Global Asbestos Disaster

Our plain-English summary of Global Asbestos Disaster, by S. Furuya, O. Chimed-Ochir, K. Takahashi, et al (International Journal of Environmental Research and Public Health, 2018).

The study

• Authors: S. Furuya, O. Chimed-Ochir, K. Takahashi, A. David, J. Takala
• Journal: International Journal of Environmental Research and Public Health
• Published: 2018;15(5)
• Type of article: Review
• Cited by: 132 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Asbestos has been used for thousands of years but only at a large industrial scale for about 100⁻150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global number of asbestosis deaths from the Global Burden of Disease estimate 2016 is 3495. Asbestos-caused cancer was identified in the late 1930's but despite today's overwhelming evidence of the strong carcinogenicity of all asbestos types, including chrysotile, it is still widely used globally. Various estimates have been made over time including those of World Health Organization and International Labour Organization: 107,000⁻112,000 deaths. Present estimates are much higher. Objective: This article summarizes the special edition of this Journal related to asbestos and key aspects of the past and present of the asbestos problem globally. The objective is to collect and provide the latest evidence of the magnitude of asbestos-related diseases and to provide the present best data for revitalizing the International Labor Organization/World Health Organization Joint Program on Asbestos-related Diseases. Methods: Documentation on asbestos-related diseases, their recognition, reporting, compensation and prevention efforts were examined, in particular from the regulatory and prevention point of view. Estimated global numbers of incidence and mortality of asbestos-related diseases were examined. Results: Asbestos causes an estimated 255,000 deaths (243,223⁻260,029) annually according to latest knowledge, of which work-related exposures are responsible for 233,000 deaths (222,322⁻242,802). In the European Union, United States of America and in other high income economies (World Health Organization regional classification) the direct costs for sickness, early retirement and death, including production losses, have been estimated to be very high; in the Western European countries and European Union, and equivalent of 0.70% of the Gross Domestic Product or 114 × 10⁸ United States Dollars. Intangible costs could be much higher. When applying the Value of Statistical Life of 4 million EUR per cancer death used by the European Commission, we arrived at 410 × 10⁸ United States Dollars loss related to occupational cancer and 340 × 10⁸ related to asbestos exposure at work, while the human suffering and loss of life is impossible to quantify. The numbers and costs are increasing practically in every country and region in the world. Asbestos has been banned in 55 countries but is used widely today; some 2,030,000 tons consumed annually according to the latest available consumption data. Every 20 tons of asbestos produced and consumed kills a person somewhere in the world. Buying 1 kg of asbestos powder, e.g., in Asia, costs 0.38 United States Dollars, and 20 tons would cost in such retail market 7600 United States Dollars. Conclusions: Present efforts to eliminate this man-made problem, in fact an epidemiological disaster, and preventing exposures leading to it are insufficient in most countries in the world. Applying programs and policies, such as those for the elimination of all kind of asbestos use-that is banning of new asbestos use and tight control and management of existing structures containing asbestos-need revision and resources. The International Labor Organization/World Health Organization Joint Program for the Elimination of Asbestos-Related Diseases needs to be revitalized. Exposure limits do not protect properly against cancer but for asbestos removal and equivalent exposure elimination work, we propose a limit value of 1000 fibres/m³.

In plain English

This article served as an introduction to a special journal issue on asbestos. The authors did not collect new data. They compiled and compared existing estimates of deaths from asbestos-related diseases (mesothelioma, lung cancer, ovarian and larynx cancers, and asbestosis), using sources such as the Global Burden of Disease (GBD) 2016 study and the WHO Mortality Database. Global mesothelioma deaths were put at 30,208 by GBD 2016 and 38,388 by an earlier paper by Odgerel and colleagues. Using mesothelioma deaths as a stand-in for asbestos exposure, the authors estimated about 255,000 asbestos-caused deaths a year worldwide (243,223 to 260,029). Of these, about 233,000 (222,322 to 242,802) were from exposure at work. As a rule of thumb, they estimated one death for every 20 tons of asbestos used. They estimated productivity losses from asbestos at work at about 0.70% of GDP in the European Union and 0.36% in the USA. The authors noted that most countries lack statistics, so they used proxy estimates. The authors concluded that efforts to eliminate asbestos have been insufficient in most countries. They proposed a limit of 1000 fibres per cubic metre for asbestos removal work.

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: Overview article compiling and comparing existing global estimates of asbestos-related deaths and costs from published and statistical sources (secondary data); written as an introduction to a special journal issue, not a new epidemiological study
• Who was studied: Global estimates, with breakdowns for China, the 28 European Union countries (EU28), the USA and WHO high-income countries, drawn from ILO statistics, the WHO Mortality Database, IHME/GBD 2016 and national health statistics
• Exposure: Asbestos exposure in general (occupational and non-occupational), with outcomes of mesothelioma, lung cancer, larynx and ovary cancers, and asbestosis; mesothelioma deaths were used as a proxy for asbestos exposure
• Main results:
  • Global mesothelioma deaths were estimated at 30,208 by GBD 2016 and 38,388 by Odgerel et al. 2017; the work-related figures were 27,612 and 35,087 respectively
  • Asbestos was estimated to cause about 255,000 deaths a year worldwide (243,223 to 260,029), of which work-related exposures accounted for about 233,000 (222,322 to 242,802)
  • Globally, GBD 2016-based estimates of work-related asbestos-related lung cancer deaths were 181,450 (alongside 27,612 mesothelioma, 6022 ovarian cancer and 3743 larynx cancer deaths at work)
  • Based on 1980 peak global consumption and the estimated deaths, the authors calculated about 18.4 tons of asbestos consumption per death 37 years later, and as a rule of thumb one death per 20 tons
  • Estimated productivity losses from asbestos at work were about 0.70% of GDP (114,900 million USD) in the EU and about 0.36% of GDP (86,100 million USD) in the USA
  • WHO high-income countries together had an estimated loss of 0.48% of GDP from asbestos
  • The authors reported no solid evidence yet that total mesothelioma numbers were starting to go significantly down in any country
  • Asbestos had been banned in 55 countries, with about 2,030,000 tons consumed annually according to the latest available data
• The authors' conclusion: The authors concluded that efforts to eliminate asbestos and the exposures causing what they called an epidemiological disaster have been insufficient in most countries. They also concluded that the ILO/WHO Joint Programme needs revitalizing, and they proposed a limit value of 1000 fibres per cubic metre for asbestos removal work.
• Limitations the authors state:
  • Under-diagnosis or non-diagnosis is a source of error, particularly for lung cancer cases
  • Comparing costs against an ideal case with no asbestos exposure may cause error, since such a location practically does not exist
  • Statistics were unavailable for most countries, so proxy estimates from comparable countries and regions were used
  • The cost estimates were based on the lower mesothelioma estimates; using the higher estimate would give higher figures

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Mesothelioma.

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

Related studies

• Global mesothelioma deaths reported to the World Health Organization between 1994 and 2008 — V. Delgermaa, K. Takahashi, et al. (2011)
• The case for a global ban on asbestos — J. LaDou, B. Castleman, et al. (2010)
• Malignant mesothelioma: global incidence and relationship with asbestos — C. Bianchi, T. Bianchi (2007)
• The global spread of asbestos — A.L. Frank, T.K. Joshi (2014)
• The global health dimensions of asbestos and asbestos-related diseases — C. Ramazzini (2016)
• A worn-out welcome: renewed call for a global ban on asbestos — R.C. Haynes (2010)

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