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Asbestos in High-Risk Communities: Public Health Implications

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  • Edward A. Emmett

    (Occupational and Environmental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA)

Abstract

Asbestos-related diseases (ARDs)—mesothelioma, lung cancer, and asbestosis—are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.

Suggested Citation

  • Edward A. Emmett, 2021. "Asbestos in High-Risk Communities: Public Health Implications," IJERPH, MDPI, vol. 18(4), pages 1-14, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1579-:d:495345
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    References listed on IDEAS

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    1. Jeremy D. Wortzel & Douglas J. Wiebe & Shabnam Elahi & Atu Agawu & Frances K. Barg & Edward A. Emmett, 2021. "Ascertainment Bias in a Historic Cohort Study of Residents in an Asbestos Manufacturing Community," IJERPH, MDPI, vol. 18(5), pages 1-20, February.
    2. Douglas, Thomas & Van den Borre, Laura, 2019. "Asbestos neglect: Why asbestos exposure deserves greater policy attention," Health Policy, Elsevier, vol. 123(5), pages 516-519.
    3. Emily Goswami & Valerie Craven & David L. Dahlstrom & Dominik Alexander & Fionna Mowat, 2013. "Domestic Asbestos Exposure: A Review of Epidemiologic and Exposure Data," IJERPH, MDPI, vol. 10(11), pages 1-42, October.
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    Cited by:

    1. Kathleen Mahoney & Tim Driscoll & Julia Collins & Justine Ross, 2023. "The Past, Present and Future of Asbestos-Related Diseases in Australia: What Are the Data Telling Us?," Sustainability, MDPI, vol. 15(11), pages 1-12, May.
    2. Terri-Ann Berry & Elena Belluso & Ruggero Vigliaturo & Reto Gieré & Edward A. Emmett & Joseph R. Testa & Gregor Steinhorn & Shannon L. Wallis, 2022. "Asbestos and Other Hazardous Fibrous Minerals: Potential Exposure Pathways and Associated Health Risks," IJERPH, MDPI, vol. 19(7), pages 1-17, March.
    3. Cézar Akiyoshi Saito & Marco Antonio Bussacos & Leonardo Salvi & Carolina Mensi & Dario Consonni & Fernando Timoteo Fernandes & Felipe Campos & Franciana Cavalcante & Eduardo Algranti, 2022. "Sex-Specific Mortality from Asbestos-Related Diseases, Lung and Ovarian Cancer in Municipalities with High Asbestos Consumption, Brazil, 2000–2017," IJERPH, MDPI, vol. 19(6), pages 1-12, March.

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