Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust.

In 1972, a procedure was introduced by the Industrial Injuries Insurance Institutes (Berufsgenossenschaften) of the Federal Republic of Germany, which is to be used by the special occupational health service for employees exposed to asbestos dust. Since 1 January 1972, occupational health examinations are performed when exposure to asbestos dust has been of at least 3 years' duration. On 1 January 1977, a prospective cohort study was started with employees formerly exposed to asbestos dust whilst working for companies manufacturing or using asbestos. Data on these persons are collected in the Central Register of Employees Exposed to Asbestos Dust of the Industrial Injuries Insurance Institutes. A total of 3,070 male and female employees in whom asbestos exposure terminated after 1 January 1972 formed subcohort I of the study. For comparison, 665 persons whose exposure terminated before 1 January 1972 served as subcohort II. In addition to several other inclusion criteria, each individual's permission was required before personal data could be evaluated. Of the subjects in the two subcohorts, 185 and 71, respectively, had died by 31 December 1982. Tumours were more frequently than this cause of death is expected in the general population. In addition to a high incidence of mesothelioma, the standard mortality rate was especially increased for lung cancer. The proportional mortality rates of about 40% for tumours of all sites (with about 17% lung cancer and 8% mesothelioma) especially in subcohort II, seemed to be comparable to the international figures for epidemiological mortality.

Asbestos-related diseases in the Federal Republic of Germany.

Until recently, in the Federal Republic of Germany there has been a lack of epidemiological data on asbestos-related tumors. Only the numbers of occupational diseases accepted for compensation by the German industrial injuries insurance institutes (Berufsgenossenschaften) can be stated. These show, for 1979, 94 cases of asbestosis, 21 cases of asbestosis associated with lung cancer, and 34 cases of mesothelioma. Since 1972 employees exposed to asbestos dust have been included in a central register by the industrial injuries insurance institutes and are medically examined periodically. By December 31, 1979, 28,476 persons were registered. Of those, 6,582 were still being followed medically, although they were no longer working with asbestos dust exposure. In January 1, 1977, a prospective epidemiological study was started with these people who were formerly exposed to asbestos dust. Up to December 31, 1980, altogether 2,944 people were enrolled in the study. Besides several other enrollment criteria, the individual's permission was required to evaluate his personal data. Of the people enrolled, 85 had died by December 31, 1980. Even if five questionable cases of lung cancer are excluded (n = 80), the observed rates of about 43% tumours of all sites, with 15% lung cancer and 6% mesothelioma, seem to be comparable to the international epidemiological mortality pattern.