Human Exposure to Asbestos in Central Asian Countries and Health Effects: A Narrative Review

Our plain-English summary of Human Exposure to Asbestos in Central Asian Countries and Health Effects: A Narrative Review, by Z. Kurzhunbaeva, K. Dzhusupov, A. Spinazzè, et al (La Medicina del Lavoro, 2024).

The study

• Authors: Z. Kurzhunbaeva, K. Dzhusupov, A. Spinazzè, S.D. Visonà, C. Sulaimanova, O. Kasymov, E. Belluso, C. Colosio
• Journal: La Medicina del Lavoro
• Published: 2024;115(6):e2024042
• Type of article: Systematic review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The discovery of the detrimental effects of asbestos on human health came long after its widespread use, with the first scientific evidence of asbestos-related diseases emerging in the late 19th and early 20th centuries. Despite efforts to ban its use, asbestos continues to be mined and used in Central Asia (as well as in Russia, China, and other countries). To gain a deeper understanding of the situation in Central Asia, we have conducted a systematic review of scientific literature on the use of asbestos, exposure assessment, and health consequences of asbestos exposure in this geographic area. This review encompasses studies about exposure assessments, epidemiological data, and biochemical or clinical surveys conducted in Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan, and Kyrgyzstan. A total of 18 articles met the inclusion criteria, and their content is summarised in this review, which represents the first attempt to systematically examine research on asbestos and its impact on the health of workers and the general population in Central Asia countries, including literature published in Russian and English. The findings here highlighted the substantial limitations of the currently available knowledge about the impact of asbestos on health in this geographical area.

In plain English

This article reviewed published research on asbestos in Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan and Kyrgyzstan. The authors searched five databases, including the Russian-language Elibrary.ru, for English or Russian articles published from 2008 to 2022. Of 105 articles found, 18 met their criteria. Most were in Russian, and none concerned Turkmenistan or Tajikistan. The authors stated that only chrysotile is mined and used there, though amphibole contamination has not been ruled out. One reviewed study reported an average daily dust level of 6 mg/m3 at Kostanay Minerals in Kazakhstan in 2014, above the national limit. The authors noted that this study did not describe its method, while measurements at the same company in 2015 and at a Kyrgyz plant in 2019 to 2020 used a weighing method that cannot count asbestos fibers. Mesothelioma rates cited by the authors were low, for example 0.28 per 100,000 in Kazakhstan. They suggested this might reflect the type of asbestos used and possible under-reporting. The authors concluded that almost no exposure assessments in the region use modern, internationally accepted methods.

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: Review of published literature (titled a narrative review), searching international and Russian-language databases
• Who was studied: Articles in English or Russian, published 2008 to 2022, on asbestos and asbestos-related diseases in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan; 18 of 105 articles found were included
• Exposure: Chrysotile asbestos mined and used in Central Asia: mining at Kostanay Minerals in Kazakhstan, and imports and asbestos-cement manufacturing in the other countries. The authors noted that possible amphibole contamination had not been ruled out.
• Main results:
  • Of 105 articles found, 18 were included. 78% of the 18 were written in Russian.
  • 88.9% of included studies concerned Kazakhstan, 5.6% Kyrgyzstan and 5.6% Uzbekistan. None concerned Turkmenistan or Tajikistan.
  • A reviewed study (Amanbekova and co-workers, 2014) reported an average daily dust concentration of 6 mg/m3 at workplaces of Kostanay Minerals JSC in Kazakhstan in 2014, higher than Kazakhstan's maximum permissible concentration.
  • The review authors noted that this 2014 study did not describe the method used to measure dust concentration.
  • For a 2015 study at the same industry (Ibraev et al.), the review authors stated that its gravimetric (weighing) method is obsolete for asbestos because it measures the whole dust rather than counting asbestos fibers.
  • A 2019 to 2020 study of air at the Kant Pipe and Slate Enterprise in Kyrgyzstan also measured dust by the gravimetric method.
  • A reviewed Kazakh study of mesothelioma cases from 2012 to 2016 (Altynbekov et al., 2018) found a documented history of occupational asbestos exposure in only 7.5% of diagnosed cases. That study's authors concluded there was no evident relationship with chrysotile. The review authors called that assertion controversial, given the recognized carcinogenicity of all forms of asbestos.
  • Mesothelioma incidence cited for the region was 0.28 per 100,000 in Kazakhstan and 0.06 per 100,000 in Kyrgyzstan. The authors suggested this low incidence might be due to the type of asbestos used and perhaps significant under-reporting.
• The authors' conclusion: The authors concluded that the reviewed studies were incomplete and did not give a clear understanding of the situation. They found only a few studies on asbestos's health impact in the region, and almost no exposure assessments that use modern, internationally accepted methods.
• Limitations the authors state:
  • The authors stated that there are no precise data on the number of workers exposed to asbestos in the region, so reliable denominators for statistical analysis are lacking.
  • The authors stated that the mesothelioma diagnosis protocol used in the region does not include immunohistochemistry.
  • The authors stated that exposure data in the reviewed studies were produced with outdated methods that are not specific to asbestos fibers.

Topics

Medical terms in this study, explained in our Lexicon: Discovery, Systematic Review, Asbestos Exposure.

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