestos exposure among men and non‐occupational asbestos exposure among women in long‐term residents' cohort. Besides, high level of excess mortality from mesothelioma persists for a while, despite the mixture of crocidolite and chrysotile no longer being used for three or four decades.

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