New Study Sheds Light on Rising Mesothelioma Deaths Among Women
When most people think of a mesothelioma patient, they usually picture an older man. This appears to be supported by the statistics: around 2/3 of mesothelioma patients are 65 or older, and over 75% of mesothelioma patients are male.
A recent study, however, revealed an alarming trend: an increasing number of women are dying from mesothelioma every year.
In the Morbidity and Mortality Weekly Report published on May 13th, 2022, the CDC reported that the number of women dying annually from mesothelioma has risen steadily by over the past 20 years, increasing by over 25% from 1999 to 2020. During that time, 12,227 women died from mesothelioma.
The rate of mesothelioma deaths has continued to rise among women between 1999 and 2020, despite increased regulations limiting unsafe exposure to asbestos and a worldwide drop in asbestos use during those 21 years, as well as increased quality of care and improved medical technology.
The trend seems especially concerning when compared with the rates of mesothelioma deaths among men during the same 21-year period, which appear to have stayed roughly the same, or even dropped slightly. In general, more men than women are diagnosed with mesothelioma (for reasons we will explore below), and there have therefore been more mesothelioma deaths among men than among women from 1999-2020. However, the CDC study reported that 489 women died from mesothelioma in 1999, and 614 women died from mesothelioma in 2020. The number of male mesothelioma deaths, meanwhile, has gone from 1,990 deaths in 1999 to 1,981 deaths in 2020.
So, why are more women dying of mesothelioma over time?
The answer, as explained in part the CDC study, can be found by breaking down a few key facts about mesothelioma, and about why mesothelioma primarily effects men over 65 to begin with.
Firstly, it’s important to understand that the primary risk factor for mesothelioma is prolonged exposure to disturbed asbestos fibers.
Asbestos is a type of mineral found in soil and rocks in many parts of the world, that was used for many years in shipyard, construction, industrial, and military fields, among others, due to its heat-resistance and fire suppressant qualities. Asbestos naturally forms in small bundles of tiny, microscopic fibers. When asbestos is disturbed, it shakes those fibers loose into the air.
We now know that exposure to the disturbed asbestos fibers can lead to cancer and other conditions in several parts of the body. If inhaled, the asbestos fibers can get into the lungs, and may travel through the lungs to the pleura, a thin membrane covering the lungs. Asbestos fibers are harmful to pleural cells, and pleural injury caused by asbestos can lead to pleural mesothelioma over time. Asbestos can also cause other forms of lung cancer, as well as lung scarring (asbestosis).
While many people are exposed to small amounts of naturally occurring asbestos, there are far fewer people who have been exposed to asbestos in a high enough concentration for a long enough time for mesothelioma to form. The mean source of asbestos exposure for people with mesothelioma generally is the workplace, usually workplaces in the fields mentioned above (i.e., shipyards construction, industrial, manufacturing, or military) that widely utilized asbestos before restrictions were put in place in the late 1970s. At the time, workers in those fields were almost exclusively men, which explains the much higher instance of mesothelioma among men.
Long Latency Period: Another thing to consider is mesothelioma’s very long latency period, or the period of time between asbestos exposure and the presentation of symptoms or malignancy. The CDC report estimated that there’s a median latency period of approximately 32 years between occupational exposure to asbestos and death from ensuing mesothelioma.
This is why the vast majority of all mesothelioma patients, both male and female, tend to be older: of the total women who died from mesothelioma in the studied period, over 90% were age 55 or older. Unfortunately, symptoms of mesothelioma often do not present until the cancer is fairly far advanced. By the time most people with mesothelioma get diagnosed, it is too late for the most effective treatments, and prognosis/rate of survival is lower accordingly. This is another reason why mesothelioma deaths among women continue to rise, despite exposure to asbestos being greatly
Unconventional Forms of Exposure: This leads to the next question: how did women get mesothelioma if they didn’t work in the fields mentioned above?
As shown in the CDC study, women who developed mesothelioma were also exposed to asbestos, but usually not by working directly in the fields commonly associated with asbestos exposure. Instead, the women in the study were exposed to asbestos in three major ways:
- Secondary Exposure from Male Household Members: The study found that one of the most common occupations among women who died from mesothelioma was “housewife.” In 2020, the last year researched by the study, 22.8% of mesothelioma deaths occurred among women who listed housewife as their occupation.
Upwards of 60 percent of the women who died from mesothelioma between 1999 and 2020, including most housewives who died from mesothelioma, were likely the victims of secondary exposure to asbestos, making it the most common means of asbestos exposure among female mesothelioma patients.
Secondary exposure occurs when workers who were directly exposed to asbestos unintentionally and unknowingly bring asbestos fibers back home with them, in large enough quantities and over a long enough time that other people in their households eventually develop mesothelioma. Usually, these women were their mothers, their wives, and sometimes their children, especially if they were responsible for cleaning and maintaining work clothes.
Since asbestos fibers are jagged, they easily attach to clothing and shoes, as well as skin and hair. Dusting off or shaking out garments with asbestos on them (or brushing off asbestos-adhered hair or skin) only disperses the fibers into the air, which makes them more likely to be inhaled or swallowed. Women may also be exposed to mesothelioma during repairs or renovations to their homes if those homes were built—as many were—with asbestos insulation.
- Exposure in a Workplace Not Conventionally Associated with Asbestos: Some of the women who died of mesothelioma were exposed to asbestos in their workplaces, which were not traditionally associated with asbestos exposure and resultant mesothelioma risk. Dr. Jaceck M. Mazurek, one of the lead authors of the CDC study, explained that in addition to secondary exposure among homemakers, “a large proportion [of mesothelioma in women] was reported among women whose occupations were not historically and traditionally associated with asbestos exposure. Women in some of these fields, such as healthcare, social work, and education, were often exposed to asbestos during renovations on older buildings where their jobs were located, or via the resuspension of settled asbestos into the air via dusting, sweeping, or cleaning in those buildings. Other women were exposed by working in factories where asbestos was used in the production or manufacturing of the product being made.
- Environmental Exposure: A smaller but still significant portion of women who died from mesothelioma were exposed to high concentrations of asbestos in their environments, usually because they lived close to an asbestos mine or an industrial facility where asbestos was being processed or manufactured. This sort of exposure to asbestos often occurs from childhood onward and can lead to mesothelioma as well as other cancers (especially endometrial cancer).
Because the means by which women were exposed to asbestos were not understood until relatively recently, many women with mesothelioma have been misdiagnosed or have not been treated in a timely fashion. This likely contributed to the rising rates of death among women with mesothelioma, despite the fact that if mesothelioma is caught earlier in women, they tend to have a higher rate of survival than men.
As Dr. Mazurek explained, “the increasing number of malignant mesothelioma deaths among women most likely represent [asbestos] exposure many years ago”, in combination with a lack of understanding about mesothelioma risk in women.
As Dr. Mazurek and his co-authors point out in the study, there are several things we can learn from this data. In particular:
- The importance of continued regulations preventing asbestos exposure
- The need for increased awareness about mesothelioma diagnoses in women
- The need for proactive mesothelioma screening for women who may be at risk
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