1. Surveillance of Mesothelioma at NIOSH WoRLD Surveillance Report http://www2a.cdc.gov/drds/WorldReportData/ 1 The findings and conclusions in this report are those of the author and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

2. Surveillance of Mesothelioma at NIOSH Trends in overall deaths from mesothelioma in the US from 1999-2008 – by race and sex Geographic distribution of deaths 1999-2007 Age group distribution of deaths 1999-2008 Years of potential life lost (YPLL) 1999-2007 Industry & Occupation Proportionate Mortality Ratios (PMR) Anatomical site 1999-2008

3. 1999200220052008 Mesothelioma Deaths 1999 – 2008 (ICD 10) 4.2 4.3 3.0 3.9 4.2 3.7 4.2 4.8 4.0 4.1 19.7 19.3 19.4 19.4 19.0 19.4 20.6 19.4 20.4 20.6 2704 2484 2509 2531 2573 2625 2657 2588 2606 2711 Pct Blk ♀ Year Regression - F = 14.2; p < 0.01 (still rising)

4. Five States with Most Deaths from Mesothelioma 199920022004 2007 Year

5. Number of Deaths by State, 1999-2007 2326 136 246 1183 141 366 127 59 44 672 248 1540 248 1100 1575 504 264 712 396 109 105 66 53 152 191 223 128 387 405 153 388 277 332 514 594 219 1146 518 841 213 1343 VT- 50 NH- 125 MA- 719 MD- 462 DC- 23 DE- 95 NJ- 1030 RI- 118 CT- 340 HI- 71

6. Number of Deaths by Age Groups 1999-2008 15-2425-3435-44 45-54 55-6465-7475-8485+ 3098 9870 7487 3845 1227 356 82 23 0.090.31.44.714.828.838.011.9 Percentages Age Group Number of Deaths

7. Decrease in Numbers of Deaths in ages 45-74 Over Time Percentage of Mesothelioma Deaths in the age group 45-74 1999 200220052008 Year

8. Increase in Numbers of Deaths in ages >74 Over Time Percentage of Mesothelioma Deaths in the age group >74 1999 200220052008 Year

9. Change in Mesothelioma Death Rates by Age Groups Over Time Percentage of Mesothelioma Deaths by Age Groups 1999 200220052008 Year Ns=185, & 25988

10. Years of Potential Life Lost (1999-2007) Based on 23,277 deaths YPLL range 13.5 – 14.1 per death Average YPLL 13.8 per death Total YPLL 321,845 1999 – 2007; Thus YPLL/year is 35,760

11. PMRs by Industry & Occupation Industry – Ship/Boat building and repair6.0 (2.4-12.3) – Industrial chemicals4.8 (2.9-7.5) – Petroleum refining3.8 (1.2-8.9) – Electric light and power3.1 (1.5-5.7) – Construction1.6 (1.2-1.9) Occupation – Plumbers/pipe- & steam-fitters4.8 (2.8-7.5) – Mechanical engineers3.0 (1.1-6.6) – Electricians2.4 (1.3-4.2) – Teachers (elementary school)2.1 (1.1-3.6)

12. Anatomical Site (1999-2008) Data derived from death certificates Data by anatomical site – Pleura8.1% – Peritoneum 3.7% – Other 13.6% – Unspecified 75.7% Data frequently missing (similarly occupation) – Case for electronic health records

13. Summary There were almost 26,000 MM deaths among U.S. residents aged >15 years old between 1999 and 2008 and ~350,000 PYLL. During the same period ~20% of deaths were among women and ~4% were Black. More than half of which were from 9 States: CA > PA > FL > NY > TX > IL > OH > NJ > MI Construction accounted for 15% of decedents

14. WoRLD Surveillance Report Asbestosis Coal workers’ pneumoconiosis Silicosis Byssinosis Unspecified and other Pneumoconioses All pneumoconioses Malignant mesothelioma Hypersensitivity pneumonitis Asthma Chronic obstructive pulmonary disease Respiratory conditions due to toxic agents Respiratory tuberculosis Lung cancer Other interstitial pulmonary diseases Pneumonia and influenza Various work-related respiratory conditions Smoking prevalence by industry and occupation

15. Acknowledgement Contributing Agencies Bureau of Labor Statistics Social Security Admin. Dept. Labor OSHA/MSHA CDC National Center for Health Stats CWXSP – NIOSH NIOSH Staff Jacek Mazurek Patti Schleiff John Wood Eileen Storey Ki-moon Bang Anita Wolfe