Asbestos and cancer in Latin America and the Caribbean: we may have won some battles, but definitely not the war

Our plain-English summary of Asbestos and cancer in Latin America and the Caribbean: we may have won some battles, but definitely not the war, by A. Hernández-Blanquisett, A. Álvarez-Londoño, M.C. Martinez-Avila, et al (Journal of Public Health Research, 2021).

The study

• Authors: A. Hernández-Blanquisett, A. Álvarez-Londoño, M.C. Martinez-Avila, S. Covo-Camacho, V. Quintero-Carreño
• Journal: Journal of Public Health Research
• Published: 2021;11(2)
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Only six countries have banned the industrial use of asbestos in Latin America and the Caribbean. In fact, the industrial use of asbestos appears to be growing in this region. Asbestos is one of the most dangerous natural substances in the world, it is contained in several types of rocks (such as serpentinites, mafic and ultramafic rocks) but fibers can be released to the atmosphere both by natural and antropogenic sources. Six countries have banned the industrial use of asbestos in this region, we expected that laws established before 2007 would be less adherent to the 2007 WHO/ILO recommendations. In contrast, the Chilean law of 2001 is one of those that most adheres to international recommendations along with the Colombian law of 2021. Which means that the newest laws are not necessarily the strongest. This article aims to draw a regional overview of the laws against asbestos production in Latin America and the Caribbean, highlighting the strengths and weaknesses of each national policy. We recommend that countries that have already banned asbestos consider updating and strengthening their existing laws and develop clinical guidelines for the management, monitoring, and rehabilitation of asbestos-related diseases. The challenge of asbestos goes far beyond a prohibition law.

In plain English

This review of national laws, not a study of patients or workers, asked whether asbestos laws in Latin America and the Caribbean followed the 2007 WHO/ILO recommendations. Only six countries in the region had laws banning asbestos: Argentina, Chile, Uruguay, Honduras, Brazil and Colombia. The other countries discussed had no such ban; Peru, for example, prohibited amphibole asbestos but allowed regulated use of chrysotile. Chile's 2001 law and Colombia's 2021 law were among those that most closely followed the recommendations. The authors described a common weakness: the laws generally set no guidelines for registering people exposed to asbestos. None included exposure limits, and none gave a concrete economic strategy to pay for asbestos removal. A guide with concrete recommendations on medical surveillance, treatment or rehabilitation of exposed workers was lacking. The authors concluded that the newest laws are not necessarily the strongest. They recommended that countries that have already banned asbestos update and strengthen their laws and develop clinical guidelines. They stated that their review could not show whether the laws were having the expected impact.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review (narrative overview of national asbestos laws, compared against the 2007 WHO/ILO recommendations)
• Who was studied: Asbestos laws of the six Latin American and Caribbean countries that banned asbestos: Argentina (2000), Chile (2001), Uruguay (2002), Honduras (2004), Brazil (2017) and Colombia (2021). The review also briefly covered regulations in Peru, Paraguay, Bolivia, Venezuela, Panama and Costa Rica.
• Exposure: Not an exposure study. The subject was national laws banning or restricting asbestos, including amphiboles and chrysotile. Examples: Chile's Supreme Decree 656 of 2001 banned all types of asbestos; Brazil's Law 9,055 of 1995 banned amphiboles but allowed chrysotile.
• Main results:
  • Chile's 2001 law was one of the laws that most closely followed the international recommendations, along with Colombia's 2021 law.
  • The laws of Argentina, Chile and Uruguay set guidelines based on ILO Convention 162. For Honduras and Brazil, the authors found no information on adherence to that convention.
  • The authors described the lack of guidelines for registering or identifying people with past or current asbestos exposure as a common weakness of the legislation in general. The Colombian law's plan aims to identify workers affected by exposure and monitor their health.
  • None of the laws included limits on asbestos exposure.
  • None of the regional laws provided a concrete economic strategy to cover the cost of asbestos removal.
  • A guide with concrete recommendations on medical surveillance, treatment or rehabilitation of exposed workers was lacking.
  • An Argentine norm on asbestos set clinical tests and follow-up times for exposed workers, but it did not include guidelines for treatment or rehabilitation.
  • Colombia set a 20-year health follow-up period for exposed workers. The authors called for a longer period, citing latency periods of more than 30 years.
  • In Brazil, there was still concern about the use of chrysotile asbestos because of the permission contained in Law 9055/95.
  • Peru, through Law 29662, prohibited amphibole asbestos but allowed regulated use of chrysotile. According to the PAHO asbestos atlas project, some countries only addressed safe management of asbestos, without planning a ban.
• The authors' conclusion: The authors concluded that the newest laws against asbestos are not necessarily the strongest. They recommended that countries that have already banned asbestos update and strengthen their laws and develop clinical guidelines for managing, monitoring and rehabilitating asbestos-related diseases.
• Limitations the authors state:
  • The authors stated that their research cannot conclude whether the existing laws are having the expected impact in each country.

Topics

Medical terms in this study, explained in our Lexicon: Serpentinite, Ultramafic Rocks.

Related studies

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• Prevention of Asbestos Exposure in Latin America within a Global Public Health Perspective — E. Algranti, J.P. Ramos-Bonilla, et al. (2019)
• Characteristics and long-term outcomes of advanced pleural mesothelioma in Latin America (MeSO-CLICaP) — L. Rojas, A.F. Cardona, et al. (2019)
• International scientific cooperation on asbestos-related disease prevention in Latin America — D. Marsili, P. Comba, et al. (2014)
• Status of the ban on asbestos use in Spain and Latin America — R.A. Accinelli Tanaka, L.M. López Oropeza (2015)
• Some personal observations on industrial health in the United States of America — B. Harvey (1954)

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