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Asbestos-linked cancer warning for emerging economies

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Cancer deaths caused by asbestos exposure are starting to fall in high-income countries thanks to widescale prohibition of its use. But many low- and middle-income countries that continue to use the mineral in building and transport industries face a surge of deaths in the coming decades, warns a study published this month in the Bulletin of the World Health Organization.

The study, for the first time, counts total deaths reported to WHO from malignant mesothelioma, a rare but fatal cancer that is almost always traced to exposure to asbestos. It usually takes longer than 30 years to develop but, once diagnosed, average survival time is less than one year.

Between 1994 and 2008, most (88%) of the 92 000 deaths from malignant mesothelioma occurred in older men in high-income settings, including Australia, Japan, the United States of America (USA) and many European countries. Most of these countries have since banned the use of asbestos. For example, the United States Environmental Protection Agency (EPA) banned all new uses of asbestos in 1989. The European Union introduced a ban in 1999 that came into effect in 2005.

«We found that mesothelioma deaths are starting to decrease in the USA but are still increasing in Europe and Japan, reflecting the time lag following historical use of asbestos,» says researcher Ken Takahashi, from the University of Occupational and Environmental Health, Kitakyushu City, Japan. «The real concern is that many developing countries continue to use this deadly material but don’t report data to WHO on the deaths it causes.»

WHO relies on countries to report death statistics. It currently receives data on mesothelioma from mostly high-income countries, representing just one-third of the world’s population. No data is available from China, India, Kazakhstan, the Russian Federation and Thailand, the world’s top five consumers of the 2.5 million metric tonnes of asbestos still produced each year.

The World Health Organization has called on countries to stop using all types of asbestos and improve reporting. «We know the risks,» says Dr Ivan Ivanov, scientist at WHO. «All forms of asbestos are carcinogenic and may cause mesothelioma and cancer of the lung, larynx and ovary, as well as other diseases. Even if these countries stop using asbestos today, they are going to see an increase in asbestos-related deaths for many decades to come.»

Malignant mesothelioma affects the protective lining that covers many of the body’s internal organs, most commonly the outer lining of the lungs and the chest wall, but also the lining of the abdominal cavity, and sacs around the heart and testes.

Read the paper here: http://www.who.int/bulletin/volumes/89/10/11-086678.pdf

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The Bulletin of the World Health Organization is one of the world’s leading public health journals. It is the flagship periodical of WHO, with a special focus on developing countries. Articles are peer-reviewed and are independent of WHO guidelines. Abstracts are now available in the six official languages of the United Nations.

This month’s issue has a special focus on the social determinants of health to coincide with a conference on this theme in Rio de Janeiro, Brazil, from 19-21 October. Items include:

  • Glasgow tackles stark inequities in health
  • Health is key to economic growth in Brazil, says Minister of Health
  • All in the family: a study of tuberculosis in children in Greenland
  • A decade towards better health in Chile
  • Estimating global numbers for Japanese encephalitis
  • Call for more research on hospital infections in Africa

The October issue table of contents can be found at: http://www.who.int/bulletin/volumes/89/10/en/index.html

The complete contents of the Bulletin, since 1948, is available free to all readers worldwide through PubMed Central, available at: http://www.pubmedcentral.nih.gov/tocrender.fcgi?journal=522&action=archive

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