Background mesothelioma mortality rates in GB have increased tenfold over the last four decades and are currently the highest of any country worldwide. The mesothelioma register contains all deaths mentioning mesothelioma and includes area of residence and occupation of the deceased.

Aim to update descriptive analyses of mortality trends by geographical area and last occupation of the deceased to provide evidence about past sources of mesothelioma risk in the GB population.

Methods Standardised Mortality Ratios (SMRs) were calculated for local and unitary authority areas; Proportional Mortality Ratios (PMRs) were calculated for categories derived from Standard Occupation Classification coding of job titles from death certificates. Temporal trends in SMRs and PMRs over the period 1981–2014 were examined using Generalised Additive Models (GAMs).

Results the influence of geographically-specific sources of past asbestos exposure is still seen in recent mesothelioma mortality rates; areas with the highest SMRs in males tend to be those known to contain large industrial sites that used asbestos such as shipyards. However, the strong effect of asbestos exposures in jobs associated with construction work – which would have been geographically less heterogeneous – is seen in analyses by occupation, and temporal trends suggest that such exposures continued for longer than those associated with specific locations.

Conclusions these results reflect the legacy of widespread industrial asbestos use in GB and particularly emphasise the effect of exposures within the building industry which are likely to have continued after those in specific industries such as shipbuilding and manufacturing were substantially reduced.