Abstract
Background. Asbestos has been used for thousands of years but in a large industrial scale for about 100–150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global number of asbestosis deaths from the Global Burden of Disease estimate 2016 is 3495. Asbestos caused cancer was identified in the late 1930’s but despite of today’s overwhelming evidence of the strong carcinogenicity of all asbestos types including chrysotile it is still widely used globally. Various estimates have been made over time including those of WHO and ILO 107,000–112,000 deaths. Present estimates are radically higher. This special edition of the Journal summarizes key aspects of the past and present of the asbestos problem globally. Methods. Documentation on milestones of asbestos related diseases, ARDs, their recognition, reporting, compensation and prevention efforts were examined, in particular from the regulatory and prevention point of view. Estimated global numbers of incidence and mortality of ARDs were looked at. Results. Asbestos causes an estimated 257,000 deaths (243,223–270,635) annually according to latest knowledge. Work-related exposures are responsible for 235,000 deaths (222,322–247,363) of those. In the European Union, USA and in other High income economies (WHO regional classification) the direct costs for sickness, early retirement and death, including production losses, have been estimated to be very high, in the Western European countries and EU equivalent of 0.70% of the GDP or 114.9*109 USD. Intangible costs could be much higher. When applying the Value of Statistical Life (VSL) of 4 million EUR per cancer death used by the European Commission we arrived 5at 410*109 USD while the human suffering and loss of life is impossible to quantify. The numbers and costs are increasing practically in every country and region in the world. Asbestos has been banned in 55 countries but used widely today, some 2,030,000 tons consumed annually according to latest available consumption data. Every 20 tons of asbestos produced and consumed kills a person somewhere in the world. Buying 1 kg asbestos powder format e.g. in Asia costs some 0.38 USD and 20 tons would cost in such retail market 7600 USD. Conclusions. Present efforts to eliminate this man-made problem, in fact an epidemiological disaster, and preventing exposures leading to it are insufficient in most countries in the world. Applying programmes and policies, such as those on the elimination of all kind of asbestos use—that is banning of new asbestos use and tight control and management of existing structures containing asbestos—need revision and resources. The ILO/WHO Joint Programme for the Elimination of Asbestos-related Diseases need to be revitalized. Exposure limits do not protect properly against cancer but for asbestos removal and equivalent exposure elimination work we propose a limit value of 1000 fibres/m3.