Not much has changed concerning the morality of continuing to produce and sell asbestos since my editorial on the subject was published in CMAJ 14 years ago.1 Jack Siemiatycki's balanced and thoughtful summary2 is useful, but one may doubt that his recipe for resolution of the question will actually contribute much toward a solution. The problem is that the range of risk estimates is so wide and the exposure data are so poor that the choice between alternatives becomes essentially arbitrary. I reviewed the problem of asbestos in 1994 but was unable to suggest any way of improving the risk estimate procedure or of resolving the question.3
Since then, the Canadian government has challenged the French government's decision to join other European countries in banning the use of asbestos, and it was threatening to raise the matter with the World Trade Organization. As far as I am aware, this issue has not been debated in the House of Commons, nor is there a white paper outlining the Canadian government's defence of the use and export of asbestos. In my editorial, I argued that the Canadian medical profession had a responsibility in relation to this question, but I am still not sure how this should be exercised.2
My own position is that the difficulty in evaluating the risk management, the undoubted danger of the material when inhaled and the existence of satisfactory substitutes should lead to a decision that the use of asbestos should be discontinued.
Signature
David V. Bates
Professor Emeritus of Medicine University of British Columbia Vancouver, BC
References
- 1.Bates DV. Asbestos: promotion or prohibition? [editorial]. CMAJ 1987;136:107-9. [PMC free article] [PubMed]
- 2.Siemiatycki J. Should Canadian health care professionals support the call for a worldwide ban on asbestos? [editorial]. CMAJ 2001;164(4):495-7. [PMC free article] [PubMed]
- 3.Bates DV. Environmental health risks and public policy: decision-making in free societies. Seattle: University of Washington Press; 1994.