Asbestos and disease - a public health success story?

Our plain-English summary of Asbestos and disease - a public health success story?, by B. Järvholm, A. Burdorf (Scandinavian Journal of Work, Environment & Health, 2024).

The study

• Authors: B. Järvholm, A. Burdorf
• Journal: Scandinavian Journal of Work, Environment & Health
• Published: 2024;50(2):53-60
• Type of article: Review
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objective: This paper discusses the failure and success of society to decrease the adverse health effects of asbestos exposure on workers' health in relation to scientific knowledge.

Methods: The findings are based on a narrative literature review.

Results: Early warnings of the adverse health effects of workplace exposure to asbestos were published already in the 1930s. Serious health effects, such as malignancies and fibrosis due to occupational asbestos exposure, were highlighted in major medical journals and textbooks in late 1960s. New technologies could detect also asbestos fibers in the lung of non-occupational exposed persons in the 1970s. The first bans for using asbestos came in the early 1970s, and more general bans by authorities came in the 1980s and continue until today.

Conclusions: The rather late recognition of adverse effects of asbestos exposure in the general population and measures to decrease the exposure through more general bans came rather late. However, the very strong measures such as general bans in many countries have been a success. A Swedish study showed that the general ban and other measures have decreased the risk of malignancies due to occupational exposure. The effect of the bans on adverse effects in the general population has yet to be studied. Analysis of fibers in the lungs of persons born after the bans could be an efficient method.

In plain English

This discussion paper was a narrative literature review without new data. The authors searched PubMed and also used websites and reference lists. They aimed to trace how science and society responded to the health effects of asbestos. Early warnings about workplace asbestos exposure were published in the 1930s. The first bans came in the early 1970s, and more general bans followed from the 1980s. Worldwide asbestos consumption peaked at around 4.7 million tons in 1980. Lung measurements in the 1980s and 1990s found asbestos fibers in the general population. Citing an earlier Swedish analysis by the same two authors, they reported that men who started work after the Swedish ban had a lower risk of pleural mesothelioma. The authors concluded that prevention was a success in many western countries, but that the pace, especially from 1960 to 1990, could have been faster. They called the large use of asbestos in some other countries a failure. They found no studies checking whether lung fiber levels in younger people and workers were almost nil, as expected if exposure had been almost eliminated.

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: Discussion paper based on a narrative literature review (historical account); no original data collected
• Who was studied: Published literature found through a PubMed search, websites known to the authors, and reference lists, on asbestos health effects, control measures and bans
• Exposure: Asbestos in general (occupational and non-occupational exposure), including discussion of chrysotile, amphiboles such as crocidolite, amosite and tremolite, and bans and exposure limits
• Main results:
  • The reviewed literature showed early warnings about workplace asbestos exposure were published in the 1930s
  • The first bans came in the early 1970s; more general bans by authorities came in the 1980s and continue to the present
  • Worldwide asbestos consumption peaked at around 4.7 million tons in 1980 and has decreased since
  • Studies cited in the review found asbestos fibers in the lungs of the general population in the 1980s and 1990s
  • An earlier Swedish analysis by the same authors (reference 68), done 30 years after the ban, found that men who started to work after the ban had a lower risk of pleural mesothelioma; the authors called the ban and other measures a success
  • The authors wrote that the importance of smoking was often emphasized before the risk of asbestos
  • The authors expected that, if asbestos exposure were almost eliminated, fiber concentrations in the lungs of younger people in the general population and workers would be almost nil, and they found no studies examining this
• The authors' conclusion: The authors concluded that preventive measures are a success in many western countries today, but that the pace, especially from 1960 to 1990, could have been faster, and that the large use of asbestos in some other countries should be considered a failure
• Limitations the authors state:
  • The authors stated it will be a challenge to prove that preventive measures, so far and in the future, have been a success
  • The authors stated a decrease in lung cancer will be much harder to show and interpret because of other risk factors such as smoking and radon

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Fibrosis, Occupational Exposure.

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