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  • Measure Summary
  • NQMC:010305
  • Mar 2016

Occupational health: annual, age-standardized mesothelioma incidence rate per million residents age 15 years or older.

Council of State and Territorial Epidemiologists (CSTE), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). Occupational health indicators: a guide for tracking occupational health conditions and their determinants. Atlanta (GA): Council of State and Territorial Epidemiologists (CSTE); 2016 Mar. 145 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: Council of State and Territorial Epidemiologists (CSTE), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). Occupational health indicators: a guide for tracking occupational health conditions and their determinants. Atlanta (GA): Council of State and Territorial Epidemiologists; 2014 Mar. 116 p.

The measure developer reaffirmed the currency of this measure in January 2017.

Primary Measure Domain

Related Population Health Measures: Population Health State

Secondary Measure Domain

Related Population Health Measure: Environment

Description

This measure is used to assess the annual, age-standardized mesothelioma incidence rate per million residents age 15 years or older (standardized by the direct method to the Year 2000 United States [U.S.] standard population).

Rationale

State health agencies, which are vested with the legal authority to require disease reporting and collect health data, play a central role in public health surveillance. Whereas public health surveillance was once focused primarily on infectious diseases, it has expanded in recent years to include surveillance of a wide range of health outcomes and their determinants, including chronic diseases, injuries and health behaviors (Halperin & Horan, 1998). National statistics on occupational injuries and illnesses have been collected largely outside of the public health infrastructure and rely almost entirely on data reported by employers. State health agencies that have access to a wide variety of public health data systems have an important role in the surveillance of occupational diseases, injuries and hazards.

Malignant mesothelioma, while relatively rare, is a fatal cancer largely attributable to workplace exposure to asbestos. Tracking of malignant mesothelioma should be undertaken to document the burden of occupational disease, to design, target, and evaluate the impact of prevention efforts over time, and to identify previously unrecognized settings in which workers may continue to be at risk of asbestos exposure.

Evidence for Rationale

Council of State and Territorial Epidemiologists (CSTE), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). Occupational health indicators: a guide for tracking occupational health conditions and their determinants. Atlanta (GA): Council of State and Territorial Epidemiologists (CSTE); 2016 Mar. 145 p.

Halperin W, Horan JM. Surveillance of injuries. Public Health Rep. 1998 Sep-Oct;113(5):424-6. PubMed External Web Site Policy

Primary Health Components

Occupational illnesses; mesothelioma

Denominator Description

Midyear resident population age 15 years or older for the same calendar year

Numerator Description

Incident cases with mesothelioma (International Classification of Diseases for Oncology [ICD-O] histology codes 9050 through 9053) (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

About 3,000 deaths with malignant mesothelioma occur each year in the United States (North American Association of Central Cancer Registries, 2012). The only well-established risk factor for malignant mesothelioma is exposure to asbestos and related fibers. It has been estimated that as much as 90 percent of cases are caused by exposure to asbestos.

Evidence for Additional Information Supporting Need for the Measure

Council of State and Territorial Epidemiologists (CSTE), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). Occupational health indicators: a guide for tracking occupational health conditions and their determinants. Atlanta (GA): Council of State and Territorial Epidemiologists (CSTE); 2016 Mar. 145 p.

North America Association of Central Cancer Registers (NAACCR). CINA+ Online: cancer in North America. [internet]. Springfield (IL): North America Association of Central Cancer Registers; 2012. 

Extent of Measure Testing

In 1998, the Council of State and Territorial Epidemiologists (CSTE), in association with the National Institute for Occupational Safety and Health (NIOSH), convened the NIOSH-States Occupational Health Surveillance Work Group to make recommendations to NIOSH concerning State-based surveillance activities for the coming decade.

The Work Group recognized the need to pilot test 19 indicators to assess the feasibility of widespread implementation and to develop specific guidance on how to compute the proposed measures. In summer 2002, the five "Core" states with NIOSH Cooperative Agreements to conduct "Core Occupational Health Surveillance" (California, Massachusetts, Michigan, New York, and Washington) agreed to pilot test the indicators and to create user-friendly "how-to" guides so that other states could calculate the indicators.

Subsequent to the initial pilot testing by the five "Core" states, eight additional states (Connecticut, Maine, Nebraska, New Jersey, New Mexico, North Carolina, Oregon and Wisconsin) pilot tested the "how-to" guides. Feedback from these additional states was incorporated into the development of the final "how-to" guides for 19 indicators in November 2004.

Procedures to review, approve, and implement new indicators are developed by the Work Group. Since 2013, four new health effects indicators have been developed, pilot tested, and adopted for implementation.

Evidence for Extent of Measure Testing

Council of State and Territorial Epidemiologists (CSTE), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). Occupational health indicators: a guide for tracking occupational health conditions and their determinants. Atlanta (GA): Council of State and Territorial Epidemiologists (CSTE); 2016 Mar. 145 p.

State of Use

Current routine use

Current Use

Monitoring and planning

Monitoring health state(s)

Public reporting

Measurement Setting

National Public Health Programs

State/Provincial Public Health Programs

Professionals Involved in Delivery of Health Services

Public Health Administrators/Managers

Public Health Professionals

Least Aggregated Level of Services Delivery Addressed

State/Provincial

Statement of Acceptable Minimum Sample Size

Specified

Target Population Age

Age greater than or equal to 15 years

Target Population Gender

Either male or female

Public Health Aims for Quality

Health Promoting

Risk Reducing

Transparency

Vigilant

IOM Care Need

Not within an IOM Care Need

IOM Domain

Not within an IOM Domain

Case Finding Period

The calendar year

Denominator Sampling Frame

Geographically defined

Denominator (Index) Event or Characteristic

Geographic Location

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Midyear resident population age 15 years or older for the same calendar year

Exclusions
Unspecified

Exclusions/Exceptions

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
Incident cases with mesothelioma (International Classification of Diseases for Oncology [ICD-O] histology codes 9050 through 9053)

Note: Refer to the "How-To Guide – Indicator #12" section of the original measure documentation for instructions to calculate the annual, age-standardized mesothelioma incidence rate (cases per million residents).

Exclusions
Events with age unknown, residence out-of-state, and unknown state of residence

Numerator Search Strategy

Fixed time period or point in time

Data Source

National public health data

Registry data

State/Province public health data

Type of Health State

Adverse Health State

Instruments Used and/or Associated with the Measure

State Cancer Registry

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Does not apply to this measure (i.e., there is no pre-defined preference for the measure score)

Allowance for Patient or Population Factors

Analysis by subgroup (stratification by individual factors, geographic factors, etc.)

Description of Allowance for Patient or Population Factors

Other Available Data: Age, gender, race/ethnicity, county of residence, usual occupation and industry

Recommendations: Age, gender, race/ethnicity, county counts and rates can be used to better define patterns of malignant mesothelioma. Because usual occupation and usual industry information is not necessarily indicative of the setting in which the causative exposure occurred, industry- and occupation-specific measures should be interpreted and reported with caution.

Standard of Comparison

External comparison at a point in, or interval of, time

External comparison of time trends

Internal time comparison

Original Title

12.3 Annual, age-standardized mesothelioma incidence rate (cases per million residents).

Measure Collection Name

Occupational Health Indicators

Measure Set Name

Occupational Illnesses

Submitter

Council of State and Territorial Epidemiologists - Professional Association

Developer

Centers for Disease Control and Prevention - Federal Government Agency [U.S.]

Council of State and Territorial Epidemiologists - Professional Association

Funding Source(s)

Centers for Disease Control and Prevention (CDC)–National Institute for Occupational Safety and Health (NIOSH) Award R01OH010094: Enhancing State-Based Occupational Health Surveillance Capacity

Composition of the Group that Developed the Measure

Original Work Group Members: National Institute for Occupational Safety and Health (NIOSH)–Council of State and Territorial Epidemiologists (CSTE) Occupational Health Indicators Work Group

  • Wayne Ball, Utah Department of Health
  • Geoffrey Calvert, NIOSH
  • Robert Castellan, NIOSH
  • Letitia Davis, Massachusetts Department of Health
  • Robert Harrison, California Department of Health Services
  • Michael Heumann, Oregon Department of Health Services
  • Kim Lim, Maine Department of Labor
  • John Myers, NIOSH
  • Matt London, New York State Department of Health
  • Latoya Osmani, CSTE
  • David Parker, Minnesota Department of Health
  • Kenneth Rosenman, Michigan State University
  • Robert Roscoe, NIOSH
  • Diana Salzman, Texas Department of Health
  • John Sestito, NIOSH
  • Catherine Thomsen, Oregon Department of Human Services
  • David Valiante, New Jersey Department of Health and Senior Services

Core State Members of the Occupational Health Surveillance Pilot Project

  • Barbara Materna, California Department of Health Services
  • Florence Reinisch, California Department of Health Services
  • Tsegaye Bekle, Massachusetts Department of Public Health
  • Letitia Davis, Massachusetts Department of Public Health
  • Rokho Kim, Massachusetts Department of Public Health
  • Thomas Largo, Michigan Department of Community Health
  • Martha Stanbury, Michigan Department of Community Health
  • Alicia Fletcher, New York State Department of Health
  • Kitty Gelberg, New York State Department of Health
  • Dave Bonauto, Washington State Department of Labor and Industries
  • Christy Curwick, Washington State Department of Labor and Industries

Current Occupational Health Indicator (OHI) and Work Group Leads

  • Marija Borjan, Co-chair (State Representative from New Jersey)
  • Tristan Victoroff, Co-chair (NIOSH Representative)
  • Patricia Schleiff, Co-chair (NIOSH Representative)
  • Amy Patel, Secretary (CSTE OHI Staff Lead)
  • Thomas Largo, OHI Lead (State Representative from Michigan)

Financial Disclosures/Other Potential Conflicts of Interest

None

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2016 Mar

Measure Maintenance

Annually

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

This measure updates a previous version: Council of State and Territorial Epidemiologists (CSTE), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). Occupational health indicators: a guide for tracking occupational health conditions and their determinants. Atlanta (GA): Council of State and Territorial Epidemiologists; 2014 Mar. 116 p.

The measure developer reaffirmed the currency of this measure in January 2017.

Source(s)

Council of State and Territorial Epidemiologists (CSTE), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). Occupational health indicators: a guide for tracking occupational health conditions and their determinants. Atlanta (GA): Council of State and Territorial Epidemiologists (CSTE); 2016 Mar. 145 p.

Measure Availability

Source available from the Council of State and Territorial Epidemiologists (CSTE) Web site External Web Site Policy.

For more information, contact CSTE at 2872 Woodcock Boulevard, Suite 250, Atlanta, GA 30341; Phone: 770-458-3811; Fax: 770-458-8516; Web site: https://cste.site-ym.com/ External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on December 23, 2014. This NQMC summary was verified by the measure developer on February 5, 2015.

This NQMC summary was updated by ECRI Institute on September 17, 2015. This NQMC summary was verified by the measure developer on October 19, 2015.

The information was reaffirmed by the measure developer on January 9, 2017.

Copyright Statement

No copyright restrictions apply.

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