Barriers and Facilitators to the Elimination of Asbestos Related Diseases-Stakeholders' Perspectives

Our plain-English summary of Barriers and Facilitators to the Elimination of Asbestos Related Diseases-Stakeholders' Perspectives, by J. Vincenten, F. George, M. Martuzzi, et al (International Journal of Environmental Research and Public Health, 2017).

The study

• Authors: J. Vincenten, F. George, M. Martuzzi, P. Schröder-Bäck, E. Paunovic
• Journal: International Journal of Environmental Research and Public Health
• Published: 2017;14(10)
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Despite sound scientific knowledge and evidence that any exposure to asbestos fibers in all of its forms, are carcinogenic to humans, its presence, use and trade is still substantial, including in the World Health Organization (WHO) European Region. Banning the production and use of all forms of asbestos, as recommended by the International Labour Organization (ILO) and WHO, has been proven as the most efficient evidence-based strategy to eliminate Asbestos Related Diseases (ARDs). To effectively move elimination of ARDs forward, attaining a greater understanding of key stakeholders perspectives was identified as an important action. The WHO Regional Office for Europe, the European Centre for Environment and Health, undertook semi-structured interviews, and follow-up discussions with diverse representatives dealing professionally with asbestos. The interview questionnaire was developed based on the current ARDs WHO Report, the Evidence Implementation Model for Public Health and categories of the theory of diffusion. Data were attained on three main questions within the interview questionnaire: (1) Identifying barriers to implementation of WHO evidence-based asbestos recommendations; (2) Describing roles of key stakeholders; and, (3) Proposing possible solutions. The results demonstrated use of sound and convincing scientific evidence along with economic evidence and facilitators can be used to achieve evidence-based policy development, and comprehensive diverse actions.

In plain English

This was a qualitative study of stakeholders' views on the barriers to eliminating asbestos-related diseases in the WHO European Region. It did not measure exposure or disease. The WHO Regional Office for Europe interviewed 21 stakeholders from 18 organisations. Preliminary findings were then discussed at a WHO meeting attended by 24 country representatives from 12 WHO European countries and 20 temporary advisors from 16 institutions. Participants described several barriers: lack of political will, the health costs of asbestos-related diseases falling mainly on society rather than industry, illegal asbestos removal that does not meet safety requirements, data and registries that are not readily available in many countries, and health research sometimes financed by the asbestos industry. Proposed solutions included a European-level agency or task force, standardised data registration for asbestos-related diseases, and joint advocacy for a total ban on all forms of asbestos. The authors concluded that the costs of continued asbestos production and use far outweigh the short-term, often only local, economic benefits. They named as a limitation that not all participants were fluent in both English and Russian.

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: Qualitative, explorative study using semi-structured interviews and follow-up workshop discussions, analysed by content analysis
• Who was studied: 21 interviewed stakeholders from 18 organisations (country representatives, experts, intergovernmental and nongovernmental organisations, European Commission representatives), plus 24 country representatives from 12 WHO European countries and 20 temporary advisors from 16 institutions at a WHO meeting in Bonn, Germany, in May 2016
• Exposure: No exposure was measured. The study concerned national policies for eliminating asbestos-related diseases, including bans on all forms of asbestos
• Main results:
  • Participants identified lack of political will, commitment, vision, goals and targets as a leadership barrier
  • Participants reported that the health costs of asbestos-related diseases are borne mainly by society rather than industry
  • Participants reported illegal, lower-cost asbestos removal that does not meet safety requirements
  • Participants reported that data and registries on exposures, risk groups, mortality, morbidity and costs are not readily available in many countries
  • A few Member States without ban legislation disagreed with the ban recommendation, claiming no evidence of negative health impacts in their countries
  • Participants reported that health research is sometimes financed by the asbestos industry
  • Participants considered a whole-of-government and whole-of-society approach necessary
  • Stakeholders proposed a European-level agency, task force, observatory or knowledge centre to support countries
  • Proposed solutions included standardised data registration systems for asbestos-related diseases in all countries
  • Proposed solutions included joint advocacy for a total ban on all forms of asbestos across the WHO European Region
• The authors' conclusion: The authors concluded that the costs of continued asbestos production and use far outweigh the short-term, often only local, economic benefits, and that scientific and economic evidence used together can make convincing arguments for policy
• Limitations the authors state:
  • Some interview statements may not be precise because not all participants were fluent in both English and Russian

Topics

Medical terms in this study, explained in our Lexicon: Carcinogenic.

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