Asbestos: promotion or prohibition?

Our plain-English summary of Asbestos: promotion or prohibition?, by D.V. Bates (CMAJ, 1987).

The study

• Author: D.V. Bates
• Journal: CMAJ
• Published: 1987;136(2):107-9
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004754).

Summary of the article

In this editorial, based on an address to a health and safety seminar in Sudbury, Ontario, in June 1986, the author asked whether Canada should promote or prohibit the use and export of asbestos. He outlined the history of asbestos production and of medical evidence on asbestosis, lung cancer and mesothelioma. He listed inquiries and actions, including the Beaudry Commission in Quebec, the Swedish import ban, the 1982 Manville Corporation bankruptcy and the 1986 US Environmental Protection Agency (EPA) proposal to phase out asbestos over 10 years. He cited an estimate of 82 lifetime excess cancers per 10 000 workers exposed for 40 years to 0.5 fibres/mL. He reported that the Canadian government had funded the Asbestos Institute of Canada to contest the EPA proposal. He disputed a Canadian expert's claim that 99% of lung cancers were related to smoking, citing Saracci's analysis that 91% of excess lung cancers in asbestos workers would be eliminated if they did not smoke, and 82% if smokers were not exposed to asbestos. He set out arguments for promotion and for prohibition. He concluded that if the government promoted asbestos, it should set up an independent commission to ensure safe export, proper labelling, purchaser acknowledgement of risks and health surveillance. He added that the government should fund research and surveillance equally with industry promotion, and that health care organizations should act together to ensure these steps were taken.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This editorial reported no new data and asked whether Canada should promote or prohibit asbestos, including exports to third world countries. The author quoted Hughes and Weill's estimate of 82 lifetime excess cancers per 10,000 workers exposed for 40 years to 0.5 fibers per milliliter of mixed asbestos fiber types. The author disputed a Canadian expert's inference that, since 99% of lung cancers were smoking-related, only 1% remained for other causes, noting that with multifactorial disease the total percentage is not 100. Citing Saracci, the author wrote that if asbestos-exposed workers did not smoke, 91% of their excess lung cancers would be eliminated. Safe handling, the author wrote, had not been demonstrated and would need a 30-year follow-up to prove. The author concluded that if the Canadian government promoted asbestos, it should create an independent commission, drawn from neither industry nor government. The commission would ensure that asbestos was exported in the safest mode, proper labelling, purchasers' signed acknowledgement of risks and health surveillance. In addition, the government should provide as much money for asbestos health research and surveillance as the industry received for promotion.

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: Editorial (opinion piece based on an address); no original research
• Who was studied: No study population. The editorial discusses the Canadian government's promotion of asbestos and its export, including to third world countries.
• Exposure: Asbestos in general. In discussing risks, the author stated that mesothelioma risk is greater with crocidolite than with chrysotile, while lung cancer risk is the same.
• Main results:
  • The author quoted Hughes and Weill's estimate, which was not the author's own finding. It gave 82 lifetime excess cancers per 10,000 workers exposed for 40 years to 0.5 f/ml of mixed asbestos fiber types. It also gave 5 lifetime excess cancers per one million students exposed to an average of 0.001 f/ml for 6 school years.
  • A Canadian expert had said that 99% of lung cancers were related to smoking, leaving only 1% for other causes including asbestos. The author challenged that inference, saying that with multifactorial disease the total percentage is not 100.
  • Citing Saracci's analysis, the author wrote that if asbestos-exposed workers did not smoke, 91% of the excess lung cancers would be eliminated. If they smoked but were not exposed to asbestos, 82% would be eliminated.
  • The author wrote that the claim that asbestos can be handled safely had not been demonstrated, and that a 30-year follow-up would be needed to prove it.
  • The author stated that health care organizations have a responsibility to act together to ensure the proposed minimal steps are taken.
• The authors' conclusion: The author concluded that if the Canadian government wished to promote asbestos, it would have to establish an independent commission, recruited neither from industry nor from government employees, to report annually to the public. The commission would ensure that asbestos was exported in the safest mode, that it was properly labelled, that purchasers signed an acknowledgement of the risks and that a health surveillance program was delineated. In addition, the government would have to provide as much money for research into asbestos health risks and surveillance of its use as is provided to the industry for promotion.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma.

Related studies

• Asbestos: promotion or prohibition? — D.V. Bates (1988)
• Asbestos: promotion or prohibition? — C.E. Forget (1987)
• Asbestos: promotion or prohibition? — W.K. Morgan (1987)
• Health promotion: Smoking control — (1983)
• The aftermath of asbestos prohibition in industry and its association with malignant mesothelioma in the south of Iran: An enduring predicament yet to be resolved — A. Rezvani, R. Shahriarirad, et al. (2024)
• Initiation-promotion versus complete skin carcinogenesis in mice: importance of dark basal keratinocytes (stem cells) — T.J. Slaga, A.J. Klein-Szanto (1983)

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