Only a total ban of asbestos will end asbestos related deaths

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Globally, asbestos-induced diseases cause 100 000 deaths annually; in Finland the figure is 100. New use of asbestos is banned in the majority of developed countries, including Finland. However, it is still in general use in many developing countries.  In the countries in which asbestos is used, morbidity is increasing. The International Conference on Monitoring and Surveillance of Asbestos-Related Diseases recommends that asbestos should be banned throughout the world.

”There is no safe use of asbestos”, reminds Panu Oksa, Chief Physician from the Finnish Institute of Occupational Health (FIOH). 

The only way in which exposure may occur in Finland today is if asbestos removal work is not carried out properly when old buildings are renovated. Asbestos removal work is subject to licence, and can only be performed by people who have undergone special training. If removal work is carried out correctly, the risk of exposure is minor. 

”Isolated cases of asbestos-induced diseases show that unfortunately the insidiousness of asbestos is still not completely understood even in Finland. In order to avoid exposure, protection and work instructions must be adhered to exactly,” Oksa stresses. 

In Finland, 600 people are diagnosed with asbestos-induced diseases every year. Of these, 100–150 develop cancer. The most common asbestos-induced diseases are lung cancer, mesothelioma, and asbestosis. The global prevalence of mesothelioma is growing at a rate of 5% per year.

Economics before health

Despite its hazards, approximately 2.5 million metric tons of asbestos is used globally per year. It is used in developing countries in particular, where not enough is known about its dangers and where people do not necessarily know how to protect themselves correctly.

”Asbestos-related deaths are preventable: by banning the use of asbestos, as WHO recommends,” says Professor Ken Takahashi from the University of Occupational and Environmental Health, Japan. 

”It is painful to see how developing countries are making the same mistakes that we have made in the past. It is partly a question of ignorance; and partly the case that developing countries have not experienced the hazards of asbestos, because of the latency time of 20–50 years between exposure and illness”, he says.

Asbestos exporters now direct their marketing towards developing countries, as they have lost their previous market areas such as Europe due to the ban on new use of asbestos. 

”The dangers of asbestos are well known in North America, and its use is closely regulated. However, industry’s interests weigh heavy: for example in 2012 in Quebec, local authorities decided to restart two of Canada’s last asbestos mines to be closed down, by granting a loan that would allow them to operate for 20 years. Luckily the decision was withdrawn,” explains Anthony Miller, Professor Emeritus from the University of Toronto.

International research community working to diminish hazards of asbestos 

One way in which to fight for human lives is the Helsinki Criteria, which is an internationally used document of expert recommendations for the assessment of asbestos exposure and the diagnostics of asbestos-induced diseases. It has been updated through the extensive collaboration of 30 experts. Its focus areas are:
1. CT Screening for asbestos-related lung cancer
2. Diagnostics and follow-up of asbestos-related cancer
3. New asbestos-related disease entities
4. Pathology and biomarkers

The document and its recommendations will receive their final touches during the International Conference on Monitoring and Surveillance of Asbestos-Related Diseases on 11.–13.2.2014 in Hanasaari in Espoo, Finland. Its focus areas and recommendations will be published as a book, as well as electronically on the FIOH website. A summary will be offered to Scandinavian Journal of Work, Environment & Health to be published in the spring of 2014. 

Further information

Panu Oksa, Chief Physician, FIOH, tel. +358 30 474 8654, +358 40 544 9415, panu.oksa[at]ttl.fi 
Professor Ken Takahashi, University of Occupational & Environmental Health, Japan, ktaka[at]med.uoeh-u.ac.jp
Professor Emeritus Anthony Miller, University of Toronto, Canada, ab.miller[at]sympatico.ca

The Finnish Institute of Occupational Health researches, develops and specializes in well-being at work. It promotes occupational health and safety and the well-being of workers. It is an independent institution under public law, working under the administrative sector of the Ministry of Social Affairs and Health. It has six regional offices, and its headquarters are in Helsinki. It employs about 750 people.