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Similar to pattern in US, extensive use of asbestos to impact future health in India


By Karen Selby, RN
The World Health Organization (WHO) estimates 125 million people around the world are exposed annually to asbestos in the workplace, and the International Labour Organization says more than 107,000 workers die each year from a related disease. In addition, several thousand people die from asbestos in the environment each year.
Despite the fact that health concerns have prompted more than 50 countries to restrict or ban the use of asbestos since the early 1970s, others continue to mine and consume the toxic mineral in alarming quantities. Supported for decades by aggressive industry campaigns, the popularity of asbestos is currently rising in developing nations where affordable, mass-produced building materials are in high demand.
But the affordability of asbestos does not come without costs — namely in human lives. Although supporters contest the toxicity of chrysotile (white) asbestos when used under controlled conditions, countless studies have linked exposure of any type or dose to an increased risk for asbestos-related diseases, including mesothelioma.
A research study published in 2021 directly compared national-level data of pleural mesothelioma mortality rates versus asbestos use across a range of countries. The researchers found that continued asbestos use correlated with an increase in asbestos-related illnesses.
WHO argues that the best way to eliminate these diseases is to stop mining and using the mineral. According to a 2017 report from the U.S. Geological Survey, Russia, Brazil and China led asbestos mine production in 2015 and 2016. Brazil announced a ban of the production, distribution and use of asbestos in 2017.

Global Efforts to Ban Asbestos

The American Public Health Association joined the call of at least three major international health organizations in asking for a global ban on asbestos use in 2010. The World Federation of Public Health Organizations, the International Commission on Occupational Health and the International Trade Union Confederation earlier recommended such a ban.
Since 2005, the World Health Organization has urged its members to work toward eliminating mesothelioma and other cancers caused by avoidable exposures to carcinogens at work and in the environment. In 2007, the World Health Assembly asked WHO to launch a global campaign to eliminate asbestos-related disease, primarily by targeting countries that still use chrysotile asbestos.
At the 66th World Health Assembly in 2013, WHO presented a global action plan for 2013 to 2020. It described a comprehensive set of policies and actions to help the organization’s 190 nations and member states prevent and control noncommunicable diseases, including those caused by asbestos.

WHO AIMS TO COMPLETELY ELIMINATE ASBESTOS-RELATED DISEASES THROUGH A NUMBER OF IMPORTANT STEPS:

  • End the worldwide use of all types of asbestos
  • Help countries replace asbestos materials with safer substitutes
  • Improve early diagnosis, treatment and rehabilitation services for asbestos-related conditions
  • Create registries of people who have been exposed to asbestos and offer medical surveillance
In addition, WHO will continue to raise awareness about the dangers of asbestos-containing materials and inform its members that asbestos-contaminated debris should be treated as hazardous waste.

Rotterdam Convention

Hoping to minimize the harmful effects of asbestos worldwide, many countries have voted to add chrysotile asbestos to the Rotterdam Convention Hazardous Substances list. This United Nations treaty requires countries that export any substances on the list to ensure receiving countries are fully informed of their health risks.
Five of the six types of asbestos have made the hazardous substances list, but some countries argue against scientific consensus and claim chrysotile can be used safely. At the 2015 Rotterdam Convention, held in Geneva, Switzerland, seven nations voted against adding chrysotile to the list: Cuba, India, Kazakhstan, Kyrgyzstan, Pakistan, Russia and Zimbabwe.
Despite an overwhelming majority of nations voting in favor of classifying chrysotile as a hazardous substance, the Rotterdam requires a unanimous consensus for a vote to pass.

Worldwide Production and Use

According to Jock McCulloch and Geoffrey Tweedale, authors of Defending the Indefensible: The Global Asbestos Industry and its Fight for Survival, “Asbestos is still mined and used in the developing world, where the problems that were experienced in America and Europe in the 20th century are now being duplicated in China, Russia, India and other countries in the Far East.”
The world leaders in asbestos production for 2015 and 2016 were Russia, China, Brazil, Kazakhstan and India, according to a 2017 report from the U.S. Geological Survey. Brazil announced a ban of asbestos in 2017.
China, the world’s leading asbestos consumer, used 570,006 metric tons of it in 2013. That’s about 765 times the amount consumed by the U.S. that year. Although China has yet to match the incidence of related diseases experienced in Europe and the U.S., researchers expect the gap to soon close. This is because consumption in China remained low well into the 1970s.
The world’s second largest asbestos consumer is Russia. Although the country banned only the amphibole type of asbestos in 1999, today it supplies 60 to 75 percent of all asbestos used worldwide.

Canada

Canada’s asbestos mining efforts started around 1850 when chrysotile deposits were discovered in Thetford. By 1876, approximately 50 metric tons of asbestos were being mined in Quebec. By the 1950s, the annual mining haul was more than 900,000 metric tons.
In early 2011, the Jeffrey Mine in Asbestos, Quebec, received scrutiny after the Canadian government proposed a $58 million grant to reopen the mine. But before the funds were transferred, the Parti Quibecois defeated the Quebec Liberal Party in a provincial election and canceled the loan.
Canada’s last asbestos mines closed in 2012. In December 2016, the Canadian government announced it will ban the manufacture of any products containing asbestos as well as the import and export of asbestos products by the end of 2018.

Russia

Russia, which is the largest country in the world in terms of land mass, also leads the planet in asbestos production. In 2000, production reached approximately 700,000 metric tons, much more than Canada and China. In 2008, mining in Russia produced more than 1 million metric tons of asbestos. In 2016, the country produced 1,100,000 metric tons.
Russia’s high production numbers stem from the city Asbest, located about 900 miles northeast of Moscow. Once known as “the dying city” because of its high rates of mesothelioma and related diseases, Asbest is home to a mine that measures seven miles long, one-and-a-half-miles wide and more than 1,000 feet deep. The company operating the mine is Uralasbest, the world’s largest producer of chrysotile asbestos.
About 500,000 metric tons of asbestos is gathered from the mine each year — roughly 20 percent of the world’s supply.
Uralasbest and Orenburg Minerals, the two largest asbestos producers in Russia, maintain that controlled use of chrysotile asbestos is not harmful to human health.
Russia is the world’s second-largest consumer of asbestos, trailing only China. Russia has widely used the mineral in roofing materials, automobile brakes and insulation. About 3,000 asbestos-containing products have been labeled as safe by the Chief Sanitary Officer of Russia.

China

China is one of the world’s largest producers of asbestos. The country mined more than 450,000 metric tons in 2000, a total that placed it behind only Russia in terms of production. Since then, Chinese production has fallen slightly. Its mining total fell to 400,000 metric tons in 2016.
Chinese manufacturers and builders consume large amounts of the mineral, using it for roofing materials, walls, brake pads, gaskets and cloth. Jukka Takala, director of the European Agency for Safety and Health at Work, believes the annual Chinese death toll from mesothelioma and related diseases could reach 15,000 by 2035.
While data on the incidence on mesothelioma in China is not available, the number of cancer registries in the country has increased in recent years. In 2011, however, researchers estimated the registries only covered 13 percent of the population.
At the 2009 Asian Asbestos Conference, a “Hong Kong Declaration towards a Complete Ban on all forms of Asbestos” and asbestos processing was recommended. The declaration asked for asbestos use to be phased out and recognized the need of assistance for those suffering from related diseases.

Brazil

Brazil was the world’s third-largest producer of asbestos in 2016, producing 311,000 metric tons. In November 2017, in a landmark decision, the Brazilian Supreme Court voted to ban the production, commercialization and use of asbestos in the country.
Before the ban, Brazil was a leading consumer of the toxic mineral. The country used 181,168 metric tons as recently as 2013, ranking it No. 4 among the world’s consumers.
Estimates predict the rate of mesothelioma and related deaths will continue rising in Brazil’s future. Dr. Ubiratan de Paula Santos, a pulmonologist at the University of São Paulo Medical School, treats about 20 mesothelioma cases a year, and he says that number is slowly climbing. The majority of his patients are current or former asbestos plant workers. Mesothelioma typically is not caught until it has reached an advanced stage.

Colombia

In 2019, Colombia joined the growing list of countries that have imposed a complete ban on asbestos, a ruling passed unanimously in a plenary session of Congress.
The Ministry of Labor has been tasked with overseeing the transition away from the toxic mineral.
The ban includes production, commercialization and distribution of asbestos. Industries throughout the country are expected to begin adapting their processes to nonharmful compounds by 2021, but a five-year transition period has been extended.
Roof sealants, cement products, pipeline wrap, felts and floor tiles are among the products that will be affected.

Kazakhstan

As of 2016, Kazakhstan was the fourth-largest producer of asbestos, mining 215,000 metric tons. Since 1965, Kostanai Minerals has mined asbestos from Djetygarinskoe, one of the five largest asbestos deposits in the world. Located in northern Kazakhstan, it holds 37 million tons of asbestos.
While Kazakhstan exports most of the mineral it mines, it does consume some. Houses, apartment buildings, hospitals, schools, commercial buildings, brakes and other products are manufactured with contaminated products. Recent developments, however, may turn this trend.
In 2009, 75 participants of a conference on the use of chrysotile asbestos and its health effects recommended the Kazakh government support a national program to eliminate asbestos-related diseases. Since the conference, the first of its kind in Kazakhstan, other seminars on the side effects of the mineral have pushed the notion that Kazakh citizens are ill-informed about these materials. Those leading the seminars say there is now stronger public participation in monitoring existing asbestos regulations.

India

The second-most populous country with more than 1.2 billion people, India’s extensive use of asbestos will likely have a significant impact on the future health of the country’s population. Experts predict a pattern similar to what developed in the United States over the past 50 years: A dramatic rise in the number of related diseases.
India no longer mines asbestos, but it is the top importer of Canadian asbestos. About 20 years ago, India handled 500,000 metric tons of asbestos cement roofing. Today, that number is closer to 4 million metric tons.
India changed its long-held stance and voted to add the mineral to the hazardous list at the 2011 Rotterdam Convention.
The Ban Asbestos Network of India (BANI) is a group of scientists, doctors, public health researchers, trade unions, activists and civil society groups that condemn the use of the mineral and push for an immediate ban. BANI has been successful in drawing attention to the hazards and toxic effects of exposure.

United Kingdom

The United Kingdom in 1931 introduced the Asbestos Industry Regulations. At the time, the regulations determined the “safe” level of exposure. In 1960, the legal exposure limit was increased, placing workers at a higher risk of contracting mesothelioma and related diseases. By 1968, the standards for exposure levels were lowered to reduce the risk of disease.
England, though, is paying for years of higher exposure. The annual number of mesothelioma deaths has increased over the years, from 153 in 1968 to 2,360 in 2010. The total number of deaths decreased to 2,291 in 2011. The U.K. has prohibited the trade, application and supply of crocidolite and amosite asbestos since the 1980s. Chrysotile asbestos was prohibited in 1999.

Australia

Australia has a long history of asbestos production and use, although its heavy-use years are long gone. Its peak year was 1975, when the country used about 70,000 metric tons. But years of overuse impacted the long-term health of Australian citizens: There were 156 deaths related to mesothelioma in 1982, and the number increased to 666 by 2009. It is estimated that 18,000 Australians will have died from mesothelioma by 2020.
Perhaps no place in the world shows the toxicity of asbestos better than the town of Wittenoom in Western Australia. Mining began there in 1939, and eventually, the predominant asbestos was crocidolite, replacing the less-toxic chrysotile asbestos. Multiple health reports indicate that exposure to crocidolite (blue) asbestos leads to an increase in the development of related diseases.
Because of Wittenoom’s long history of mining and the exposure that occurred as a result of that history, Western Australia has the highest rate of mesothelioma and related diseases in the world. The mine was shut down in 1966 because of low profits and rising concerns over disease. A mesothelioma diagnosis almost always comes with a short life expectancy.
In 2006, officials stopped providing electricity to Wittenoom, and they stopped mail delivery the following year. Plans to remediate the highest risk sites are underway.

South Africa

South Africa began mining asbestos around 1883 after a crocidolite mine was established in the Northern Cape region in Koegas. The country developed into a major producer of crocidolite, supplying Australia and the United Kingdom with the heat-resistant mineral for many years.
South Africa’s mining of asbestos peaked in 1977 at 380,000 metric tons, making it the third-largest supplier in the world. But within a decade, the Northern Cape mines were closed because of the health risks involved and a growing concern over litigation.
Because the health effects of asbestos exposure were largely hidden by the mining industry, there was little public awareness of mesothelioma and related diseases until the late 1970s. Following the lead of the Northern Cape mines, several other mines in South Africa also closed, and residents of Prieska formed Concerned People Against Asbestos (CPAA), which focuses on improving access to compensation for citizens battling related diseases.

Legal Costs

In addition to the lives lost to mesothelioma and other diseases, rampant asbestos use can cause harmful economic effects as well. For decades after the end of asbestos use, a country’s economy will be left with the burden of compensating victims and paying for their health care.
Even with the mineral banned in the European Union and severely limited in the United States, research suggests that mesothelioma will cost the U.S. up to $200 billion and Europe up to $80 billion over the next 40 years. From the early 1970s to 2002, more than 730,000 asbestos claims were filed in the U.S., costing the industry approximately $70 billion.

Karen Selby worked in several subspecialties within nursing before becoming a registered nurse, author and a Patient Advocate at The Mesothelioma Center, the USA’s most trusted mesothelioma resource. Courtesy: asbestos.com

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