Asbestos-Related Disorders in Germany: Background, Politics, Incidence, Diagnostics and Compensation

Our plain-English summary of Asbestos-Related Disorders in Germany: Background, Politics, Incidence, Diagnostics and Compensation, by X. Baur (International Journal of Environmental Research and Public Health, 2018).

The study

• Author: X. Baur
• Journal: International Journal of Environmental Research and Public Health
• Published: 2018;15(1)
• Type of article: Review
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

There was some limited use of asbestos at end of the 19th century in industrialized countries including Germany, but its consumption dramatically increased after World War II. The increase in use and exposure was followed by the discovery of high numbers of asbestos-related diseases with a mean latency period of about 38 years in Germany. The strong socio-political pressure from the asbestos industry, its affiliated scientists and physicians has successfully hindered regulatory measures and an asbestos ban for many years; a restrictive stance that is still being unravelled in compensation litigation. This national experience is compared with the situation in other industrialized countries and against the backdrop of the constant efforts of the WHO to eliminate asbestos-related diseases worldwide.

In plain English

This article was a review by a single author of the history of asbestos use, regulation, disease and compensation in Germany. It did not report new research data. The author reported that about 95% of Germany's asbestos imports were chrysotile, that consumption reached a plateau of about 260,000 metric tons a year by the 1970s, and that Germany banned asbestos in 1993. A national surveillance registry set up in 1972 now includes about 600,000 workers. After a mean latency of about 38 years, acknowledged asbestos-related diseases rose rapidly. About 9400 asbestos-related diseases are reported each year. About 4100 are acknowledged as occupational diseases and about 2500 receive compensation. Acknowledgement ranged from 80% of reported mesothelioma cases to 20% of reported lung cancer cases. The author stated there is evidence that asbestos-related lung cancer and asbestosis are underreported. The author linked a plateau of about 800 accepted lung cancer cases a year to a requirement for asbestos fibre and asbestos body counts in lung tissue. The author concluded that corporate interests can hinder preventive measures, a timely ban and fair compensation.

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 of the German experience with asbestos (history, regulation, disease statistics, diagnosis, compensation, industry influence)
• Who was studied: Germany as a whole; includes a national registry of current and former asbestos-exposed workers, established in 1972, of approximately 600,000 workers
• Exposure: Occupational (and some household and environmental) asbestos exposure in Germany, mostly chrysotile imported from Canada and Russia; construction was the dominant use
• Main results:
  • German asbestos consumption reached a plateau of about 260,000 metric tons annually by the 1970s; Germany banned asbestos in 1993
  • In German factories, the 90th percentile of asbestos fibre concentrations declined from 100 per cm3 in the early 1950s to 3 per cm3 in the early 1980s, based on more than 26,000 measurements reported in cited sources
  • After a mean latency of malignant disorders of about 38 years, acknowledged asbestos-related diseases rose rapidly, then plateaued
  • About 9400 asbestos-related diseases are reported annually in Germany; about 4100 (45%) are acknowledged as occupational diseases and about 2500 (25%) receive compensation
  • The share of reported cases later acknowledged ranged from 80% for mesothelioma to 20% for lung cancer
  • The author stated there is evidence that asbestos-related lung cancer and asbestosis are significantly underreported, attributing this mainly to overreliance on lung fibre counts
  • The author reported that the Mesothelioma Register defined a certain number of asbestos fibres and asbestos bodies in lung tissue as a precondition for asbestosis and asbestos-related lung cancer, and that accepted lung cancer cases then plateaued at about 800 per year
  • Current expenses for all acknowledged asbestos-related diseases in Germany are more than 500 million euros annually
• The authors' conclusion: The author concluded that, although the causal relation between asbestos exposure and these diseases was well known, corporate interests were able to hinder regulatory and preventive measures, a timely ban, and often fair compensation
• Limitations the authors state:
  • Estimates of exposed workers are hampered by a lack of reliable data on occupational and environmental exposure, especially for women
  • Historical asbestos exposure data are not known in detail for most workplaces
  • The number of previously exposed workers in the registry may be significantly underestimated

Topics

Medical terms in this study, explained in our Lexicon: Discovery, Latency.

Related studies

• Justice for asbestos victims and the politics of compensation: the French experience — A. Thébaud-Mony (2003)
• Incidence of malignant mesothelioma in Germany 2009-2013 — M. Lehnert, K. Kraywinkel, et al. (2017)
• Cancer incidence in urban, rural, and densely populated districts close to core cities in Bavaria, Germany — M. Radespiel-Tröger, K. Geiss, et al. (2018)
• Asbestos-related occupational cancers compensated under the Industrial Accident Compensation Insurance in Korea — Y.S. Ahn, S.K. Kang (2009)
• Compensation for environmental asbestos-related diseases in South Africa: a neglected issue — N. Ndlovu, J.T. Naude, et al. (2013)
• Non-malignant occupational respiratory diseases in Germany in comparison with those of other countries — X. Baur, U. Latza (2005)

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