Malignant mesothelioma, recognised as a new disease in the 1950s, is almost exclusively
caused by asbestos exposure and usually diagnosed decades after first exposure. The
disease was initially restricted to asbestos workers, but diagnoses after non-occupational
exposure continue to surge. Despite the acknowledgment by WHO and the International
Agency for Research on Cancer (IARC), more than 40 years ago, that all forms of asbestos
are carcinogenic, global asbestos use increased exponentially,
The global spread of asbestos.
leading to an almost ubiquitous presence of these minerals in homes, commercial buildings,
ships, vehicles, and thousands of products. When asbestos bans were introduced in
Europe and Australia, their use surged in countries where traders suggested that chrysotile
asbestos were safe.
- Furuya S
- Chimed-Ochir O
- Takahashi K
- David A
- Takala J
Global asbestos disaster.
Despite mounting evidence of the carcinogenicity, many countries have yet to recognise
the urgency of banning asbestos and do not support WHO’s aim of reducing or ending
the incidence of asbestos-related cancers (figure 1). Representatives of ten countries—Russia, Kazakhstan, Syria, Zimbabwe, Kyrgyzstan,
Venezuela, Pakistan, Cuba, India, and Iran—continue to block a 15-year-old UN motion
to label chrysotile asbestos as especially hazardous. As the global malignant mesothelioma
epidemic shows no sign of abating,
- Zhai Z
- Ruan J
- Zheng Y
- et al.
Assessment of global trends in the diagnosis of mesothelioma from 1990 to 2017.
- Alpert N
- van Gerwen M
- Taioli E
Epidemiology of mesothelioma in the 21st century in Europe and the United States,
40 years after restricted/banned asbestos use.
oncologists should reinforce the idea that the continued harm caused by asbestos
cannot be reduced without ceasing all asbestos mining and trade, increasing public
awareness, enforcing regulations, and improving diagnosis and treatment. In this Essay,
we re-examine how asbestos has silently caused a global epidemic and summarise mesothelioma
carcinogenesis, prevention, and novel treatments. The role of the pro-asbestos lobby
will be exemplified. Further reading can be found in the appendix.
Figure 1Asbestos use worldwide
Show full caption
Provisional asbestos use data and national asbestos bans (2019). Figure adapted and
reproduced with permission of International Asbestos Ban Secretariat.