Rates of malignant mesothelioma (MM) have levelled off in Australia, but the changing patterns of asbestos-related diseases mean clinicians must be vigilant about taking exposure histories from their patients, according to the authors of an Editorial published in the Medical Journal of Australia.

"Since prohibition of the production and importation of asbestos in Australia in 2004, patterns of workforce and domestic exposure have further changed," lead author Professor Arthur (Bill) Musk, from Sir Charles Gairdner Hospital in Perth, wrote.

"Increasingly, claimants are presenting with MM arising solely from domestic exposure.

"Asbestosis also remains a problem because it cannot be distinguished on clinical or pathological grounds from diffuse interstitial pulmonary fibrosis of other or unknown cause, other than on the basis of evidence (historical, radiological or pathological) of asbestos exposure.

"As exposure to asbestos in the community declines, it will be increasingly unlikely that clinicians will be mindful of the condition and diligent in taking an asbestos exposure history."

Overall rates of MM in Australia have levelled off at around 50 per million per annum in men and tenfold less in women, the authors wrote.

Article: Asbestos exposure: challenges for Australian clinicians, Arthur W (Bill) Musk, Nicholas H de Klerk and Anna K Nowak, Medical Journal of Australia, doi: 10.5694/mja15.01072, published 1 February 2016.