Prevention of Asbestos-Related Disease in Countries Currently Using Asbestos

Our plain-English summary of Prevention of Asbestos-Related Disease in Countries Currently Using Asbestos, by D. Marsili, B. Terracini, V.S. Santana, et al (International Journal of Environmental Research and Public Health, 2016).

The study

• Authors: D. Marsili, B. Terracini, V.S. Santana, J.P. Ramos-Bonilla, R. Pasetto, A. Mazzeo, D. Loomis, P. Comba, E. Algranti
• Journal: International Journal of Environmental Research and Public Health
• Published: 2016;13(5)
• Type of article: Review
• Cited by: 39 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

More than 40 years of evaluation have consistently confirmed the carcinogenicity of asbestos in all of its forms. This notwithstanding, according to recent figures, the annual world production of asbestos is approximatively 2,000,000 tons. Currently, about 90% of world asbestos comes from four countries: Russia, China, Brazil and Kazakhstan; and the wide use of asbestos worldwide represents a global threat. The purpose of this paper is to present a review of the asbestos health impact and to discuss the role of epidemiological investigations in countries where asbestos is still used. In these contexts, new, "local" studies can stimulate awareness of the size of the problem by public opinion and other stakeholders and provide important information on the circumstances of exposure, as well as local asbestos-related health impacts. This paper suggests an agenda for an international cooperation framework dedicated to foster a public health response to asbestos, including: new epidemiological studies for assessing the health impact of asbestos in specific contexts; socio-cultural and economic analyses for contributing to identifying stakeholders and to address both the local and global implications of asbestos diffusion; public awareness on the health and socio-economic impact of asbestos use and banning.

In plain English

This article was a review, not a new study. It summarized presentations and discussion from a 2015 symposium in São Paulo, Brazil, on preventing asbestos-related disease in Latin America. The authors reviewed evaluations by the International Agency for Research on Cancer. In 2009 that agency judged all forms of asbestos, including chrysotile, to be carcinogenic, with sufficient evidence for mesothelioma and cancers of the lung, larynx and ovary. The authors reported figures from other sources: world production of about 2,000,000 tons a year, and an estimated 107,000 deaths each year worldwide from occupational exposure. They disputed industry claims that chrysotile products can be used safely, citing studies of high chrysotile exposures among auto mechanics in Iran and Colombia. For Brazil, they described earlier studies, including one reporting that mesothelioma mortality rose from 0.56 to 1.01 per 1,000,000 between 1980 and 2003. They noted that local estimates are scarce in most countries still using asbestos. The authors concluded that continued asbestos use is incompatible with sustainable development and called for international scientific cooperation, new local studies and public awareness 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: Review and discussion paper summarizing a 2015 conference symposium; no new data were collected
• Who was studied: No study population. The review focused on countries still using asbestos, especially Latin America and Brazil.
• Exposure: Asbestos in all its forms (chrysotile, crocidolite, amosite, tremolite, actinolite, anthophyllite), with particular attention to chrysotile and asbestos-cement, brake and transmission products
• Main results:
  • As reviewed by the authors, IARC (2009, Volume 100) judged the evidence of a causal relationship to be sufficient for mesothelioma and cancers of the lung, larynx and ovary, and limited for cancers of the pharynx, stomach and colorectum.
  • As reported by the authors, IARC found considerable evidence that chrysotile has lower potency than amphibole asbestos for mesothelioma. IARC drew no firm conclusion on relative potency for lung cancer.
  • According to figures the authors cited, annual world asbestos production was about 2,000,000 tons, less than half of the 1977 figure (4,793,451 tons).
  • Citing the WHO, the authors reported an estimated 107,000 deaths each year worldwide from occupational asbestos exposure.
  • Citing the Collegium Ramazzini, the authors reported estimated deaths per year of 41,000 for asbestos-related lung cancer, 43,000 to 59,000 for mesothelioma and 7000 to 24,000 for asbestosis.
  • The authors cited studies from Iran and Colombia documenting high chrysotile exposures among auto mechanics handling non-friable asbestos-containing products. They presented this as evidence against claims that such products prevent exposure.
  • In a Brazilian study cited by the authors, overall mesothelioma mortality was estimated at 0.56 per 1,000,000 in 1980, rising to 1.01 per 1,000,000 in the last study year (2003). Another cited study forecast a mortality peak around 2021 to 2026.
  • In a cited Brazilian study of 828 former asbestos-cement workers, 29.7% had pleural thickening and 8.9% had asbestosis.
• The authors' conclusion: The authors concluded that continuing asbestos use is not compatible with sustainable development. They called for international cooperation between scientific institutions of industrialized and low- and middle-income countries to prevent asbestos-related disease worldwide.
• Limitations the authors state:
  • The authors stated that local estimates of the health impact of asbestos are scarce in most countries that still use it.
  • The authors stated that whether chrysotile and amphiboles differ in mesothelioma risk remains an open question.

Related studies

• International scientific cooperation on asbestos-related disease prevention in Latin America — D. Marsili, P. Comba, et al. (2014)
• Prevention of Asbestos Exposure in Latin America within a Global Public Health Perspective — E. Algranti, J.P. Ramos-Bonilla, et al. (2019)
• An Approach to Overcome the Limitations of Surveillance of Asbestos Related Diseases in Low- and Middle-Income Countries: What We Learned from the Sibaté Study in Colombia — J.P. Ramos-Bonilla, M. Giraldo, et al. (2023)
• Finnish Institute of Occupational Health (FIOH): prevention and detection of asbestos-related diseases, 1987-2005 — M.S. Huuskonen, J. Rantanen (2006)
• Asbestos related diseases in Italy: an integrated approach to identify unexpected professional or environmental exposure risks at municipal level — A. Marinaccio, A. Scarselli, et al. (2008)
• Interstitial Lung Diseases in Developing Countries — P. Rivera-Ortega, M. Molina-Molina (2019)

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