The World Health Organization identifies Asbestos as one in ten chemicals of major public health concern. Established as a human carcinogen, this material is found in earth soils and has been widely used by human industry. Its exposure occurs through the inhalation of fibers in the ambient by air, in factories handling asbestos, its surrounding skirts or in the indoor air in housing and buildings containing asbestos materials. Historically identified by ancient cultures and published at the beginning of the 20th century, its harmful effects received the ARD acronym (Asbestos-Related Diseases) to identifying this worldwide health issue.

The properties of asbestos in terms of resistance and insulating against all type of agents and its relatively low cost of exploitation, explain the extensive industrial applications reinforcing all sort of materials. With mechanical strength, asbestos fibers decompose at high temperatures, do not dissolve in water or evaporate into the air in which It can remain transported over long distances. It cannot be degraded to other composites, and remain virtually unchanged forever, according to its etymological Greek-rooted name.

The ARD profiles

The human body also cannot dissolve asbestos and its deposit in the respiratory system induces the occurrence of ARD. After a latency period of several decades, It develops chronic pathology as well as malignant diseases such as pleural and peritoneal mesothelioma which show high risk of death. Globally, mesothelioma death numbers and asbestos-related cancer deaths are both increasing and are expected to increase in future. Asbestos related cancer is estimated to cause more than 200,000 deaths in the next decade only in the UK.

High-scale traumatic events can amplify a long-term trend in a previous known exposure profile. This is the case of the sudden World Trade Center attacks in New York on September 11, 2001, in which many tens of thousands of asbestos kilograms were released after the buildings collapsed and dusted into the atmosphere or the war crisis in Ukraine spraying asbestos debris all along Eastern Europe.

Legislation

From the tallest peak consumption in the world of asbestos acquired in 1980, World use is slightly lower progressively due to a restrictive commerce legislation. However, the annual market demand for asbestos exceeds 2,000,000 MT and under these conditions several authors have predicted a revival of ARD in the coming decades despite the worldwide ARD pandemic. Less than 70 territories, which includes the European Union, have banned the use of asbestos which is marked by the Rotterdam Convention but not agreed countries still import-export asbestos because economic and trade domestic interests outweigh global environmental and health concerns.

The direct costs for ARD, early retirement, death and production losses, are very high. Moreover, the legal impact of ARD liability claims in terms of the overall cost of covering the victims of these conditions is so high that it dangerously unbalances occupational disease compensation schemes. In the USA, nearly 50,000 people a year file a complaint for ARD and the French and German governments each spend more than a billion euros a year on its compensations.

Implications for a preventable and avoidable health problem

Advanced countries in industrial legislation implement health plans to promote and protect health workers while an unidentified worldwide work force remains exposed to this material as well as an unknown and much larger world population. It is impossible not only to find a populated location without any asbestos installed fiber globally, but also to find statistics from exposure and ARD outcomes from many countries in the world, especially in low-income countries. Although proxy ARD estimates based on comparable countries and regions are used, extensive and full data is not available.

Asbestos poses a sustained and pandemic crisis in a world forced by outbreaks of diseases, droughts, famines and all sort of wars fueled by global warming, climate change, inequity and geopolitical rivalry. Remove this material and avoid its exposure are the key answer for this preventable and avoidable health problem.

The better future for all

All this asbestos outcome can only be explained by inadequate preventive and protective measures against this material helped by a permissive trade market legislation during decades. Under these conditions, ARD can be considered as a neglected worldwide disease because It is common in areas where people do not have access to clean environment or safe way to dispose of human waste.

The World needs to eradicate asbestos from all applications. It needs to redirect the global industrial and environmental policy to stop the production and commercial use of asbestos as well as the temptation to use this material as a substitute in front of the actual lake of other materials. Undoubtedly, the absence of an international government platform dedicated to eradication of asbestos use and to reinforce the actual efforts to study and control its effects, removes the possibility of eradicate ARD.

Author: Rafael Abós-Herràndiz

Dr. Rafael Abós-Herràndiz is epidemiologist, MD, PhD in Public Health, and Works in the Institut Català de la Salut, Generalitat de Catalunya (Catalonia, Spain).