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An Occupational Legacy

Malignant Mesothelioma Incidence and Mortality in Wisconsin

Tomasallo, Carrie D., PhD, MPH; Christensen, Krista Y., PhD, MPH; Raymond, Michelle, MS; Creswell, Paul D., PhD; Anderson, Henry A., MD; Meiman, Jon G., MD

Journal of Occupational and Environmental Medicine: December 2018 - Volume 60 - Issue 12 - p 1143–1149
doi: 10.1097/JOM.0000000000001461

Objectives: The aim of the study was to describe mesothelioma occurrence in Wisconsin from 1997 to 2013 by usual industry and occupation (I&O), including occupations generally considered low risk.

Methods: Population-based rates and standardized incidence and mortality ratios were calculated. Two case–control analyses were designed to compare mesothelioma incidence and mortality in specific I&O groups with occurrence of (1) brain and central nervous system cancers and (2) other causes of death, using logistic regression.

Results: Mesothelioma incidence and mortality were elevated in Wisconsin (SIRadj = 1.20 [1.13 to 1.28]; SMRadj = 1.30 [1.22 to 1.38]). Certain industry (construction, manufacturing) and occupation (construction and extraction) groups were associated with increased odds of mesothelioma, with some evidence of increased risk among teachers.

Conclusions: Forty years after the Occupational and Safety Health Act, mesothelioma incidence and mortality remain elevated in Wisconsin, with increased risk continuing for certain I&O groups.

Wisconsin Department of Health Services, Division of Public Health, Bureau of Environmental and Occupational Health, Madison, WI (Dr Tomasallo, Dr Christensen, Ms Raymond, Dr Creswell, Dr Anderson, and Dr Meiman); Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI (Dr Christensen); Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI (Ms Raymond, Dr Creswell, and Dr Anderson).

Address correspondence to: Carrie D. Tomasallo, PhD, MPH, Wisconsin Department of Health Services, 1 W. Wilson Street—Rm 150, Madison, WI 53703 (

Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Wisconsin Fundamental-Plus Occupational Health Surveillance project Grant no. 5U60OH010898-03. Centers for Disease Control and Prevention, National Center for Environmental Health, Enhancing Innovation and Capabilities of the Environmental Public Health Tracking Network in Wisconsin project Grant No. 6 NUE1EH001342-01-01. US Environmental Protection Agency Great Lakes National Program Office, Great Lakes Restoration Initiative Grant No. GL-00E01285.

HAA has served as a consultant to government and international agencies on asbestos health effects, and has been a consultant and witness on plaintiff's litigation concerning asbestos and disease.

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2018 by the American College of Occupational and Environmental Medicine