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      The Case for a Global Ban on Asbestos

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          Abstract

          Background

          All forms of asbestos are now banned in 52 countries. Safer products have replaced many materials that once were made with it. Nonetheless, many countries still use, import, and export asbestos and asbestos-containing products, and in those that have banned other forms of asbestos, the so-called “controlled use” of chrysotile asbestos is often exempted from the ban. In fact, chrysotile has accounted for > 95% of all the asbestos used globally.

          Objective

          We examined and evaluated the literature used to support the exemption of chrysotile asbestos from the ban and how its exemption reflects the political and economic influence of the asbestos mining and manufacturing industry.

          Discussion

          All forms of asbestos, including chrysotile, are proven human carcinogens. All forms cause malignant mesothelioma and lung and laryngeal cancers, and may cause ovarian, gastrointestinal, and other cancers. No exposure to asbestos is without risk. Illnesses and deaths from asbestos exposure are entirely preventable.

          Conclusions

          All countries of the world have an obligation to their citizens to join in the international endeavor to ban the mining, manufacture, and use of all forms of asbestos. An international ban is urgently needed. There is no medical or scientific basis to exempt chrysotile from the worldwide ban of asbestos.

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          Most cited references60

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          Inhaled Carbon Nanotubes Reach the Sub-Pleural Tissue in Mice

          Summary Carbon nanotubes have fibre-like shape1 and stimulate inflammation at the surface of the peritoneum when injected into the abdominal cavity of mice2, raising concerns that inhaled nanotubes3 may cause pleural fibrosis and/or mesothelioma4. Here we show that multi-walled carbon nanotubes reach the sub-pleura in mice after a single inhalation exposure of 30 mg/m3 for 6 hours. Nanotubes were embedded in the sub-pleural wall and within sub-pleural macrophages. Mononuclear cell aggregates on the pleural surface increased in number and size after 1 day and nanotube-containing macrophages were observed within these foci. Sub-pleural fibrosis increased after 2 and 6 weeks following inhalation. None of these effects were seen in mice that inhaled carbon black nanoparticles or a lower dose of nanotubes (1 mg/m3). This work advances a growing literature on pulmonary toxicology of nanotubes5 and suggests that minimizing inhalation of nanotubes during handling is prudent until further long term assessments are conducted.
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            The global burden of disease due to occupational carcinogens.

            The worldwide mortality and morbidity from lung cancer, leukemia, and malignant mesothelioma arising from occupational exposures to carcinogens are described. Cases reported in the year 2000 that resulted from relevant past and current exposures are assessed. The proportions of workers exposed to the carcinogens of interest, and their levels of exposure, were estimated using workforce data and the CAREX (CARcinogen EXposure) database. These were combined with relative risk measures (for lung cancer and leukemia) or absolute risk measures (for malignant mesothelioma) to develop estimates of deaths, disability-adjusted life years (DALYs) and attributable fraction (for lung cancer and leukemia). There were an estimated 152,000 deaths (lung cancer: 102,000; leukemia: 7,000; and malignant mesothelioma: 43,000) and nearly 1.6 million DALYS (lung cancer: 969,000; leukemia: 101,000; and malignant mesothelioma: 564,000) due to exposure to occupational carcinogens. Occupational carcinogens are an important cause of death and disability worldwide. 2005 Wiley-Liss, Inc.
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              Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution.

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                Author and article information

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                1552-9924
                July 2010
                1 July 2010
                : 118
                : 7
                : 897-901
                Affiliations
                [1 ] Division of Occupational and Environmental Medicine, University of California–San Francisco, San Francisco, California, USA
                [2 ] Environmental Consultant, Garrett Park, Maryland, USA
                [3 ] Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
                [4 ] Department of Environmental and Occupational Medicine, Robert Wood Johnson Medical School, Piscataway/New Brunswick, New Jersey, USA
                [5 ] Former HM Inspector of Factories, London, United Kingdom
                [6 ] Chemical Carcinogenesis, Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
                [7 ] Center for Occupational and Environmental Health, New Delhi, India
                [8 ] Global Health Program, Mount Sinai School of Medicine, New York, New York, USA
                [9 ] National Institute for Occupational Safety and Health (retired), Canton, Georgia, USA
                [10 ] Center for Occupational and Environmental Health Research, University of Cape Town, Cape Town, South Africa
                [11 ] European Foundation for Oncology and Environmental Sciences, Bologna, Italy
                [12 ] School of Public Health, University of Alberta, Edmonton, Alberta, Canada
                [13 ] Department of Epidemiology, University of Occupational and Environmental Health, Kitakyushu, Japan
                [14 ] School of Public Health, University of Colorado, Denver, Colorado, USA
                [15 ] Center for Cancer Prevention, University of Torino, Torino, Italy
                [16 ] Occupational and Environmental Health Research Group, University of Stirling, Stirling, Scotland
                Author notes
                Address correspondence to J. LaDou, Division of Occupational and Environmental Medicine, University of California School of Medicine, San Francisco, CA 94143-0924 USA. Telephone: (415) 476-4951. Fax: (415) 476-6426. E-mail: joeladou@ 123456aol.com

                B.C., A.F., R.L., and D.T. have served as expert witnesses in asbestos-related litigation cases. The remaining authors declare they have no actual or potential competing financial interests.

                Article
                ehp-118-897
                10.1289/ehp.1002285
                2920906
                20601329
                15f6805a-6dc2-47e0-976d-176223dc94b6
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                History
                : 12 April 2010
                : 8 June 2010
                Categories
                Commentary

                Public health
                controlled use,product defense,asbestos-related diseases,chrysotile,ban,asbestos cancer pandemic,asbestos,disinformation,mesothelioma,cancer

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