Asbestos Disease Data in Lung Disease Surveillance Report

Read the report from the CDC regarding the lung diseases associated with exposure to asbestos and other carcinogens. This section details the limitations of the data.

Work-related respiratory diseases are typically, though not always, chronic and may also have long latencies. As reflected in median ages at death presented in this report for the pneumoconioses, many affected individuals live to or even beyond average life expectancy. The fact that many affected individuals do not die as a direct result of their work-related respiratory disease led to a decision to consider all causes of death, underlying and contributing, in the development of the summary tables and figures of mortality data presented in this report. In the absence of national incidence and prevalence morbidity data specific to occupational diseases, the intent is to provide a better assessment of disease occurrence and distribution than would be possible if consideration were restricted to underlying causes of death.

Certifying physicians typically do not list all of a decedent’s diseases on the death certificate. Therefore, even though contributing causes of death are considered, the mortality data presented in this report probably underestimate the total occurrence of pneumoconioses and other diseases.

As with any analysis based on death certificate data, there is undoubtedly some misclassification of cause of death. A treating physician may not correctly diagnose a particular disease during a patient’s life or, as mentioned above, a certifying physician may fail to list a correctly diagnosed disease on the death certificate, particularly if another disease was directly responsible for the decedent’s death. In addition, the diagnoses listed on the death certificate are sometimes miscoded.

Data that depend, either directly or indirectly, on physician reporting or recording of occupational disease diagnoses can be influenced significantly by the physician’s ability or willingness to suspect and evaluate a relationship between work and health. These, in turn, are influenced by evolving medical/ scientific information, and by the legal, political, and social environment. Some factors may lead to increased diagnosis and recording/reporting (e.g., the Coal Mine Health and Safety Act of 1969 increasing recognition and recording of coal workers’ pneumoconiosis), while other factors may reduce occupational disease recognition or reporting by physicians (e.g., long latency between a work exposure and disease development, or concern about involvement in litigation).

Courtesy of the CDC

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