The debate on banning asbestos

The principal reason for the Collegium Ramazzini's call for an international ban on all uses of asbestos is to protect the health of workers in developing nations.¹ In many of those countries, production and use of asbestos are increasing,² occupational safeguards are weak to non-existent and the prospect looms for an epidemic of asbestos-related disease that will dwarf the epidemics that occurred in North America and Western Europe.

Richard Wilson and colleagues and David Janigan miss this central point when they argue that a ban on asbestos is unnecessary because rates of mesothelioma are declining in the United States and other developed countries. It is well to recall that these declines are the result of strong regulations that were imposed on asbestos despite the continuing objections of the asbestos industry and their apologists, and despite continuing calls by those groups for yet more study, more risk assessment and more cost–benefit analysis.

The asbestos industry, like other industries that manufacture hazardous products, is deliberately transferring its operations and its markets to developing nations to escape the strict legal controls that now exist in virtually all industrially developed nations, Canada among them. It is quite hypocritical of those industries to relocate to the least-developed nations and then to claim that workers there can work safely with toxic materials such as asbestos. Anyone who has travelled in the poor nations of South America, sub-Saharan Africa and Southeast Asia will have seen workers using asbestos in the most uncontrolled of conditions, for example, cutting asbestos–concrete pipe with circular saws or trowelling asbestos insulation on to walls in the complete absence of any form of respiratory protection. The argument that workers can be protected against asbestos in nations that have no legal infrastructure in occupational health is a cruel joke.

The claim that chrysotile asbestos from Canada is “safe” is simply not true. Epidemiologic as well as toxicologic studies have shown abundantly that all forms of asbestos including Canadian chrysotile can cause the full range of asbestos-related diseases including mesothelioma, lung cancer, asbestosis and other malignancies.² An analysis from Quebec published 3 years ago showed a 7-fold excess mortality rate for pleural cancer (presumably mesothelioma) among women in the chrysotile-mining townships; no such excess was seen elsewhere in the province.³ The International Agency for Research on Cancer,⁴ the US Environmental Protection Agency⁵ and the World Health Organization⁶ have all accepted that chrysotile is a potent carcinogen.

The claim by Dildar Ahmad and William Morgan that the Collegium Ramazzini accepted funding from a consortium of trial lawyers to sponsor a conference a decade ago is old news. The Collegium receives no such funding at present.

Laurie Kazan-Allen is absolutely correct in noting that this issue has been studied to death. A call for further review might on its face seem reasonable, but in fact it is simply a summons for yet another journey down a well-trodden and diversionary pathway.

I thank David Muir, David Bates and Tee Guidotti for their thoughtful comments in support of this ban.

Those who support the continuing export of asbestos to the developing nations of the world are in the same unhappy position as those who would advocate the export of cigarettes to those nations — they are defending the indefensible.

Signature

Philip Landrigan
President Collegium Ramazzini New York, NY