Asbestos Ban in Italy: A Major Milestone, Not the Final Cut

Our plain-English summary of Asbestos Ban in Italy: A Major Milestone, Not the Final Cut, by D. Marsili, A. Angelini, C. Bruno, et al (International Journal of Environmental Research and Public Health, 2017).

The study

• Authors: D. Marsili, A. Angelini, C. Bruno, M. Corfiati, A. Marinaccio, S. Silvestri, A. Zona, P. Comba
• Journal: International Journal of Environmental Research and Public Health
• Published: 2017;14(11)
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use.

In plain English

This article was not a new study of patients or workers. It was a narrative review by the authors of how Italy came to ban asbestos in 1992 (Law 257/92) and what followed. Italy had been one of Europe's main asbestos producers and consumers, with exposure in mining, asbestos cement production, shipyards and the textile industry. The authors described policies on asbestos substitutes, the national mesothelioma register (ReNaM), health checks for exposed and formerly exposed workers, asbestos removal and waste disposal, and scientific cooperation with Latin American countries. They reported that by December 2016 the register had gathered 27,035 malignant mesothelioma cases from 1993 to 2015, with exposure investigated for 21,108 (78%). They also reported that the mesothelioma epidemic curve had not yet decreased. Using data from some regions and national institutions, they reported that yearly removal work took away about 1% by weight of the asbestos-containing material present in 1992, leaving 75% still to be recovered. The authors named excessive fragmentation of tasks among regional and local institutions as a failure. They concluded that Italy's lessons could support countries still using asbestos.

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: Narrative review / policy analysis of the Italian asbestos ban and its implementation (not an original epidemiological study)
• Who was studied: Italy, a former major asbestos producer and consumer, before and after its 1992 national asbestos ban
• Exposure: Occupational asbestos exposure in mining and marketing, asbestos cement production, shipyards and the textile industry, plus environmental exposure of surrounding communities
• Main results:
  • The national mesothelioma register (ReNaM) had gathered 27,035 malignant mesothelioma cases diagnosed from 1993 to 2015 by December 2016. Modes of asbestos exposure were investigated for 21,108 of them (78%).
  • The epidemic curve of mesothelioma in Italy had not yet decreased.
  • Citing registry analyses, the paper put the current share of mesothelioma cases from non-occupational exposure at around 10%.
  • Based on data collected in some regions and from national institutions, annual asbestos removal accounted for about 1% by weight of the asbestos-containing materials present in 1992, with 75% still to be recovered.
  • Without special economic conditions, the authors stated that asbestos removal would be completed by the end of the current century.
  • The authors stated that, from a technological point of view, asbestos had been replaced with other materials in 100% of cases.
  • In the Tuscany Region, a list of asbestos reclamation workers formed a cohort of potentially exposed workers totalling nearly 6500.
  • The authors identified as a failure the excessive fragmentation of tasks among public institutions dealing with environmental and health protection at regional and local level.
• The authors' conclusion: The authors concluded that key factors and lessons from Italy's successful and ineffective asbestos policies could support stakeholders in countries still using asbestos in ending its use. Among these, they listed engaging local and central authorities, training professionals, engaging affected communities, managing contaminated sites, and further research.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Asbestos-Cement.

Related studies

• Occupational exposure in the removal and disposal of asbestos-containing materials in Italy — A. Scarselli, M. Corfiati, et al. (2016)
• Pleural mesothelioma mortality and asbestos exposure mapping in Italy — L. Fazzo, M. De Santis, et al. (2012)
• Burden of Mortality from Asbestos-Related Diseases in Italy — L. Fazzo, A. Binazzi, et al. (2021)
• Statement in response to asbestos industry efforts to prevent a ban on asbestos in Pakistan: chrysotile asbestos use is not safe and must be banned — G. Aguilar Madrid, M. Beaudry, et al. (2013)
• Rationing health protection: a proposal to exempt nuisance dust from US Clean Air Act regulations — T.J. Centner, G. Colson (2013)
• Environmental Health Education for Asbestos-Contaminated Communities in Italy: The Casale Monferrato Case Study — D. Marsili, A. Canepa, et al. (2019)

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