Authors: Becklake, M.R.¹; Bagatin, E.²; Neder, J.A.³

Source: The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 4, April 2007 , pp. 356-369(14)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

Asbestos is a descriptive term for a group of naturally occurring minerals known to mankind since ancient times. The main types of asbestos (chrysotile, and the amphiboles crocidolite and amosite) differ in chemical structure, biopersistence in human tissue and toxicity. Commercial exploitation, with little thought for environmental controls, increased over the twentieth century, particularly after World War II, to accommodate globalisation and the demands of the world's burgeoning cities. As its ill-health effects, both non-malignant (fibrosis of the lungs or asbestosis; pleural effusion, plaques and thickening) and malignant (mesothelioma, lung and other cancers), became evident, public pressure rose to control its use. The last decades of the last century saw decreases in exposure and rates of asbestosis in industrialised and in some less-industrialised countries, where pleural plaques and malignant mesothelioma are currently the most frequent manifestations of asbestos exposure. Longer follow-up of asbestos-exposed cohorts in mining and manufacturing has also strengthened the evidence of a fibre gradient in toxicity, with chrysotile exhibiting lower toxicity than the amphiboles, and amosite lower toxicity than crocidolite. The last decades of the twentieth century saw stabilisation and/or declines in mesothelioma rates in several industrialised countries. In less-industrialised countries, data on disease are sparse, exposure generally high and rates may peak in the future. Management of asbestos-related disease in the workplace requires collaboration between workers and unions (responsible for monitoring workplace dust levels, to which they must have access) and companies (responsible for engineering controls), reinforced by appropriate government regulations and by community support.

Keywords: asbestos; diseases of the lung and pleura; trends in disease; industrialised and less-industrialised countries

Document Type: Invited paper

Affiliations: 1: Respiratory Epidemiology and Clinical Research Unit, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada 2: Area of Occupational Health, State University of Campinas (UNICAMP), Campinas, Brazil; and Jundiai School of Medicine, Jundiai, Brazil 3: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Federal University of Sao Paulo (UNIFESP), São Paulo, SP, Brazil

Publication date: 2007-04-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

  Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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