Claims that asbestos is not hazardous to health is wrong, say researchers

= A response to Prof. Ravindra Fernando’s article

Ina recent commentary piece in the Sunday Times of January 14, Prof. Ravindra Fernando tried to make the claim that chrysotile asbestos is safe and “is not harmful or hazardous to health”. This is an inaccurate claim as are some other claims in his commentary, as well as a biased selection of the science of asbestos disease.

His views go contrary to studies in the United States by the Environmental Protection Agency ( EPA), the National Institute for Occupational Safety and Health ( NIOSH), and the Occupational Safety and Health Administration (OSHA), as well as internationally by the World Health Organisation ( WHO), and the Internationals Agency for Research on Cancer (IARC). all these institutions document that chrysotile asbestos is indeed carcinogenic and OSHA even states, as have scientists in the past, that there is no known safe level of exposure to asbestos. Cases of lung cancer and mesothelioma have been documented with as little as one day of exposure, certainly not enough to cause asbestosis, a scarring of the lung usually found on chest X- ray, but enough to cause cancer.

Together we have presented in the fall of 2017 at two international meetings the first data on cases of asbestosis in Sri Lanka, where it is acknowledged that only chrysotile has been used. There is copious data in the scientific literature, ignored by Professor Fernando, of chrysotile causing cancer and asbestosis.

Of the countries he names, Russia supports asbestos since it produces half of the world’s yearly supply and together China and India use half of the yearly world supply. Canada, a former major supplier of chrysotile to the world, has now banned the sale or use of asbestos, and Brazil, after a recent ruling by its Supreme Court, became the first country with active mines to ban the use of asbestos. At present, some 60 countries have banned any use of asbestos, including chrysotile. As for the United States, where it regrettably is still a legal product, use has almost disappeared with about 1000 tons now imported compared to 803,000 tons at its peak use.

As for the issue of bio-persistence, it is true that chrysotile does not stay in the lung as long as the amphiboles. However, as many studies show, it is much more likely to move to the pleura, the lining of the lung, and the site of the asbestos- related cancer mesothelioma. In some studies, up to 80 percent of the cases only have chrysotile in the pleural tissue in cases of mesothelioma.

In his commentary, Prof. Fernando speaks of two asbestos- cement factory studies. The lack of disease in the Weil study was for workers with less than two years of exposure. The Gardner study states “the durations of exposure were short”, and they did find a mesothelioma. Asbestos cement studies from elsewhere, such as Brazil, Denmark, and Poland have found asbestos- related cancers.

The last issue is that of supposed and implied “safe” levels. Prof. Fernando notes that the United States Permissible Exposure Limit ( PEL) is 0.1 fiber per cubic metre. This is correct, but it is not based entirely upon science but must take into consideration economic factors as pushed by industry. Scientific data have shown that one year of working at this allowed level, intended ideally to protect a person from a forty- year lifetime of work, is sufficient to raise the risk of mesothelioma by a factor of 4.

Safe use is a fallacy. Disease in Sri Lank exists. The only rational approach to the use of asbestos would be for Sri Lanka to join the other truly civilised countries of the world and fully ban all uses of asbestos to protect workers and the public.

( Arthur L. Frank, MD, PhD, Professor of Public Health and Professor of Medicine, Fellow: ACP, ACPM, Collegium Ramazzini, AAAs, Drexel University, USA, has been studying asbestos- related diseases since 1968. This includes work in China, Sri Lanka, Colombia and the United States. He has published more than 100 papers on the issue. His PhD was related to asbestos, and he practises occupational medicine.

( Dr. Aseni Wickramatillake , MBBS, MPH, Consultant in Occupational Safety and Health Sri Lanka)