Australia's Ongoing Legacy of Asbestos: Significant Challenges Remain Even after the Complete Banning of Asbestos Almost Fifteen Years Ago

Our plain-English summary of Australia's Ongoing Legacy of Asbestos: Significant Challenges Remain Even after the Complete Banning of Asbestos Almost Fifteen Years Ago, by M. Soeberg, D.A. Vallance, V. Keena, et al (International Journal of Environmental Research and Public Health, 2018).

The study

• Authors: M. Soeberg, D.A. Vallance, V. Keena, K. Takahashi, J. Leigh
• Journal: International Journal of Environmental Research and Public Health
• Published: 2018;15(2)
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The most effective way of reducing the global burden of asbestos-related diseases is through the implementation of asbestos bans and minimising occupational and non-occupational exposure to respirable asbestos fibres. Australia's asbestos consumption peaked in the 1970s with Australia widely thought to have had among the highest per-capita asbestos consumption level of any country. Australia's discontinuation of all forms of asbestos and asbestos-containing products and materials did not occur at a single point of time. Crocidolite consumption ceased in the late 1960s, followed by amosite consumption stopping in the mid 1980s. Despite significant government reports being published in 1990 and 1999, it was not until the end of 2003 that a complete ban on all forms of asbestos (crocidolite, amosite, and chrysotile) was introduced in Australia. The sustained efforts of trade unions and non-governmental organisations were essential in forcing the Australian government to finally implement the 2003 asbestos ban. Trade unions and non-government organisations continue to play a key role today in monitoring the government's response to Australian asbestos-related disease epidemic. There are significant challenges that remain in Australia, despite a complete asbestos ban being implemented almost fifteen years ago. The Australian epidemic of asbestos-related disease has only now reached its peak. A total of 16,679 people were newly diagnosed with malignant mesothelioma between 1982 and 2016, with 84% of cases occurring in men. There has been a stabilisation of the age-standardised malignant mesothelioma incidence rate in the last 10 years. In 2016, the incidence rate per 100,000 was 2.5 using the Australian standard population and 1.3 using the Segi world standard population. Despite Australia's complete asbestos ban being in place since 2003, public health efforts must continue to focus on preventing the devastating effects of avoidable asbestos-related diseases, including occupational and non-occupational groups who are potentially at risk from exposure to respirable asbestos fibres.

In plain English

This article is a descriptive review rather than a new study. It described how crocidolite and chrysotile were mined in Australia, how chrysotile, crocidolite and amosite were imported, the trade union campaigns that led to a complete ban in 2003 (with a few time-limited exceptions for the Australian Defence Organisation), later government programs, and national data on asbestos-related disease. The authors reported that 16,679 people were newly diagnosed with malignant mesothelioma in Australia between 1982 and 2016, and 84% (13,928) of them were men. The age-standardised incidence rate for men and women combined was 3.2 per 100,000 in 2003 and 2.5 per 100,000 in 2016, using the Australian standard population. Between July 1998 and June 2015 there were 2041 hospital episodes for asbestosis. The national registry assessed asbestos exposure for 701 people with mesothelioma between July 2010 and April 2017. Of these, 113 men and 119 women were assigned non-occupational exposure. The authors concluded that, almost fifteen years after the ban, Australia was only now seeing the peak of its asbestos-related disease epidemic, with ongoing risks of exposure.

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: Descriptive review of asbestos use, the history of the ban, and policy in Australia, with descriptive epidemiology drawn from national administrative health datasets (cancer registries, mortality and hospitalisation data, and the Australian Mesothelioma Registry)
• Who was studied: Australia. People newly diagnosed with malignant mesothelioma, 1982 to 2016. National hospitalisations, July 1998 to June 2015. 701 people with mesothelioma whose asbestos exposure data were collected by the Australian Mesothelioma Registry, 1 July 2010 to April 2017.
• Exposure: Asbestos consumed in Australia: locally mined crocidolite (mainly at Wittenoom, closed 1966) and chrysotile (mainly in New South Wales), plus raw chrysotile imported from Canada and crocidolite and amosite imported from South Africa. Also asbestos-containing products such as asbestos cement, friction products and gaskets. Chrysotile use continued until the complete ban in 2003.
• Main results:
  • Crocidolite was the main asbestos produced from mining at Wittenoom, Western Australia, and chrysotile was mined in New South Wales (Baryulgil and Woodsreef)
  • From the end of 2003, asbestos and asbestos-containing products could no longer be imported into Australia. There were a few time-limited exceptions for chrysotile in mission-critical parts used by the Australian Defence Organisation.
  • 16,679 people were newly diagnosed with malignant mesothelioma in Australia between 1982 and 2016, of whom 84% (13,928) were men
  • Around 70% of these mesothelioma cases were aged 65 years or more
  • Combined male and female age-standardised mesothelioma incidence rate (Australian standard population): 3.2 per 100,000 in 2003, declining to 2.5 per 100,000 in 2016
  • The highest male mesothelioma incidence rate was 5.9 per 100,000 in 2003 (Australian standard population)
  • Since 1997, the incidence rate for women ranged between 0.8 and 1.0 per 100,000 (Australian standard population) and between 0.5 and 0.7 per 100,000 (Segi world population)
  • Between July 1998 and June 2015 there were 2041 hospitalisations for asbestosis, compared with 833 for respiratory conditions due to inhalation of chemicals, gases, fumes and vapours, and 517 for silicosis
  • There were 1148 hospital episodes for pleural plaques between July 1998 and June 2015. 43% (487 hospitalisations) were recorded as pleural plaques with the presence of asbestos.
  • Among people with mesothelioma in the registry exposure data (2010 to April 2017), almost equal proportions of males (113, 48%) and females (119, 52%) were assigned non-occupational asbestos exposure
  • Fifty people in the registry exposure data were assigned as having no evidence of occupational or non-occupational asbestos exposure
  • Only 33 people received workers' compensation for asbestosis during 2014 to 2015, compared with 127 known asbestosis deaths in 2015
• The authors' conclusion: The authors concluded that almost fifteen years after the complete ban, Australia is only now seeing the peak of its asbestos-related disease epidemic, with ongoing risks of asbestos exposure, and that public health prevention and surveillance must continue
• Limitations the authors state:
  • Registry exposure assessment does not account for duration, frequency or intensity of asbestos exposure
  • Data on non-malignant asbestos-related diseases need to be interpreted with caution because their reporting requirements differ from those for cancers
  • Hospitalisation data count separate hospital episodes, not individual people
  • Pleural plaque hospitalisation data were missing for July 2008 to June 2013
  • Other data sources such as workers' compensation data are unlikely to capture the total burden of asbestos-related disease

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: Non-Occupational Exposure, Crocidolite, Amosite, Chrysotile, Malignant Mesothelioma, Incidence.

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• Mesothelioma continues to increase even 40 years after exposure - Evidence from long-term epidemiological observation — B. Świątkowska, N. Szeszenia-Dąbrowska (2017)
• Fifteen years in the evaluation of extrapleural pneumonectomy: Lessons to be learned — T. Treasure, F. Macbeth (2015)
• How Canada Changed from Exporting Asbestos to Banning Asbestos: The Challenges That Had to Be Overcome — K. Ruff (2017)
• 24 years of pneumoconiosis mortality surveillance in Australia — D.R. Smith, P.A. Leggat (2006)

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