Recent alarming news reveals a sudden rise in mesothelioma victims over the last 12 months. An asbestos victim charity reports that the number of people diagnosed with terminal cancer of the lung linings has nearly doubled from the year before. The shock figures are a grim reminder, not only of our heightened asbestos awareness today, but also of how asbestos still continues to cause terrible devastation as a result of exposures, which occurred during the 1960s and 70s.

Between September 2015 and August 2016, Asbestos Action Tayside – based in a traditional shipbuilding region of north-east of Scotland – received 210 referrals, of whom, 30 per cent (62) were diagnosed with terminal mesothelioma cancer. In the previous year, the Dundee charity received 163 referrals – nearly a fifth less – of whom, only around 20 per cent (34) had received the same terminal diagnosis.

As the health service improves its ability to recognise asbestosis symptoms, it is understandable that the number of referrals would rise, say the Scottish charity. However, the sudden, near doubling overall of terminal conditions is a “scary” trend, which the Action group expects will continue to rise.

Known as an ‘asbestos blackspot’

During Britain’s most intensive period of asbestos use, from the 1940s to the late 1970s and early 1980s, around 170,000 tons of asbestos was imported each year into the UK. Thousands of shipbuilding and dockyard workers were continuously exposed and would inhale asbestos fibre dust due to a lack of any breathing masks or personal protection equipment. Areas such as Tayside became known as an ‘asbestos blackspot’ and still continue to record a rising number of confirmed mesothelioma and asbestosis cases long after asbestos was banned from use in the mid 1980s.

In 2014, figures released by the NHS show that more than 100 people living in the Tayside area were admitted to hospital in 2013 for asbestos-related diseases compared to just 74 annual cases five years previously. Between 2011 and 2012, the Dundee area saw a rise of nearly 30 per cent of asbestos-related deaths since 2007 – the Clydebank area, in particular, recorded the highest rate of mesothelioma mortality.

Industrial use of asbestos use declined from late 1970s, and in particular after the UK’s first ban on the most dangerous blue and brown asbestos types in 1985. However, the numbers of mesothelioma and asbestos-related cases continue to confound prediction.

HSE mortality rate challenged

Incidence of mesothelioma as a cause of industrial disease has actually increased in the UK almost four-fold in the last 30 -35 years. Even recent Health and Safety Executive (HSE) warnings that the overall mesothelioma mortality rate will continue to increase to at least 2020 with around 2,500 fatalities each year has also been challenged.

The building industry was not prevented from using their stock-holding of white asbestos insulation products after the mid 1980s ban, until formally prohibited in 2000. As a result, non-occupational exposure was shown to be a mesothelioma risk to those employed in schools, local council offices, public facilities, and council housing. However, new research shows another picture emerging to account for the continuing number of asbestos-related victims.

Studies have found that there has been a gradual shift in the age group of those who lose their life to mesothelioma cancer. Between 1968 and 1972, nearly all of the deaths (90 per cent) occurred to patients below the age of 74. However, between 2009 and 2013, the proportion of those who died who were above that age had risen to 50 per cent.

Researchers offer several reasons…

A larger proportion of victims are living longer lives

Firstly, the previously high incidence of asbestos-induced diseases early in life has reduced, i.e. males in their teens starting apprenticeships in asbestos-using industries. Secondly, a larger proportion of exposure victims are living longer lives and are more likely to develop mesothelioma, due to its exceptionally long ‘latency’, i.e. the period of time in which the potential for cells to turn cancerous lays dormant. There is usually a 15 – 50 year time lapse from an initial period of exposure to the first symptoms appearing, such as constant coughing, breathlessness and tight chests.

Studies also show that the severity of exposure to asbestos is related to the length of time the disease remains dormant. Those individuals who experienced only low levels of exposure to asbestos would have longer periods of dormancy and would therefore, develop mesothelioma only if they survive into their 70s or older. For each 10 year reduction in age for a first exposure below the age of 30 there is a doubling of the mesothelioma risk. Each 10 year increase in life expectancy beyond the age of 80 also doubles the mesothelioma risk.

While HSE expect 2,500 annual UK deaths from mesothelioma cancer until 2020 before numbers may begin to decline, different studies are less optimistic. Some researchers suggest that given that men aged over 70 accounted for 72 per cent of male mesothelioma deaths in 2013, the predicted increase in the number of men above that age diagnosed with the incurable cancer over the next four decades indicates that mesothelioma deaths will continue to rise sharply throughout the same period. According to the ‘Projection of Mesothelioma Mortality in Great Britain’ (Tan and Warren, 2009), the number of deaths could actually reach more than 2,800 every year by 2025.