The asbestos disease epidemic: here today, here tomorrow

Abstract

In what may be the best ever use of a Wellcome grant, Geoffrey Tweedale, in his fascinating history of the multinational asbestos company Turner & Newall,1 reminds us that asbestos was once known as the ‘magic mineral’. Indeed, in many ways, it is the ideal construction material: tough, durable, light in weight, fire-resistant and very cheap. Unfortunately, asbestos is also, as every respiratory physician knows, highly toxic when inhaled. Total bans on its use are in place in 52 countries including those of the European Union, Australia, Japan and South Africa2; and its use is tightly restricted in the USA, New Zealand and Canada—the last, ironically, among the world's largest exporters of the material. Readers from these countries may be surprised to learn that elsewhere the production, sale and use of asbestos continue to flourish and even increase. In 1994, one of us (NP) edited a book3 on occupational cancer in developing countries for the International Agency for Research on Cancer and reported that global asbestos production and use had not declined; rather, the problem was simply being moved from Western countries to emergent economies. Unhappily, the situation has not improved in the intervening 17 years. In India, for example, the use of asbestos has doubled in the last decade to about 300 000 tonnes a year by an industry that now employs an estimated 100 000 workers.4 Other major users include China, Brazil, Russia, Ukraine, Kazakhstan and Indonesia. In these parts of the world, where occupational exposures may be difficult to control and enforce, the great majority of …