Asbestos and environmental diseases

Abstract

Asbestos causes several asbestos related diseases (ARDs). Not only occupational asbestos exposure but also environmental asbestos exposure can cause ARDs. In Korea compensation for workers with ARDs has been provided by workers' compensation. Because the asbestos damage relief act (ADRA) was enacted in 2011, ARDs by environmental exposure can now be compensated. Korea is the sixth country in the world to compensate environmental asbestos victims. In the ADRA, the list of compensable diseases eligible for relief consists of lung cancer, malignant mesothelioma, and asbestosis. Because the back ground and criteria of each ARD for relief is different, physicians need to be familiar with all of them in order to deal with ARD patients. In this paper, the properties of asbestos, history of ARDs, and contents of the ADRA are discussed. Although the relationships between occupational asbestos exposure and ARDs have been well established, those for environmental exposure have not. More specifically, the relationship between lung cancer and environmental asbestos exposure is still not clear because of strong confounders. The first wave of asbestos problems arose from occupational exposure directly involving asbestos production, the second wave arose from usage of asbestos products, and the third wave would be related to asbestos ubiquitous in the environment. In Korea the second wave is just beginning to swell. Physicians must to prepare for these waves to crest in the near future.