Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study

Rosemary J. Korda, Mark S. Clements, Bruce K. Armstrong, Hsei Di Law, Tenniel Guiver, Phil ANDERSON, Susan M. Trevenar, Martyn D. Kirk

Research output: Contribution to journalArticle

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Abstract

Background The health risks associated with living in houses insulated with asbestos are unknown. Loose-fill asbestos was used to insulate some houses in the Australian Capital Territory (ACT). We compared the incidence of mesothelioma and other cancers in residents of the ACT who did and did not live in these houses. Methods Our cohort study included all ACT residents identified using Medicare enrolment data. These data were linked to addresses of affected residential properties in the ACT to ascertain exposure. We followed up residents by linking data to the Australian Cancer Database and National Death Index. Outcomes were diagnosis of mesothelioma and selected other cancers. Effects were estimated for males and females separately using standardised incidence ratios (SIRs), adjusting for age and calendar time of diagnosis. Findings Between Nov 1, 1983, and Dec 31, 2013, 1 035 578 ACT residents were identified from the Medicare database. Of these, 17 248 (2%) had lived in an affected property, including seven (2%) of 285 people diagnosed with mesothelioma. The adjusted incidence of mesothelioma in males who had lived at an affected property was 2·5 times that of unexposed males (SIR 2·54, 95% CI 1·02–5·24). No mesotheliomas were reported among females who had lived at an affected property. Among individuals who had lived at an affected property, there was an elevated incidence of colorectal cancer in women (SIR 1·73, 95% CI 1·29–2·26) and prostate cancer in men (1·29, 1·07–1·54); colorectal cancer was increased, although not significantly, in males (SIR 1·32, 95% CI 0·99–1·72), with no significant increase in the other cancers studied. Interpretation Residential asbestos insulation is likely to be unsafe. Our findings have important health, social, financial, and legal implications for governments and communities in which asbestos has been used to insulate houses. Funding ACT Government.

Original languageEnglish
Pages (from-to)522-528
Number of pages7
JournalThe Lancet Public Health
Volume2
Issue number11
DOIs
Publication statusPublished - 1 Nov 2017

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Australian Capital Territory
Asbestos
Cohort Studies
Mesothelioma
Incidence
Population
Neoplasms
Medicare
Colorectal Neoplasms
Databases
Health
Prostatic Neoplasms

Cite this

Korda, R. J., Clements, M. S., Armstrong, B. K., Law, H. D., Guiver, T., ANDERSON, P., ... Kirk, M. D. (2017). Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study. The Lancet Public Health, 2(11), 522-528. https://doi.org/10.1016/S2468-2667(17)30192-5
Korda, Rosemary J. ; Clements, Mark S. ; Armstrong, Bruce K. ; Law, Hsei Di ; Guiver, Tenniel ; ANDERSON, Phil ; Trevenar, Susan M. ; Kirk, Martyn D. / Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study. In: The Lancet Public Health. 2017 ; Vol. 2, No. 11. pp. 522-528.
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Korda, RJ, Clements, MS, Armstrong, BK, Law, HD, Guiver, T, ANDERSON, P, Trevenar, SM & Kirk, MD 2017, 'Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study', The Lancet Public Health, vol. 2, no. 11, pp. 522-528. https://doi.org/10.1016/S2468-2667(17)30192-5

Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study. / Korda, Rosemary J.; Clements, Mark S.; Armstrong, Bruce K.; Law, Hsei Di; Guiver, Tenniel; ANDERSON, Phil; Trevenar, Susan M.; Kirk, Martyn D.

In: The Lancet Public Health, Vol. 2, No. 11, 01.11.2017, p. 522-528.

Research output: Contribution to journalArticle

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T1 - Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study

AU - Korda, Rosemary J.

AU - Clements, Mark S.

AU - Armstrong, Bruce K.

AU - Law, Hsei Di

AU - Guiver, Tenniel

AU - ANDERSON, Phil

AU - Trevenar, Susan M.

AU - Kirk, Martyn D.

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N2 - Background The health risks associated with living in houses insulated with asbestos are unknown. Loose-fill asbestos was used to insulate some houses in the Australian Capital Territory (ACT). We compared the incidence of mesothelioma and other cancers in residents of the ACT who did and did not live in these houses. Methods Our cohort study included all ACT residents identified using Medicare enrolment data. These data were linked to addresses of affected residential properties in the ACT to ascertain exposure. We followed up residents by linking data to the Australian Cancer Database and National Death Index. Outcomes were diagnosis of mesothelioma and selected other cancers. Effects were estimated for males and females separately using standardised incidence ratios (SIRs), adjusting for age and calendar time of diagnosis. Findings Between Nov 1, 1983, and Dec 31, 2013, 1 035 578 ACT residents were identified from the Medicare database. Of these, 17 248 (2%) had lived in an affected property, including seven (2%) of 285 people diagnosed with mesothelioma. The adjusted incidence of mesothelioma in males who had lived at an affected property was 2·5 times that of unexposed males (SIR 2·54, 95% CI 1·02–5·24). No mesotheliomas were reported among females who had lived at an affected property. Among individuals who had lived at an affected property, there was an elevated incidence of colorectal cancer in women (SIR 1·73, 95% CI 1·29–2·26) and prostate cancer in men (1·29, 1·07–1·54); colorectal cancer was increased, although not significantly, in males (SIR 1·32, 95% CI 0·99–1·72), with no significant increase in the other cancers studied. Interpretation Residential asbestos insulation is likely to be unsafe. Our findings have important health, social, financial, and legal implications for governments and communities in which asbestos has been used to insulate houses. Funding ACT Government.

AB - Background The health risks associated with living in houses insulated with asbestos are unknown. Loose-fill asbestos was used to insulate some houses in the Australian Capital Territory (ACT). We compared the incidence of mesothelioma and other cancers in residents of the ACT who did and did not live in these houses. Methods Our cohort study included all ACT residents identified using Medicare enrolment data. These data were linked to addresses of affected residential properties in the ACT to ascertain exposure. We followed up residents by linking data to the Australian Cancer Database and National Death Index. Outcomes were diagnosis of mesothelioma and selected other cancers. Effects were estimated for males and females separately using standardised incidence ratios (SIRs), adjusting for age and calendar time of diagnosis. Findings Between Nov 1, 1983, and Dec 31, 2013, 1 035 578 ACT residents were identified from the Medicare database. Of these, 17 248 (2%) had lived in an affected property, including seven (2%) of 285 people diagnosed with mesothelioma. The adjusted incidence of mesothelioma in males who had lived at an affected property was 2·5 times that of unexposed males (SIR 2·54, 95% CI 1·02–5·24). No mesotheliomas were reported among females who had lived at an affected property. Among individuals who had lived at an affected property, there was an elevated incidence of colorectal cancer in women (SIR 1·73, 95% CI 1·29–2·26) and prostate cancer in men (1·29, 1·07–1·54); colorectal cancer was increased, although not significantly, in males (SIR 1·32, 95% CI 0·99–1·72), with no significant increase in the other cancers studied. Interpretation Residential asbestos insulation is likely to be unsafe. Our findings have important health, social, financial, and legal implications for governments and communities in which asbestos has been used to insulate houses. Funding ACT Government.

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