The worldwide pandemic of asbestos-related diseases

Our plain-English summary of The worldwide pandemic of asbestos-related diseases, by L. Stayner, L.S. Welch, R. Lemen (Annual Review of Public Health, 2013).

The study

• Authors: L. Stayner, L.S. Welch, R. Lemen
• Journal: Annual Review of Public Health
• Published: 2013;34:205-16
• Type of article: Review
• Cited by: 186 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos-related diseases are still a major public health problem. The World Health Organization (WHO) has estimated that 107,000 people worldwide die each year from mesothelioma, lung cancer, and asbestosis. We review what is known about asbestos use, production, and exposure and asbestos-related diseases in the world today, and we offer predictions for the future. Although worldwide consumption of asbestos has decreased, consumption is increasing in many developing countries. The limited data available suggest that exposures may also be high in developing countries. Mesothelioma is still increasing in most European countries and in Japan but has peaked in the United States and Sweden. Although the epidemic of asbestos-related disease has plateaued or is expected to plateau in most of the developed world, little is known about the epidemic in developing countries. It is obvious that increased asbestos use by these countries will result in an increase in asbestos-related diseases in the future.

In plain English

This article is a review, not a new study. The authors summarized published data on asbestos use, exposure and disease worldwide and offered predictions. They cited a World Health Organization estimate that about 107,000 people die each year from asbestos-related diseases, which the article linked to occupational exposures. Worldwide consumption had stabilized at roughly half its 1980s peak, but use was rising in some countries. India's consumption reached approximately 420,000 metric tons in 2010. Published studies from India and China suggested high exposures, such as 200 to 400 fibers per cubic centimeter in Indian asbestos mills in 1994. A cited analysis of 92,253 mesothelioma deaths reported by 83 countries from 1994 to 2008 found a worldwide age-adjusted mortality rate of 4.9 per million. It also found a significant yearly increase in Japan (3.5%) and a decrease in the United States (0.8%). Sweden's mesothelioma rates peaked in 1995, while a cited study predicted Japan's would peak in 2030 to 2039. The authors concluded that rising use and likely poor exposure control in developing countries will raise disease rates there. They also noted that data from those countries are scarce.

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 of published data on asbestos use, exposure and asbestos-related diseases worldwide, with predictions for the future
• Who was studied: No study population of its own; the review drew on worldwide published statistics and studies of asbestos consumption, production, exposure, and the incidence and mortality of asbestos-related diseases
• Exposure: All commercial asbestos types (chrysotile, crocidolite, amosite, tremolite, actinolite, anthophyllite); chrysotile accounts for more than 99% of current worldwide production; occupational, building, community and naturally occurring exposures
• Main results:
  • The WHO estimated that about 107,000 people worldwide die each year from asbestos-related diseases. In the article's wording the estimate refers to asbestos-related diseases and those resulting from occupational exposures (cited estimate)
  • Worldwide consumption stabilized from the late 1990s at roughly 2 million metric tons per year, about half the 1980s peak
  • India's asbestos consumption reached approximately 420,000 metric tons in 2010, making India the second largest consumer after China
  • A cited 1994 study in India reported 200 to 400 fibers per cubic centimeter in asbestos mills. By comparison, the permissible limit is 0.1 fb/cc in the United States and many western countries and 1.0 fb/cc in India
  • A cited analysis (Delgermaa et al.) included 92,253 mesothelioma deaths reported by 83 countries between 1994 and 2008. The worldwide age-adjusted mesothelioma mortality rate was 4.9 per million
  • In the same cited analysis there was a significant annual increase in mesothelioma mortality in Japan (3.5%) and a decrease in the United States (0.8%)
  • Mesothelioma rates peaked in Sweden in 1995
  • A cited study predicted that mesothelioma rates in Japan would peak between 2030 and 2039
  • In the United States, asbestosis mortality peaked in 2000 at 1,493 deaths and was 1,470 deaths in 2004
  • A cited ecologic analysis (Lin et al.) found historical asbestos use to be a strong predictor of mesothelioma mortality (R-squared 0.74, p less than 0.0001)
• The authors' conclusion: The authors concluded that rising asbestos consumption and likely poor exposure control in developing countries will lead to higher rates of asbestos-related diseases there in the future
• Limitations the authors state:
  • Data on exposures and disease in developing countries are very limited
  • Mesothelioma may be underreported because pathologic diagnosis can be difficult
  • The predictive models are ecologic and may be biased
  • The models do not account for changes in the type of asbestos consumed

Topics

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

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

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