A review of epidemiological aspects of malignant mesothelioma was presented. Topics included the historical aspects of malignant mesothelioma cases indicating the first diagnosis to have been made at least as early as 1870; a descriptive epidemiology emphasizing natural history of the disease; diagnostic problems; problems with obtaining information from death certificates and tumor registries; geographic distribution of cases of malignant mesothelioma including reports from different countries, regions, cities, shipyard areas, mining regions, and urban areas; the incidence in males and females; an analytical epidemiology with information drawn from case referent studies, cohort studies, prevalence surveys, evidence of lung burden, and exposure and response studies; the importance of etiologic agents other than asbestos (1332214) such as tobacco, natural mineral fibers, man made mineral fibers, organic fibers, cement, copper (7440508), fiberglass (14808607), nickel (7440020), rubber, and wood; and public health aspects including information on risk estimates and control measures. Studies have indicated that most major cities have similar incidence ratios for malignant mesothelioma with the exception of higher rates being found in ports with large naval shipyards or dockyards, or cities with large asbestos industries. Lower rates were found in agricultural regions. Surveys among persons residing within short distances from chrysotile (12001295) mines in Canada or the United States were negative except for individuals directly or indirectly occupationally exposed. Distinctions between fiber types in terms of health risk and regulations were discussed.
