British Journal of Industrial Medicine 1987;44:788-789 Malignant mesothelioma in Singapore

Malignant mesothelioma is a rare tumour strongly associated with asbestos exposure. ' It is a notifiable disease in Singapore-voluntarily to the Cancer Reg-istry since 1968 and statutorily under the Factories Act, 1973. Singapore's industrial exposure to asbestos started in the late 1940s with the establishment of a factory engaged in manufacturing asbestos cement products. Asbestos is now being used in about 60 establishments. This report presents an epidemio-logical and occupational profile of the few cases of malignant mesothelioma confirmed in Singapore. Case selection A total of 16 cases were notified between 1968 and 1984. Three foreigners who had left the country and four subjects who were not confirmed to have malig-nant mesothelioma on a review of the histology were rejected from this report which is thus confined to nine Singapore residents. A chronological occupa-tional history of these subjects, their parents, spouses, and children was obtained through interviews with their nearest living relatives except for two who were personally interviewed. Epidemiology Of the nine cases ofmalignant mesothelioma reported in the 17 year period, five occurred in the five years 1980-4. This gives a crude average annual incidence rate of about 0 43 per million population; there were five peritoneal and four pleural cases. Eight were men, ofwhom six had had their diagnosis made before they were 50 with the youngest at 34. The only woman was diagnosed at 62. Occupational profile (table 1) Two of the subjects who were personally interviewed before death had definite exposure while working in the same factory manufacturing asbestos cement products. This factory started operations more tha