A new study of naval personnel published in November 2023 has shown that approximately 27% of lung cancers in Australian seamen and 12% in British seamen were related to onboard asbestos exposure.
Asbestos-containing materials (ACM) were present in British and Australian naval vessels throughout the twentieth century. The aim of this study was to identify and quantify the incidence of cancer in naval personnel from onboard asbestos exposure.
Subjects were four cohorts of subjects who had served in the armed forces of the United Kingdom and Australia in the 1950s and 1960s. All cohorts had previously been studied, three of them in relation to radiation exposures from British nuclear testing.
Excess mesotheliomas were found in naval personnel in all cohorts. In all but one cohort the lung cancer incidence was highest in navy personnel.
Comparison of other smoking-related conditions indicated that the excess in navy personnel was not smoking-related. The relatively high SIRs for mesothelioma and the occurrence of deaths from asbestosis were indicative of high levels of asbestos exposure, with an expectation of cases of asbestos-related lung cancer.
The findings are consistent with the occurrence of significant excesses of mesotheliomas.
Material and Methods
The study population is comprised of four cohorts of Australian and British service personnel. Two cohorts are derived from British and Australian participants in the British atmospheric nuclear tests undertaken primarily in the 1950s (minor trials and clean-up operations continued into the 1960s).
In the study of 21,357 British participants, cancer and mortality rates were compared with a control cohort of civilians and service personnel who had served overseas but not participated in the nuclear testing.
The control cohort contained a similar mix of subjects from the different armed services, and of officers and other ranks, as the cohort of test participants, and were also similar in matters such as date of birth. The small percentage of civilians in each cohort were excluded from the present study.
For the present study, mortality and cancer data in naval veterans were compared with those of the army and the air force. To assess the contribution of smoking to lung cancer incidence, comparison of other smoking-related conditions was made by service. The analyses were based on tables from the published reports of the Australian and British nuclear test participants and of Australian Korean War veterans.
Data on deaths from asbestosis by service were supplied by the authors of the update of the UK cohort study. Asbestosis deaths in the Australian cohort could not be ascertained as the data set is no longer readily available.
To estimate the number of lung cancers attributable to asbestos in naval veterans, we multiplied the expected number by the SIR for army veterans as an approximation for the number expected from smoking, and subtracted the product from the observed number in naval veterans.
Discussion
The high rates of mesothelioma seen only in naval veterans can be confidently attributed to onboard asbestos exposure, and are consistent with findings of other studies of naval and merchant seafarers, in particular in veterans of the US nuclear weapons testing.
Lung cancer incidence was highest in the navy personnel and lowest in the air force, with the exception of the Korean War veterans’ cohort. The excess in naval personnel cannot be attributed automatically to asbestos: whereas most mesotheliomas are caused by asbestos, most lung cancers are not.
Since the lung cancer excesses in the navy are not explicable by higher smoking prevalence, asbestos is a likely alternative explanation. This is supported by the high SIRs for mesothelioma in naval veterans, comparable to those of occupations ranked with the highest levels of risk identified from other studies. High mesothelioma incidence indicates high cumulative asbestos exposure, with a corresponding high likelihood of some ARLCs.
This conclusion is supported by the occurrence of asbestosis deaths in the British navy, suggesting that the threshold exposure of 2fibre/ml years has been exceeded.
The incremental risk of lung cancer for per fibre/ml year exposure to amphibole asbestos or mixed fibres has been estimated at 4.8%, so that the additional burden of lung cancer from asbestos exposure expected in an occupational group where asbestosis has occurred would be at least 10%
Conclusion
Naval veterans have elevated rates of mesothelioma, not found in the other armed services, and attribution to onboard exposure to asbestos is non-contentious.
They also have excess rates of lung cancer which are not fully explained by any differences in smoking prevalence.
The occurrence of mesothelioma is comparable to levels in occupational groups with the highest reported incidence or mortality from mesothelioma, suggesting that onboard exposures are comparable to those of industries with a high likelihood of ARLCs.
Significant asbestos exposures are also indicated by the occurrence of asbestosis deaths in British naval veterans.
Notwithstanding some inconsistencies in the results between the cohorts, the findings are consistent with the occurrence not only of significant excesses of mesotheliomas but also of a substantial number of asbestos-related lung cancers.
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Asbestos Exposure Claims Against the Royal Navy
One of the biggest MoD industries using asbestos in their operations was the Royal Navy. Many navy personnel were exposed to asbestos not only during the shipbuilding process but while working in the boiler rooms of vessels.
Asbestos was routinely used to insulate the pipes following World War II. Researchers at the London School of Hygiene and Tropical Medicine (LSHTM) have estimated that more than 2,500 Royal Navy veterans will die from mesothelioma in the next 30 years, as a result of asbestos exposure.
Under the Mesothelioma Act 2014, any Royal Navy veterans diagnosed with mesothelioma may be entitled to a lump sum of compensation of £140,000 or a War Pension.
Further information can be found on the Royal British Legions website: