Predictions of future cases of asbestos-related disease among former miners and millers of crocidolite in Western Australia.

In a cohort of 6502 male and 410 female former workers from the crocidolite (blue asbestos) mining and milling works at Wittenoom, Western Australia, there were 94 cases of malignant mesothelioma (12 cases of peritoneal mesothelioma), 141 cases of lung cancer and 356 successful compensation claims for asbestosis to the end of 1986. After adjusting for measured covariate effects by means of proportional hazards regression analysis, smooth curves were fitted to the resulting "underlying" incidence rates for malignant mesothelioma, lung cancer and asbestosis, separately, and for mortality of any cause. By the use of these curves and individual risk estimates, predictions have been made of the future incidence of these diseases to the year 2020. With the assumption that all subjects who were not known to be dead or departed overseas still were alive at December 31, 1986, and excluding persons of more than 85 years of age, the number of new cases of mesothelioma is expected to rise to a peak of around 25 cases per year in 2010, with an expected total number of 692 cases of mesothelioma (95% confidence interval [CI], 394-990 cases) between 1987 and 2020. A total of 2898 deaths (95% CI, 2284-3511 deaths) of any cause is expected in the same period. New cases of lung cancer and asbestosis are expected to continue at roughly the current rates of eight and 17 cases per year, respectively, before declining after the year 2000, leading to totals of 183 cases (95% CI, 34-335 cases) and 482 cases (95% CI, 236-728 cases), respectively, being expected by the year 2020. Predictions that were based on the censoring of subjects at the date that they last were known to be alive resulted in slightly higher, but probably less accurate, estimates.