Academic journal article Scandinavian Journal of Work, Environment & Health

The 18th Collegium Ramazzini Statement: The Global Health Dimensions of Asbestos and Asbestos-Related Diseases

Academic journal article Scandinavian Journal of Work, Environment & Health

The 18th Collegium Ramazzini Statement: The Global Health Dimensions of Asbestos and Asbestos-Related Diseases

Article excerpt

The Collegium Ramazzini reaffirms its long-standing position that responsible public health action is to ban all extraction and use of asbestos, including chrysotile. This current statement updates the Collegium's earlier statements with a focus on global health dimensions of asbestos and asbestos-related diseases (ARD). The ARD epidemic will likely not peak for at least a decade in most industrialized countries and for several decades in industrializing countries. Asbestos and ARD will continue to present challenges in the arena of occupational medicine and public health, as well as in clinical research and practice, and have thus emerged as a global health issue. Industrialized countries that have already gone through the transition to an asbestos ban have learned lessons and acquired know-how and capacity that could be of great value if deployed in industrializing countries embarking on the transition. The accumulated wealth of experience and technologies in industrialized countries should thus be shared internationally through global campaigns to eliminate ARD.

Background

Every mined asbestos fiber is indestructible. As a result, many individuals are repeatedly exposed during the silicate mineral's lifecycle, from mining and extraction of asbestos-containing rocks to manufacturing of asbestoscontaining products (ACP), and further during use, repair, demolition and abatement of ACP. Since 1993, the Collegium has repeatedly called for a global ban on all mining, manufacture, and use of asbestos (1-4). The Collegium has taken this position based on well-validated scientific evidence showing that all types of asbestos, including chrysotile the most widely used form, cause cancers (such as mesothelioma and lung cancer) and additionally that there is no safe level of exposure. The Collegium has continued to criticize as fallacious and unachievable the so-called "controlled use" of chrysotile advocated by the asbestos industry. Unfortunately, despite these concerns and abundant scientific evidence, global usage of chrysotile has remained at around two million metric tons per year in recent years. Most of this current use is concentrated in low- and middle-income countries (5).

The Collegium reaffirms its position that, given the well-documented availability of safer, cost-effective alternative materials, the responsible public health action is to ban all extraction and use of asbestos. State-of-theart technologies must be employed in asbestos removal and disposal. This current statement updates earlier statements with a focus on the global health dimensions of asbestos and asbestos-related diseases (ARD).

UN Organizations

In 2006, the World Health Organization (WHO) called for the elimination of ARD (6), taking the position that the most efficient way to eliminate such diseases is to cease using all types of asbestos. The 2014 update of this statement, which was attached to the WHO document "Chrysotile Asbestos" (7), published in response to the continuing widespread production and use of chrysotile, emphasized that all forms of asbestos, including chrysotile, are causally associated with an increased risk of cancer of the lung, larynx and ovary, mesothelioma and asbestosis. These observations are in line with the recent evaluation by the International Agency for Research on Cancer (IARC) (8). In its 2014 update, the WHO reiterated its call for global campaigns to eliminate ARD. These efforts have been joined by other UN agencies including the International Labour Organization (ILO) and the United Nations Environment Programme (UNEP). The Chemical Review Committee of the Rotterdam Convention has repeatedly recommended that chrysotile asbestos be put on the Convention's list of hazardous substances, thus requiring exporting countries to obtain prior informed consent (PIC) from the importing countries. A handful of countries have opposed that recommendation, thus preventing this basic safety protection from coming into effect. …

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