The Third Wave of Asbestos Disease: Exposure to Asbestos in Place [antikvár]

For close to sixty years data on the health hazards of asbestos have been documented in the scientific literature. Twenty-six years ago, in 1965, the New York Academy of Sciences published the seminal document Biological Effects of Asbestoswhich conveyed this knowledge to the generál public. That publication was followed twelve years later by the release of the report entitled Health Hazards of Asbestos Exposure.1 Those two reports documented the etiologic associations between asbestos exposure and the development of asbestosis, lung cancer, and mesothelioma. They detailed the extent of the asbestos-related disease epidemic in the United States, and they provided the essential basis for prevention. Now, with the publication of this report, The Third Wave of Asbestos Disease: Exposure to Asbestos in Place-Public Health Control, the latest developments in the continuing asbestos experience are documented. The need to convene yet another conference on asbestos disease is sad testimony to how much has yet to be accomplished in the dissemination of information to protect public health. On a positive note, the interest generated by the convening of this meeting under the auspices of the Collegium Ramazzini is proof that concern about the health effects of occupational and environmental exposures remains high. The first phase of asbestos disease was associated with work in the mining and milling of ore and the manufacture of asbestos products. It began to be recognized in the 1920s and its legacy is still with us. The second phase came to be recognized in persons who used asbestos products. The numbers of persons so exposed was very large; conditions of exposure were more complex, and not readily amenable to control. In a world habituated to acute illness and injury, the concept of latency in the development of chronic or late disease was not appreciated. Persons exposed in the 1940s and 1950s are only now reaching their sixth and seventh decades, and their risk of illness induced by asbestos is very great indeed. Although the documentation of asbestos hazards has resulted in somé mandated reduction of grosser exposures in somé settings, it has alsó led to the recognition that even very short-term and/or low-level exposures pose risk. And this risk now extends to other settings, other populations. Asbestosis, lung cancer, mesothelioma, and a wide rangé of other types of cancer have been shown to be caused by exposure to asbestos. Epidemiologic studies conducted worldwide have established that all forms of asbestos have the capacity to cause these illnesses. These studies have shown that the incidence of asbestosis, lung cancer, and other tumors is quantitatively related to cumulative asbestos exposure in a positive dose-response relationship. By the end of the century, an estimated 30,000 to 50,000 premature deaths will have occurred in New York State alone as the result of occupational exposures to asbestos that occurred prior to 1980. Today, as buildings constructed with asbestos over the past six decades begin to age and deteriorate, serious potential exists for a third phase of asbestos disease among persons engaged in the repair, renovation and