Category: International News
Asian Asbestos Tsunami Forecast
The number of people in Asia who develop mesothelioma and other asbestos-related diseases will increase sharply in the next two decades new research projects.
According to the study in Respirology, the journal of the Asian Pacific Society of Respirology, the increase in asbestos use in Asian countries since 1970 is likely to trigger a surge in asbestos-related disease in the next 20 years. Mesothelioma, a cancer of the lining of the lung, is a signature disease of asbestos. But workers exposed to asbestos typically take 20 to 50 years to experience symptoms of mesothelioma or lung cancer after inhaling microscopic asbestos fibers.
Dr. Ken Takahashi, the lead author and acting director of the World Health Organization Collaborative Center for Occupational Health, said that Asian governments should brace for an “asbestos tsunami” in the years ahead.
Asia’s share of worldwide asbestos use has steadily increased from 14 percent in the decades before 1970 to 64 percent from 2001 to 2007, the study said. Yet, the 12,882 deaths attributed to asbestos-related disease in Asia account for only 13 percent of the overall deaths linked to asbestos during the period.
In Asia, asbestos, a mineral fiber, is still widely used in building materials, roofing, cement and power plants. Many Asian countries that import asbestos have weak or non-existent workplace safety laws, leaving workers exposed to asbestos.
In the United States and Europe, most uses of asbestos have been banned since the late 1970s and workers must wear safety equipment to prevent inhaling asbestos.
The World Health Organization identifies asbestos as a dangerous workplace carcinogen and occupational hazard. It called for a worldwide ban on asbestos. An estimated 107,000 people die from asbestos-related diseases annually including approximately 3,000 in the U.S.
Asbestos Fuels Mesothelioma Epidemic in Hong Kong
With a booming Asian economy, Hong Kong used asbestos extensively in the 1950s and 1960s, particularly in the shipyard and construction industries. Asbestos exposure is closely associated with asbestos-related respiratory diseases such as pleural mesothelioma that often appear decades after workers inhale asbestos fibers.
Since 2000, Hong Kong has experienced an epidemic of malignant mesothelioma, a cancer of the lining of the lungs or abdomen, according to a recent article in the journal Environmental Health Perspectives. The epidemic parallels the peak usage of asbestos in the early 1960s since symptoms of asbestos-related disease typically take 30 to 40 years to appear.
Researchers from Australia and China predict that the number of cases of mesothelioma in Hong Kong will peak around 2014, then slowly taper off based on data from the Hong Kong Cancer Registry.
Malignant mesothelioma was rare before the 1950s, but has increased sharply since the 1970s in many parts of the world. Exposure to asbestos in the workplace is considered the highest risk factor for developing asbestos cancer.
The researchers observed a notable increase in incidence of mesothelioma from 1976 to 2006 in Hong kong. The highest incidence was among males 70 years or older.
The increasing incidence of mesothelioma in Hong Kong is similar to trends observed in many countries including France, Germany, Great Britain, the Netherlands, Australia and Japan. The number of cases of mesothelioma in the United States, which restricts asbestos use, has increased to 2,500 to 3,000 a year. The incidence of mesothelioma in many South American countries such as Brazil is expected to keep rising for 10 to 20 more years because of later restrictions on asbestos use.
Hong Kong banned the import and sale of blue asbestos (crocidolite) and brown asbestos (amosite) in 1996. But the country has allowed the continued use of chrysotile asbestos in various industries. While the asbestos industry has claimed that chrysotile asbestos is less toxic than other forms, health organizations have said chrysotile asbestos is a human carcinogen and also causes malignant mesothelioma.
Asbestos Exposure Still Experienced by Majority of World’s Population
The use of asbestos has dropped from more than 4 million metric tons to 2.1 million metric tons in the past 25 years as one country after another has banned the cancer-causing mineral fiber. Yet, a majority of the world’s population still lives in countries including the United States that do not ban asbestos or asbestos-containing products. And demand for asbestos is surging in industrializing countries such as China and India where safeguards on worker exposure are weak or non-existent.
Today, the top users of asbestos are China, Russia, India, Kazakhstan and Brazil. These countries export asbestos-containing products to other countries including the U.S. where the products are used in the automotive and construction industries and pose an ongoing threat of asbestos exposure. Asbestos causes about half the of total deaths from workplace-related cancers such as mesothelioma, a cancer of the lining of the lung or abdomen, according to the World Health Organization.
While the U.S. stopped mining asbestos and producing asbestos in 2002, according to a recent article in Environmental Health Perspectives, a peer-reviewed scientific journal, U.S. companies imported more than 1,400 metric tons on chrysotile asbestos, primarily from Canada, in 2008. Much of it is used for roofing products. In addition, the U.S. imports large quantities of asbestos-containing products such as cement pipe, asbestos-lined brake pads and gaskets.
According to global estimates reported by the World Health Organization 125 million people are exposed to asbestos in the workplace and more than 107,000 people die each year from asbestos-related mesothelioma, lung cancer and asbestosis resulting from occupational exposures. Many experts believe current estimates of asbestos-related disease and deaths understate the actual numbers. Since mesothelioma did not receive its own classification in the International Classification of Diseases until the mid-1990s, many asbestos-related deaths were not classified as such.
Given the decades-long latency period from exposure to asbestos to development of mesothelioma, the epidemic of asbestos-related diseases is still spreading and will for decades to come, particularly in countries still heavily using asbestos.
Guidelines for Mesothelioma Treatment
The incidence of malignant mesothelioma, a respiratory cancer associated with inhaling asbestos, is expected to double in many countries in the next 20 years, according to the European Society of Medical Oncology. In the United States, approximately 2,500 to 3,000 people die of mesothelioma each year.
In an article in the July issue of the Annals of Oncology, the European Society of Medical Oncology outlines treatment guidelines for patients with mesothelioma. The clinical practice guidelines are developed by the non-profit professional organization, which promotes advances in cancer treatment and prevention, to assist doctors and patients in making decisions about appropriate health care. According to the practice guidelines:
Patients with mesothelioma often first have symptoms of shortness of breath due to excess fluid in the chest. Patients with more advanced cases may have chest pain. A chest x-ray or scan may suggest a case of mesothelioma based on thickening of the membrane lining the the lung called the pleura. Laboratory examination of chest fluid can confirm a diagnosis of mesothelioma. But the lab reports are often equivocal.
Doctors should interview the patient about their work history to try to determine if they were exposed to asbestos in their workplace, the most common cause of mesothelioma. Most cases of mesothelioma are due to occupational exposure
The gold standard for diagnosis of mesothelioma is a microscopic examination of specific antigens in a tissue biopsy obtained through a surgical procedure called a pleuroscopy. A surgical instrument is inserted into the patient’s chest through an incision to collect tissue. Research studies suggest that certain proteins and oseteopontin, a human gene product, are useful indicators to support a diagnosis of mesothelioma.
After doctors confirm a diagnosis, a CT scan of the patient’s chest is used to assess the advancement of the cancer. An accurate assessment of the mesothelioma’s stage is essential to determine the most appropriate treatment and the patient’s prognosis. Malignant pleural mesothelioma rarely spreads to distant parts of the body, but patients often have advanced localized cancer in their respiratory system when they are diagnosed.
Various surgical procedures have been used with varying degrees of success, according to the European Society of Medical Oncology. Surgery should be performed only on patients with less advanced cases of mesothelioma as part of a multi-pronged approach to treatment combined with chemotherapy and/or radiation. The use of radiation in treating mesothelioma has been limited because of the difficulty of irradiating such a large area of the body as a lung without irreparably harming the adjacent healthy lung. Still, it is used.
As far as chemotherapy, the use of combinations of cancer drugs, permetrexed and cisplatin, and to a lesser extent, raltitrexed and cisplatin, have led to improved survival results in patients as well as lung function and symptom control, compared to use of cisplatin in clinical trials. The combination of permetrexed and carboplatin is an effective alternative chemotherapy.
Researchers Observe Epidemic of Mesothelioma in Hong Kong
Researchers report an increasing incidence of mesothelioma from 1976 to 2000 in Hong Kong, particularly among older men and women ages 70 or older. Mesothelioma is a cancer of the lining of the lung or abdomen closely associated with asbestos exposure.
The increasing incidence in Hong Kong has culminated in an epidemic of mesothelioma since 2000 that corresponds to peak use of asbestos in the early 1960s, the researchers say in a recent article published in Environmental Health Perspectives. The average length of time from exposure to appearance of symptoms they observed was 42 years.
The researchers from the Australian National University in Canberra and the Chinese University of Hong Kong predict the number of cases of mesothelioma in Hong Kong will peak around 2014 and then slowly decline but not return to background levels. While the country has banned the use of blue and brown asbestos, Hong Kong industries continue to import and use chrysotile asbestos so the researchers say they expect new cases of mesothelioma in the future.
The trend in Hong Kong is similar to trends of asbestos-related disease in recent decades in Western European countries such as Britain, France, Germany and Italy as well as Australia and Norway.
Consumption of asbestos in Hong Kong started to increase in the 1950s in response to booming economic development in construction and shipyard industries. The country also began building massive public housing projects to accommodate the influx of hundreds of thousands of refugees from mainland China. The largest amounts of asbestos were used in 1960 to 1963, according to trade statistics.
Workplace exposure to asbestos is considered the leading risk factor associated with malignant mesothelioma. But second hand exposure also poses a risk.
The country has thousands of older buildings containing asbestos shingles and other asbestos-containing building materials that don’t meet modern fire safety codes and are candidates for urban renewal. The demolition of those buildings will unleash asbestos fibers into the environment and potentially increase the risk of mesothelioma in the community, the researchers said.
The researchers said the study provided support for an immediate worldwide ban on asbestos.
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