Mesothelioma is a rare but highly aggressive cancer that primarily affects the lining of the lungs, but can also appear in the abdomen, heart, and other organs. 

The primary cause of this lethal cancer is exposure to asbestos, a naturally occurring fibrous mineral once widely used in construction, shipbuilding, textiles and the automotive industry for its heat resistance and durability. Asbestos fibers can become airborne and, when inhaled or ingested, lodge in internal tissues, eventually leading to the development of mesothelioma.

Mesothelioma: Rare but aggressive

Despite its uncommon nature, mesothelioma’s global burden remains significant, especially given its severe health implications, limited treatment options, and notably low survival rate. The latency period between exposure and the onset of symptoms makes it difficult to trace the origins of the disease to asbestos and tends to lead to misdiagnosis and late identification.

This article explores the primary and emerging risk factors associated with mesothelioma, shedding light on occupational, military, secondhand, and new potential risks, including talc exposure. While traditionally the cancer was assumed to be limited to those exposed to asbestos on the job, research has revealed that a large number of individuals never employed in high-risk industries have developed the disease, pointing to its prevalence both in the workplace and at home.

Occupational Asbestos Exposure

For decades, occupational exposure has been identified as the leading risk factor for mesothelioma. Asbestos, a fibrous mineral that has been used by humans since ancient times, was widely sought after during the days of the Industrial Revolution in the U.S., quickly becoming a staple additive in various products such as insulation, floor and ceiling tiles, cement, brake pads and even common household goods and children’s toys.

The popularity of asbestos meant it was common to find in a number of industrial workplaces as well as in numerous residences. Among the industries where employees were considered to be at highest risk for exposure, asbestos was handled daily. The following illustrates just a few ways in which asbestos was integrated into everyday materials before stricter regulations on its use were put into place:

The Construction Industry

Insulation: Asbestos was commonly used to insulate walls, ceilings, pipes, and boilers due to its fire-resistant properties.

Fireproofing: Fibers were applied as a fireproof coating on structural steel beams and ceilings in commercial and residential buildings.

Flooring and Roofing Materials: Incorporated into tiles, adhesives, cement sheets, and shingles, asbestos enhanced durability and resistance to fire.

Joint Compounds and Plasters: Often added to drywall joint compounds, plasters, and stucco, the fibers aided in strengthening these mixtures and made them fire resistant.

Automotive Parts

Brake Pads and Linings: Asbestos was widely used in brake pads, linings, and clutch facings because it could withstand high friction and heat.

Gaskets and Seals: Incorporated into gaskets, seals, and heat shields for its resilience against heat, asbestos ensured effective insulation in engines and exhaust systems.

Transmission Components: Fibers were found in parts requiring high-temperature resistance, especially in heavy-duty vehicles.

Shipbuilding

Insulation for Pipes and Boilers: Asbestos was used extensively for insulating pipes, boilers, and engines aboard ships, as these areas required materials resistant to both heat and corrosion.

Fireproofing and Electrical Insulation: The mineral was applied in engine rooms, bulkheads, and other fire-prone areas to reduce fire risks on board.

Flooring and Wall Panels: Asbestos was used in the construction of floors, walls, and ceilings to increase durability and protect against fire hazards in confined shipboard environments.

Textiles

Protective Clothing: Woven into protective clothing, gloves, aprons, and blankets, these fibers protected workers exposed to high heat, like firefighters, welders, and foundry workers.

Asbestos Cloth and Insulation Fabrics: Asbestos was used in heat-resistant fabrics, including fireproof blankets, ironing board covers, and curtains in industrial settings.

Textile-Based Machinery Components: Integrated into machinery belts, gaskets, and protective covers, asbestos prevented these from overheating and reduced fire risks in industrial machinery.

Studies have repeatedly shown that the incidence of mesothelioma is considerably higher among workers in industries, such as those above, involving prolonged exposure. And since asbestos fibers embed in the lining of the lungs, chest cavity, or abdominal cavity, people with intense or long-term exposure have a significantly higher risk of developing mesothelioma compared to the general population. As a result, countries where these industries were most prevalent, including the United States, the United Kingdom, and Australia, have historically shown higher mesothelioma rates.

Military Asbestos Use

Military veterans, especially those who served from World War II through the 1970s, also represent a significant high-risk group for asbestos exposure and related health conditions. During this period, the U.S. military relied extensively on asbestos, making it a staple material in ships, submarines, and various military facilities as well as other artillery. This heavy usage was particularly prominent in the U.S. Navy, where nearly every part of a ship or submarine—including boilers, engines, pipes, and more—was lined with asbestos to protect against fire and maintain heat insulation.

Veterans working in shipyards or in close quarters on vessels faced daily exposure to airborne fibers as they performed maintenance, repair, or construction tasks in confined areas with poor ventilation. Similarly, military housing and commonplaces contained asbestos in their walls, floors, and ceilings, exposing countless military personnel and their families.

As a result, former service members are disproportionately affected by asbestos-related diseases, including mesothelioma, asbestosis, and lung cancer. Veterans account for approximately one-third of mesothelioma cases in the U.S., a striking statistic underscoring the extensive asbestos exposure they faced. Because mesothelioma has a long latency period, often veterans don’t begin experiencing symptoms until well into retirement. This delayed onset has led to late diagnoses and complicated treatment options, impacting health and quality of life.

Fortunately, many veterans are now eligible for specialized medical care and compensation through the Department of Veterans Affairs (VA). Yet, the legacy of asbestos exposure in military service remains a substantial public health concern for former service members and their families.

Secondhand Exposure: A Significant Risk for Families

While primary asbestos exposure occurs directly at worksites or in environments with asbestos products, secondhand exposure is increasingly recognized as a major risk factor. Family members of those directly exposed to asbestos are also frequently placed at risk due to fibers carried home on clothes, skin, and hair, as well as in shared vehicles. Studies have estimated that secondhand exposure accounts for a significant portion of mesothelioma cases, with some suggesting that nearly 20–25% of new cases may be attributed to secondhand exposure.

In addition to being exposed through fibers brought home, spouses and children of those in the service and individuals working in high-risk industries also commonly lived in close proximity to asbestos inside the home, amplifying the problem.  They came into regular contact with asbestos in kitchenware, dental products, cosmetics, building sets, toy ovens, arts and crafts supplies, and numerous other everyday items. They also lived in residences constructed with asbestos materials.

Today, mesothelioma is understood to be far more than an occupational hazard—it’s one that can impact literally anyone who lived during asbestos’ heyday, before regulations were put into place limiting its use. Equally as concerning, asbestos is still currently allowed in some products and imports still account for a large portion of present-day asbestos making its way into the U.S. Because of this, the asbestos issue isn’t one that’ll die down anytime soon, and mesothelioma cases are likely to continue rising.

Contaminated Talc: Yet Another Mesothelioma Source

While asbestos remains the primary risk factor for mesothelioma as a standalone contributor, recent studies have indicated a potential link between mesothelioma and talc, a mineral often found naturally near asbestos deposits. Talc is widely used in cosmetics, personal care products, and even some industrial applications. The concern arises because talc may be contaminated with asbestos due to their close proximity in the earth. Talc, or talcum, deposits tend to overlap with asbestos, and if not thoroughly purified, products made with the mineral can be contaminated from the time of mining onward.

Numerous products have been identified as contaminated in recent years, including face and body powders, makeup, dry shampoo, linen and shoe fresheners, chalk, and even candy and chewing gum. This is due largely to the Food and Drug Administration (FDA) implementing stricter testing following litigation over cancer cases resulting from exposure to contaminated talc. Some companies have faced legal issues over their talc-based products, while others have opted to voluntarily remove entire lines from the market. Studies continue to surface as well, reporting mesothelioma cases in talc consumers with no known occupational or secondhand asbestos exposure.

Current Legal and Scientific Scrutiny
 Recent groundbreaking litigation over Johnson & Johnson (J&J)’s talc powder has caused a spike in contamination awareness over the past few years. Lawsuits against the company surfaced after consumers who had fallen ill began to suspect its baby powder could be to blame. One of the most well-known legal battles related to J&J’s talcum products occurred in California, where a woman successfully sued the company for $417 million after developing ovarian cancer. She had used baby powder for most of her life, unaware of the risks until diagnosed with the disease.

As a result, regulatory agencies are under increasing pressure to establish clear guidelines on asbestos testing in talc products. A definitive scientific consensus is still needed, as research continues to investigate the extent and the mechanisms behind the talc-mesothelioma connection. However, as the body of evidence continues to grow, scientists and health experts are expressing concern that the talc issue is far from one that’s been sensationalized by the media, but rather, a serious issue that will lead to more mesothelioma and other cancer cases in the near future.

Data from sources like the Global Cancer Observatory and the Global Burden of Disease project has repeatedly shown that mesothelioma incidence is especially prevalent in countries with higher human development indices, GDP per capita, and asbestos exposure. While the global incidence is decreasing, in general—possibly due to asbestos restrictions—some countries, like Bulgaria and Korea, have witnessed rising rates in recent years.

Mesothelioma’s long latency period, aggressive nature, and poor survival rates make it a critical area for public health research. The cancer represents about 0.17% of global cancer cases worldwide, and the survival rate remains low at only 12% over five years. This stands in stark contrast to the general cancer survival rate, which is over 60% for other types.

Unfortunately, due to the rarity of the disease, mesothelioma has not seen the same level of drug and treatment development or research focus as other cancers have. This lack of innovation is, in part, responsible for the stagnant survival rates, as most treatment approaches remain based on older methods with limited effectiveness. Despite some advancements in immunotherapy and personalized treatments, the majority of mesothelioma patients still face grim prognoses.

Geographical and Demographic Disparities

The incidence of mesothelioma varies widely by region, country, age group, and gender. Developed nations with historical asbestos use in industries show the highest rates. Northern Europe, Australia, and New Zealand report the highest age-standardized rates, particularly among older males who were likely exposed occupationally. In contrast, regions with minimal asbestos exposure, such as Africa and the Caribbean, report significantly lower incidence rates.

Mesothelioma predominantly affects men, who make up over two-thirds of cases globally, primarily due to higher exposure in male-dominated industries, as well as older populations, especially those over 50. This corresponds to the latency period between initial exposure to asbestos and symptom onset, which is often decades-long.

Economic indicators such as the Human Development Index (HDI) and GDP per capita correlate strongly with mesothelioma rates. Countries with higher HDI and GDP, where industrial development historically led to higher asbestos use, tend to have more cases. Conversely, in regions with less industrialization, rates remain lower, but as globalization and industrialization increase, future mesothelioma cases could develop in new areas.

The Ongoing Battle Against Mesothelioma

Mesothelioma remains an uncommon cancer, but its deadly nature and high latency make it a serious global health issue. The primary risk factor remains asbestos exposure, which, while controlled in many countries, still impacts workers and their families decades after initial contact. Secondhand exposure, often affecting family members of exposed workers, highlights the disease’s far-reaching impact, as does new data on the alarming number of cases in women overall. Emerging concerns about talc contamination introduce potential new avenues for exposure, further affecting women and other individuals who’ve used talc products extensively.

While mesothelioma accounted for only 0.17% of global cancer cases in 2020, its status as an orphan disease has limited treatment advancements. The five-year survival rate of 12% reflects the limited therapeutic progress over the past five decades. The significant latency between exposure and diagnosis adds to the disease’s difficulty, often preventing early intervention.

Asbestos regulations have reduced occupational exposure in many regions, but cases continue to appear due to latent exposure. New research exploring the potential risks associated with talc-based products, along with improved diagnostic techniques, may pave the way for future prevention and treatment strategies. Increased global attention, targeted research, and comprehensive asbestos regulations will be key to effectively reducing incidences of mesothelioma moving forward. Public health initiatives and awareness campaigns are also necessary to prevent future cases and improve early diagnosis and treatment options for those impacted, potentially shifting mesothelioma in the long-term from a lethal disease to one that can be well-managed and more treatable.