Standardized Incidence Ratio and Standardized Mortality Ratio of Malignant Mesothelioma in a Worker Cohort Using Employment Insurance Database in Korea

Malignant mesothelioma is one of the appropriate indicators for assessing the carcinogenic effects of asbestos. This study compared the risk ratio of mesothelioma according to the industry in the worker cohort. A cohort was constructed using the Korean employment insurance system during 1995-2017, enrolling 13,285,895 men and 10,452,705 women. The standardized mortality ratio (SMR) and standardized incidence ratio (SIR) were calculated using the indirect standardization method. There were 641 malignant mesotheliomas that occurred; the SIR was significantly higher than the general population (men 1.36, 95% confidence interval (CI) 1.24-1.48, women 1.44, 95% CI: 1.23-1.7). More than half (52.8%) of malignant mesothelioma cases occurred in the manufacturing (n = 240, 38.6%, SIR: men, 1.72, 95% CI: 1.37-2.15, women, 3.31, 95% CI: 1.71-5.79) and construction industries (n = 88, 14.2%, SIR: men, 1.54 95% CI: 1.33-1.78, women, 1.62 95% CI: 1.25-2.11). The accommodation and food service (men, 2.56 95% CI: 1.28-4.58, women 1.35, 95% CI: 0.65-2.48) and real estate (men 1.34, 95% CI: 0.98-1.83, women 1.95, 95% CI: 0.78-4.02) also showed a high SIR, indicating the risk of asbestos-containing materials in old buildings. The incidence of malignant mesothelioma is likely to increase in the future, given the long latency of this disease. Moreover, long-term follow-up studies will be needed.