Background Brazil has a long history of heavy asbestos consumption. However, the number of asbestos-related diseases (ARDs) falls far below the one expected compared with other asbestos consumer countries. Aims To examine underreporting of ARDs, that is mesothelioma, asbestosis and pleural plaques, in Brazil’s Mortality Information System (SIM). Methods Health information systems (HIS) were mapped, datasets retrieved and records of ARD deaths extracted. Records were pair-matched using anonymous linkage to create a single database. ARD-reported cases missing in SIM were considered unreported. The study’s period ranged from 2008 to 2014, when every HIS contributed to the ARD records pool. Results A total of 1298 registered ARD deaths were found, 996 cases of mesothelioma (77%) and 302 (23%) of asbestosis and pleural plaques. SIM was the major single data source of ARD but 335 mesothelioma deaths were missing, an average underreporting of 33%, with no clear time trend. For asbestosis and pleural plaques, underreporting of ARD oscillated from 55% in 2010 to 25% in 2014, a declining trend. ARD underreporting was not associated with sex or age. Conclusions One-third of underreported ARD deaths in the universal SIM is unacceptably high and, apparently, it has not been improving substantially over time. After recoveries from multiple databases, the number of cases is still below, which could be expected based on asbestos consumption. Interoperability of multiple information systems could enhance case detection and improve the precision of mortality estimates, which are crucial for surveillance and for evaluation of remedial policies.

中文翻译：

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巴西间皮瘤、石棉沉着病和胸膜斑的少报

背景 巴西长期大量消费石棉。然而，与其他石棉消费国相比，石棉相关疾病 (ARD) 的数量远低于预期。目的 检查巴西死亡率信息系统 (SIM) 中 ARD 的漏报情况，即间皮瘤、石棉沉着症和胸膜斑块。方法 绘制健康信息系统 (HIS)，检索数据集并提取 ARD 死亡记录。使用匿名链接对记录进行配对匹配以创建单个数据库。SIM 中缺失的 ARD 报告病例被视为未报告。该研究的时期从 2008 年到 2014 年，当时每个 HIS 都对 ARD 记录库做出了贡献。结果共发现登记ARD死亡1298例，间皮瘤996例（77%），石棉沉着症和胸膜斑302例（23%）。SIM 是 ARD 的主要单一数据源，但缺少 335 例间皮瘤死亡，平均漏报 33%，没有明确的时间趋势。对于石棉沉着病和胸膜斑块，ARD 的漏报率从 2010 年的 55% 波动到 2014 年的 25%，呈下降趋势。ARD 漏报与性别或年龄无关。结论 在通用 SIM 中，三分之一被低估的 ARD 死亡人数高得令人无法接受，而且很明显，随着时间的推移，它并没有显着改善。从多个数据库恢复后，病例数仍低于石棉消耗量。多个信息系统的互操作性可以加强病例检测并提高死亡率估计的准确性，这对于监测和评估补救政策至关重要。