Asbestos neglect: Why asbestos exposure deserves greater policy attention

Our plain-English summary of Asbestos neglect: Why asbestos exposure deserves greater policy attention, by T. Douglas, L. Van den Borre (Health Policy, 2019).

The study

• Authors: T. Douglas, L. Van den Borre
• Journal: Health Policy
• Published: 2019;123(5):516-519
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

While many public health threats are now widely appreciated by the public, the risks from asbestos exposure remain poorly understood, even in high-risk groups. This article makes the case that asbestos exposure is an important, ongoing global health threat, and argues for greater policy efforts to raise awareness of this threat. It also proposes the extension of asbestos bans to developing countries and increased public subsidies for asbestos testing and abatement.

Copyright © 2019 Elsevier B.V. All rights reserved.

In plain English

This article was a policy commentary, not a research study. The authors collected no new data. Drawing on published estimates and earlier studies, they argued that asbestos exposure is an ongoing global health threat that gets too little public and policy attention. They cited a 2015 Global Burden of Disease estimate that occupational asbestos exposure resulted in 184,677 deaths and 3.1 million disability-adjusted life years that year. They also cited Australian Mesothelioma Registry data showing that 232 (33%) of 701 surveyed mesothelioma patients diagnosed between 1 July 2010 and the end of 2016 reported no work-related asbestos exposure. A third source they cited was a 2007 UK study in which 60% of plumbers were exposed to airborne asbestos in a single working week. The authors proposed three policies: bans on asbestos mining, importation and use where none exist yet; wider public awareness campaigns; and public subsidies for asbestos testing and abatement. They noted that there are almost no data on asbestos-related disease rates in the countries that now use asbestos most heavily.

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: Policy commentary (argument piece) drawing on previously published studies and estimates; no original data
• Who was studied: No study population of its own. The authors discussed published figures on workers, home renovators and the general public in several countries, including the UK, Australia, Belgium and Asian countries, and global estimates.
• Exposure: Asbestos exposure in general, from five source categories: mining; production, handling and installation of asbestos-containing products; unsafe removal or damage; natural disintegration of asbestos-containing materials; and proximity to contaminated sites. Occupational and non-occupational exposures, such as home renovations, were both discussed.
• Main results:
  • The authors cited the 2015 Global Burden of Disease Study estimate that occupational asbestos exposures resulted in 184,677 deaths and 3.1 million DALYs worldwide in that year.
  • The authors cited a recent estimate of 38,400 mesothelioma deaths worldwide each year.
  • The authors cited Australian Mesothelioma Registry data: 232 (33%) of 701 surveyed mesothelioma patients diagnosed between 1 July 2010 and the end of 2016 reported no work-related asbestos exposure.
  • The authors cited a 2007 UK study finding that 60% of UK plumbers were exposed to airborne asbestos in a single working week.
  • The authors cited the same 2007 UK plumbers study as finding that only around a third of actual asbestos exposures were identified by the plumbers.
  • The authors cited an Australian general-public survey: 23.7% of the sample had done do-it-yourself home renovations, and of those, 61.4% reported exposure to asbestos.
  • The authors cited a WHO Regional Office for Europe survey: only eight of the 25 participating countries with an asbestos ban had a national strategy to prevent environmental exposure in the general population.
• The authors' conclusion: The authors concluded that asbestos exposure should get policy attention comparable to other public health threats. They urged bans on asbestos mining, importation and production where bans do not yet exist, public awareness campaigns like those for smoking, sun exposure and unsafe sex, and subsidized asbestos testing and abatement.
• Limitations the authors state:
  • The authors noted that there are almost no data on current rates of asbestos-related disease in the countries that now use asbestos most heavily.
  • The authors acknowledged that no good data are available on asbestos awareness among casual home renovators, so their view on this was an assumption.

Topics

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

Related studies

• A ban on asbestos must be based on a comparative risk assessment — M. Camus (2001)
• Should Canadian health care professionals support the call for a worldwide ban on asbestos? — J. Siemiatycki (2001)
• A ban on asbestos: is now the time? — (2001)
• Asbestos is still with us: Repeat call for a universal ban — C. Ramazzini (2011)
• The case for a global ban on asbestos — J. LaDou, B. Castleman, et al. (2010)
• Human exposure to urban air pollution — C.E. Boström, J. Almén, et al. (1994)

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