Will the marked increase in asbestos use in Asia since the 1970s trigger a surge of ARD in the immediate decades ahead? What policy and public health measures can counterbalance a rise in asbestos-related diseases and mortality?
The World Health Organization (WHO) recognizes that asbestos is one of the most significant occupational carcinogens (cancer-causing agents). In 2006, it declared the need to eliminate the rise of ARD and asbestos use.
WHO estimates that, globally, some 107,000 deaths annually are caused by ARD; these include asbestos-related lung cancer, mesothelioma and asbestosis.
Despite gradually growing international awareness, at the regional level the analysis of asbestos use and ARD in Asia has been limited. The first regional-level discussions of the issue only took place in 2002, and a comparative understanding of the situation is patchy at best.
Ongoing data limitations make the task of filling the knowledge void on asbestos is Asia particularly challenging. ARD are known to be generally rare and difficult to diagnose. Furthermore, questions on data validity emerge in countries that have limited experience in diagnosing ARD. Similarly, under-reporting and inconsistent reporting of both asbestos use and ARD create additional barriers to obtaining a comprehensive picture: Of 47 Asian countries studied, 30 had data available for asbestos use only (not ARD), 15 countries had data available for both asbestos use and ARD mortality, and 2 countries only had data available for ARD mortality.
Nevertheless, using the indicators of per-capita asbestos use (measured in kilograms per capita per year) and age-adjusted mortality rates (AAMR, measured in cases per million population per year), recent groundbreaking research from the UNU International Institute for Global Health (UNU-IIGH) attempted to map the dimensions of Asia’s asbestos situation. Drawing on a comparative assessment of public data, this research compared the impact of asbestos in 47 selected Asian countries over the observation period of 1920 to 2007.
Overall, asbestos use in Asia from 1920 to 2007 totaled 55.5 metric tons, or 29 per cent of the world’s asbestos use. Asia’s proportion of global asbestos use increased significantly overall, from a 14 per cent share in 1920-1970 to 33 per cent in 1971-2000, then rising to 64 per cent in 2000 – 2007. In terms of ARD, 12.5 per cent of ARD deaths (or 12,882 deaths, or which 12,012 were mesothelioma) were recorded cumulatively in Asia.
During the observation period (1920 to 2007), most individual Asian countries (60 per cent) increased their asbestos use: Between 1920 and 1970 (period A), 5 countries recorded high values of asbestos use (greater than 1.0 kg/capita/year), while 13 countries recorded high values from 1970 to 2000 (period B). This spike in asbestos use was followed by a dip, back to 5 countries that recorded high values between 2000 and 2007 (period C).
Kazakhstan was the only county studied that maintained high values during all three periods. Cyprus and Lebanon both had high values for periods A and B and Kyrgyzstan, UAE, Thailand and Uzbekistan had high values for the two later periods (B and C). China, Thailand, India and Indonesia all increased their use of asbestos over the three periods.
Asia’s overall share of worldwide asbestos use is summarized in the chart below: