ORIGINAL ARTICLES

Population-based asbestosis surveillance in British Columbia

W Q Gan¹, P A Demers^1,2, C B McLeod^2,3, M Koehoorn^1,2,3

¹ School of Environmental Health, The University of British Columbia, Vancouver, British Columbia, Canada
² School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
³ Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada

^{Correspondence to} Dr Paul Demers, School of Environmental Health, The University of British Columbia, Room 360B - 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada; pdemers{at}interchange.ubc.ca

Objectives: To investigate the use of multiple health data sources for population-based asbestosis surveillance in British Columbia, Canada.

Methods: Provincial health insurance registration records, workers’ compensation records, hospitalisation records, and outpatient medical service records were linked using individual-specific study identifiers. The study population was restricted to individuals 15 years of age living in the province during 1992–2004.

Results: 1170 new asbestosis cases were identified from 1992 to 2004 for an overall incidence rate of 2.82 (men: 5.48, women: 0.23) per 100 000 population; 96% of cases were male and average (SD) age was 69 (10) years. Although the annual number of new cases increased by 30% during the surveillance period (β = 2.36, p = 0.019), the observed increase in annual incidence rates was not significant (β = 0.02, p = 0.398). Workers’ compensation, hospitalisation and outpatient databases identified 23%, 48% and 50% of the total new cases, respectively. Of the new cases, 82% were identified through single data sources, 10% were only recorded in the workers’ compensation records, and 36% only in each of the hospitalisation and outpatient records. 84% of hospitalisation cases and 83% of outpatient cases were not included in the workers’ compensation records. The three data sources showed different temporal trends in the annual number of new cases and annual incidence rates.

Conclusions: Single data sources were not sufficient to identify all new cases, thus leading to serious underestimations of the true burden of asbestosis. Integrating multiple health data sources could provide a more complete picture in population-based surveillance of asbestosis and other occupational diseases.

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