The World Health Organization’s Perspective on Asbestos

Breaking Down the Dangers of Global Asbestos

Asbestos, a once sought-after mineral due to its versatility and durability, is now synonymous with severe health risks and preventable deaths. After nearly a decade of extensive asbestos use in industry, the International Agency for Research on Cancer (IARC) labeled the substance a class 1 carcinogen and manufacturers have since replaced it with more benign alternatives.

Asbestos: A Virtually Indestructible Toxin

However, these steps came after decades of continued exposure, particularly with construction, automotive parts, textiles, shipbuilding, and in the military, and numerous workers and their families have suffered from asbestos-related health conditions as a result. Because of its former prevalence, latent asbestos use also continues to plague society. It can still be found beneath floorboards and inside walls, as well as in roofing shingles, cement and asphalt, and in adhesives. Asbestos can even be found in vintage and imported household goods, such as in children’s toys like play ovens, modeling kits, chalk, crayons, and other arts and craft supplies, as well as in kitchenware, dental products, cosmetics, fire blankets, and many other items.

The World Health Organization (WHO) has long been at the forefront of global efforts to mitigate the risks posed by asbestos, providing critical guidance to governments, industries, and public health organizations designed to limit exposure and eliminate ongoing industrial uses. This article provides a summary of the WHO’s key findings and recommendations, contextualizing the ongoing challenges and outlining actionable steps to make concerns over asbestos-related diseases a thing of the past.

What Is Asbestos?

Asbestos refers to a group of naturally occurring mineral fibers known for their heat resistance, tensile strength, and insulating properties. Historically, asbestos was widely used in construction, manufacturing, and other industries. However, its fibers, when inhaled or ingested, can cause fatal illnesses, and it has been gradually phased out since its partial ban in the mid-1980s.

Types of Asbestos

There are six primary forms of asbestos, the most common of which is chrysotile, or white asbestos. Despite its wide commercial use, chrysotile, along with other types, is classified by the WHO as carcinogenic to humans.

Historical Use

Asbestos was extensively used in building materials, automotive components, and industrial products. Its widespread application has left a legacy of exposure risks, even in countries that have since banned its use.

Health Impacts of Asbestos Exposure

As mentioned, asbestos exposure has been linked to many cancers and other significant health conditions. These diseases can take many decades to manifest after initial contact, often making it difficult to determine whether asbestos is to blame.

Some of the health complications caused by exposure include the following:

·        Asbestosis: 

Also called asbestos fibrosis, asbestosis is a chronic lung disease caused by inhaling asbestos fibers, leading to scarring of lung tissue and difficulty breathing.

·        Mesothelioma: 

A rare and aggressive cancer that affects the thin lining of the lungs (pleura), abdomen (peritoneum), or heart (pericardium).

·        Lung Cancer: 

Cancer of the lungs linked to prolonged asbestos exposure, especially in smokers.

·        Pleural Plaques: 

Thickened, calcified areas on the pleura (the lining of the lungs), which indicate past exposure to asbestos.

·        Pleural Effusion: 

A buildup of fluid between the lungs and the chest wall, which can cause chest pain and breathing difficulties.

·        Pleural Thickening: 

Widespread scarring and thickening of the pleura, which can restrict lung function.

·        Peritoneal Mesothelioma: 

Cancer affecting the lining of the abdominal cavity, often due to swallowing or inhaling asbestos fibers.

·        Pericardial Mesothelioma: 

A rare cancer of the lining around the heart.

·        Laryngeal Cancer: 

Cancer of the voice box, with asbestos exposure recognized as a contributing risk factor.

·        Ovarian Cancer: 

Evidence links asbestos exposure to an increased risk of ovarian cancer.

·        Chronic Obstructive Pulmonary Disease (COPD) and asthma: 

While not directly caused by asbestos, these conditions may worsen significantly in individuals with a history of asbestos exposure.

Those who’ve worked in high-risk industries and their family members are most likely to develop asbestos-related conditions. The WHO estimates that occupational exposure to asbestos causes over 200,000 deaths annually, accounting for more than 70% of all work-related cancer fatalities. However, because exposure is not limited to the workplace, countless others have been impacted as well.

Risk Amplification

Certain lifestyle factors can substantially increase one’s risk of developing an asbestos-related condition, including:

Smoking:

·        Increases the risk of lung cancer in individuals exposed to asbestos with research suggesting that smokers who’ve been exposed are up to 90 times more likely to develop this cancer.

·        Weakens the lungs, making them more susceptible to asbestos-related damage.

Poor Nutrition:

·        A diet lacking antioxidants, vitamins, and essential nutrients can lower immunity and impair the body’s ability to repair damage and combat inflammation caused by asbestos fibers.

Occupational Exposure Without Protection:

·        Failing to use personal protective equipment (PPE), such as respirators or protective clothing, increases the risk of prolonged and severe exposure when handling asbestos.

Lack of Medical Observation:

·        Not undergoing regular medical checkups can delay the detection and treatment of asbestos-related illnesses, increasing their severity. Anyone who has been employed in a high-risk industry or those who’ve had a loved one who worked with asbestos should undergo regular health screenings.

Chronic Exposure to Other Environmental Pollutants:

·        Living or working in areas with high air pollution, industrial emissions, or exposure to additional carcinogens increases overall respiratory stress. Individuals who live near abandoned asbestos mines and Superfund sites are also placed at risk of coming into contact with asbestos in the soil, air, and their water supplies (with this risk amplified in areas where underground lead pipes are used to transport water).

Excessive Alcohol Consumption:

·        Heavy drinking can weaken their immune system and impair the liver’s ability to process toxins, exacerbating health risks. Alcohol itself is associated with many different forms of cancer, making the combination of excessive consumption and exposure particularly dangerous.

Sedentary Lifestyle:

·        Physical inactivity can impair lung function and overall health, making it harder to cope with respiratory damage caused by asbestos.

Stress and Lack of Sleep:

·        Chronic stress and insufficient sleep can weaken the immune system and reduce the body’s ability to repair and defend against asbestos-related damage.

Other Known Risk Factors

Other situations can increase an individual’s risk of asbestos exposure, including:

• Natural disasters: 

Natural disasters, such as hurricanes, earthquakes, tornadoes, and fires, can destroy or damage buildings containing asbestos. This destruction can release asbestos fibers into the air, creating a health hazard for residents, first responders, and cleanup crews.

• Improper disposal: 

Improper handling and disposal of asbestos-containing materials (ACMs) can lead to exposure. Regulations exist to safely manage asbestos waste, but non-compliance can result in significant health risks. It is vital to solicit the help of a licensed contractor to perform abatement services.

• Talc products: 

Talc, or talcum, is also a naturally occurring mineral and is mined near asbestos, making it easily contaminated with the toxin. The mineral is commonly found in cosmetics and personal care products, particularly those that are powder-based. In recent years, lawsuits have been brought against manufacturers of talc-based products claiming a connection between use and cancer (i.e., ovarian cancer). Companies have also voluntarily recalled entire product lines due to this issue. This is an emerging concern globally, with more cases continuing to mount.

Preventing and Controlling Asbestos Exposure

The best way to control exposure is to ban asbestos use altogether while finding ways to minimize risk in structures that already contain the substance. The WHO provides technical support to countries seeking to ban asbestos and eliminate asbestos-related diseases. Its recommendations include:

• Establishing national policies to eliminate asbestos use.
• Strengthening healthcare systems to diagnose and manage asbestos-related diseases.
• Collaborating with international partners to share knowledge and strategies.

Over 50 WHO member states have already enacted bans.

Other ways to minimize risk follow.

Substitution with Safer Alternatives

Many non-fiber materials, such as conventional building supplies like fiberglass, cellulose, and polyurethane foam, can effectively replace asbestos in various applications, including insulation, roofing, and fireproofing. These alternatives are widely available and offer similar durability and performance without the significant health risks associated with exposure.

However, while many substitutes come with minimal or no health risks, others may still contain carcinogenic or otherwise toxic properties, posing a risk if mishandled or exposed to high temperatures. For example, certain synthetic mineral fibers or silica-based materials have been linked to respiratory issues and require careful evaluation to ensure their safety during production, installation, and use. Testing, proper labeling, and adherence to safety standards are essential to ensuring these replacements do not introduce similar safety risks.

Workplace Protections

In regions where asbestos remains in use or is being removed, measures include:

• Training workers on safe handling practices
• Using personal protective equipment (PPE)
• Implementing engineering controls to minimize airborne fibers

Following these processes can greatly restrict inhalation of fibers while also ensuring workers don’t carry these home to their families.

Asbestos Abatement

Proper removal and disposal of asbestos are critical to preventing exposure. The WHO advocates for strict regulations around removal and treating asbestos-containing waste as hazardous.

Ongoing Challenges to Eliminating Asbestos Risks

In an ideal world, asbestos would be easily abated from existing structures and completely banned in the workplace. However, in reality, there are ongoing difficulties with eliminating exposure risk. Some of these include:

Legacy Issues: The historical use of asbestos means exposure risks persist in many countries. Maintenance and demolition of older buildings often disturb asbestos-containing materials, releasing harmful fibers. The high cost of proper abatement has also led to a preference around containing latent asbestos rather than removing it altogether.

Long Latency Period: Due to the decades-long delay between exposure and disease onset, the full impact of asbestos may continue for years, even in countries that have recently banned it.

Global Disparities: While many countries have prohibited asbestos, others continue to use it due to economic and political factors. There has yet to be a push to eliminate asbestos use globally, and even those regions that have banned asbestos are susceptible to its impact when it is present in imported goods.

Lack of Awareness: Public and professional awareness about asbestos hazards remains insufficient in many regions, particularly when it comes to the large number of ways individuals can be exposed even outside of the workplace. Health organizations like the WHO continue to advocate for public health campaigns focusing on increasing overall awareness and stressing the importance of preventive screenings.

WHO’s Response and Recommendations

WHO, in partnership with the International Labour Organization (ILO) and other stakeholders, has developed a comprehensive strategy to combat asbestos-related diseases. Key components of this plan include:

Policy and Advocacy:

• Encouraging member states to legislate bans on asbestos use
• Promoting the use of safer substitutes and technologies

Protection and Prevention:

• Establishing surveillance systems for exposed populations
• Supporting early diagnosis, treatment, and rehabilitation

Capacity Building:

• Training medical professionals, labor inspectors, and occupational health experts
• Raising public awareness about the dangers of asbestos

Waste Management:

• Ensuring asbestos-containing waste is handled as hazardous material
• Implementing safe disposal practices

Moving Towards an Asbestos Free Future

The WHO’s extensive work draws attention to an urgent need for global action to eliminate asbestos exposure and the diseases that stem from it. By banning asbestos, substituting safer materials, and protecting workers and the public, the world can ward off hundreds of thousands of preventable deaths annually. However, addressing legacy issues, gaps in regulations and emerging concerns like the presence of asbestos in talc products and the prevalence of domestic exposure cases will require cross-country collaboration and a willingness to work towards common goals.

More than anything, there is a need to continue to increase public awareness of exposure risks and shift the common perception that asbestos is a problem of the past. Despite efforts to replace its use over the years, unfortunately the legacy of asbestos is likely to live on for a long time to come.