Working with asbestos and the possible health risks

Our plain-English summary of Working with asbestos and the possible health risks, by D. Sen (Occupational Medicine, 2015).

The study

• Author: D. Sen
• Journal: Occupational Medicine
• Published: 2015;65(1):6-14
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: The generic term asbestos refers to a group of crystalline mineral silicates that occur naturally in various forms. Because of their properties of strength, heat and electrical resistance and their ability to withstand corrosion by acids and sea water, asbestos was used extensively both in the UK and worldwide.

Aims: To provide a historical perspective of this ubiquitous occupational hazard, consider the key changes in UK legislation aimed at improving the management of this occupational health risk and describe the evidence from the scientific literature concerning asbestos and disease.

Methods: Original articles, reviews (including reference textbooks) and scientific literature in PubMed and other principal medical science databases, 1960-2014, were searched. Publications by regulatory agencies and by governmental organizations were also considered and included where relevant.

Results: Asbestos remains the biggest cause of cancer deaths worldwide. For malignant mesothelioma deaths alone, it is estimated that in the UK, between 2015 and 2020, the number of cases will peak at 2500 cases annually. It is not clear whether there is a safe level of asbestos fibres in air. Evidence for the efficacy of health surveillance is lacking.

Conclusions: Although the use of asbestos was banned in the UK in 1985 (amosite and crocidolite) and 1999 (chrysotile), it remains a significant occupational risk factor for work-related morbidity and mortality, causing both benign and malignant diseases, often with long latency. Further research is needed regarding exposure levels and health surveillance.

© Crown copyright 2015.

In plain English

This was a narrative review by a single author at the University of Manchester, published in 2015, of research on asbestos and health, mainly from a UK perspective. The author searched PubMed and other medical databases for original articles, reviews and textbooks from 1960 to 2014, and also used publications from regulators and government bodies. The review described the fiber types (chrysotile, amosite, crocidolite and others), the history of UK asbestos law, and the diseases linked to asbestos, including pleural plaques, diffuse pleural thickening, asbestosis, lung cancer and mesothelioma. Drawing on other sources, it reported that yearly mesothelioma deaths in Great Britain rose from 153 in 1968 to 2535 in 2012. A revised estimate put the peak at around 2500 deaths in 2020. It also reported that asbestos currently caused about 4500 UK deaths a year. The review stated that it is not clear whether any level of airborne asbestos fibres is safe, and that evidence that health surveillance works is lacking. The author concluded that asbestos remains a significant occupational risk and that more research is needed on exposure levels and health surveillance.

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 literature and regulatory and government publications (labelled an in-depth review); not an original study
• Who was studied: No study population of its own. The review covered the scientific literature on asbestos and disease, with a focus on the UK, its legislation, and asbestos-exposed workers.
• Exposure: Asbestos in general, mainly occupational exposure. The fiber types named are chrysotile (white), crocidolite (blue) and amosite (brown), plus tremolite, actinolite and anthophyllite. Amosite and crocidolite were banned in the UK in 1985 and chrysotile in 1999.
• Main results:
  • Citing an HSE publication, the review reported that annual mesothelioma deaths in Great Britain rose from 153 in 1968 to 2535 in 2012.
  • An earlier estimate (Hodgson et al.) of a peak in mesothelioma deaths between 2011 and 2015 was reported as revised to a peak in 2020 of around 2500 deaths.
  • The review stated that asbestos is currently responsible for about 4500 deaths in the UK every year.
  • The review reported results of the UK Asbestos Survey (1971 to 2005): 15 496 deaths among the 98 912 workers included in that analysis.
  • The review cited a 2009 British case-control study (Peto et al.). That study calculated a lifetime mesothelioma risk of about 1 in 17 for men born in the 1940s who worked as carpenters for more than 10 years before age 30.
  • The review stated that it is not clear whether any level of airborne asbestos fibres is safe, and that evidence for the efficacy of health surveillance is lacking.
  • The review reported that randomized trials from the 1960s to 1980s that screened for lung cancer with chest X-rays found no difference in mortality between screened and unscreened groups.
• The authors' conclusion: The author concluded that, despite the UK bans, asbestos remains a significant occupational risk factor for work-related illness and death, causing benign and malignant diseases often with long latency. The author also concluded that further research is needed on exposure levels and health surveillance.

Topics

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

Medical terms in this study, explained in our Lexicon: Crystalline, Silicate, Malignant Mesothelioma, Amosite, Crocidolite, Chrysotile, Latency.

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