© 2002 British Occupational Hygiene Society Published by Oxford University Press DOI: 10.1093/annhyg/mef669 Malignant Mesothelioma in Australia, 1945–2000

Australia has maintained a national malignant mesothelioma register since 1980. The register includes all cases in Australia. Currently 450–600 cases are notified annually in a population of 20 million. Australia has had 6329 cases of mesothelioma in the period 1 January 1945– 31 December 2000. A further 680 cases have been notified in the period 1 January 2001–31 December 2001. Annual incidence rates for Australia per million population ≥20 yr (1998) were male, 59.8; female, 10.9; total, 35.4. Incidence rates have been continually increasing in males and females and are the highest reported national rates in the world. While Western Australia has the highest rate (1998, 52.8), most cases arise from the two most populous eastern states, New South Wales and Victoria. In 88 % (male 90%, female 61%) of cases a history of asbestos exposure was obtained. Exposures occurred in a wide variety of occupational and environ-mental circumstances. In 81 % of cases with no history of exposure, TEM lung asbestos fibre counts>200000 fibres>2 µm length/g dry lung were obtained, suggesting unrecognized exposure. Australia’s high incidence of mesothelioma is related to high past asbestos use, of all fibre types, in a wide variety of occupational and environmental settings. The number of cases in total is expected to be about 18000 by 2020, with about 11000 yet to appear