The Swedish experience with asbestos: history of use, diseases, legislation, and compensation

Our plain-English summary of The Swedish experience with asbestos: history of use, diseases, legislation, and compensation, by G. Hillerdal (International Journal of Occupational and Environmental Health, 2004).

The study

• Author: G. Hillerdal
• Journal: International Journal of Occupational and Environmental Health
• Published: 2004;10(2):154-8
• Type of article: Review
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

After World War II, large quantities of asbestos were imported to Sweden and used in construction and ship building. In 1976, the use of asbestos was for practical purposes prohibited. Today, the only exposures are environmental, from asbestos in place and when buildings are demolished or rebuilt, and there are very strict rules for such work. Consequently, it is assumed that the asbestos-related diseases will gradually disappear from society, but due to the long latency time, about 100 mesotheliomas still occur every year in Sweden, and so far there is no certain sign of a decrease in incidence. Compensation is from the state via general insurance and consists basically of compensation for lost income and medical costs.

In plain English

This article was a review by the author of the history of asbestos in Sweden, covering prehistoric use, modern imports, disease, regulation and compensation. It did not report a new study. The author described pottery containing anthophyllite asbestos made in eastern Finland from about 4000 BC, and later in Sweden and Norway. The article stated that asbestos use was for practical purposes prohibited in 1976. According to the author, 3-4% of Swedish men over 40 carry pleural plaques, asbestosis is now rare, and about 100 mesotheliomas still occur yearly, with no decrease seen yet. The author estimated about 250 lung cancers a year at least partly due to asbestos, noting such cases are rarely reported as asbestos-related. The article summarized earlier Swedish work, including a thesis by Maria Albin on an asbestos-cement plant that found significantly increased mortality from all causes, non-malignant respiratory disease and respiratory cancers. A plaque compensation scheme paying 10,000 Swedish Crowns ended in June 1985 as too expensive. The author concluded that asbestos-related diseases will decline over decades, but asbestos in place requires continued vigilance.

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: narrative review / historical overview of asbestos use, disease, legislation and compensation in Sweden (no new data collected)
• Who was studied: Sweden as a whole, from prehistoric times to about 2004, with attention to occupational groups: construction workers (described as the largest exposed group; about 180,000 monitored by the construction workers' health service), asbestos-cement plant workers, shipyard workers and miners
• Exposure: Imported asbestos used mainly in construction and ship building after World War II. In prehistory, local anthophyllite was used in pottery and chrysotile in threads. At the asbestos-cement plant studied by Albin, mainly chrysotile was used, with small amounts of amosite in the 1950s and crocidolite up to 1966.
• Main results:
  • Asbestos use in Sweden was for practical purposes prohibited in 1976
  • According to the author, 3-4% of the Swedish male population over age 40 carry pleural plaques
  • Asbestosis was described as rare in Sweden today
  • About 100 mesotheliomas occur in Sweden each year, and the expected decrease in incidence had not yet been seen
  • The author estimated, assuming two to three lung cancers per mesothelioma as in other countries, about 250 lung cancers a year in Sweden at least partly due to asbestos
  • In Albin's earlier thesis on a southern Swedish asbestos-cement plant (operating 1907 to 1977), mortality from all causes, non-malignant respiratory disease and all respiratory cancers including mesothelioma was significantly increased among workers. This finding comes from that earlier study, not from this article.
  • A scheme compensating anyone with pleural plaques with 10,000 Swedish Crowns ended in June 1985 because it had proven too expensive
  • Government-funded health surveys from 1986 to 1988 of thousands of people who believed they had been exposed found mainly pleural plaques, and the author judged their scientific value low
• The authors' conclusion: The authors concluded that asbestos-related diseases such as mesothelioma will diminish as the occupationally exposed population declines, which will take a few more decades. Cases from background environmental exposure are increasing, though at much lower risk, and asbestos in place calls for continued vigilance.
• Limitations the authors state:
  • The author noted that lung cancers are seldom reported as due to asbestos, so asbestos's role in lung cancer is underestimated

Topics

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

Medical terms in this study, explained in our Lexicon: Latency, Mesothelioma.

Related studies

• Justice for asbestos victims and the politics of compensation: the French experience — A. Thébaud-Mony (2003)
• Classification and management of asbestos-containing waste: European legislation and the Italian experience — F. Paglietti, S. Malinconico, et al. (2016)
• Necessity and approach to integrated nanomaterial legislation and governance — J. Wang, J.D. Gerlach, et al. (2013)
• Workers' compensation for nonmalignant asbestos-related lung disease — C. Nevitt, W. Daniell, et al. (1994)
• A guide to compensation for asbestos-related diseases — M.G. Britton, D.T. Hughes, et al. (1981)
• Compensation for asbestos-related diseases--the U.K. model — M. Britton (1989)

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