International asbestos trade and mesothelioma deaths: shifting the burden to the less developed world

INTRODUCTION: This study was to examine how the burden of asbestos has been transferred from developed countries to developing countries and how this shift of asbestos will influence future mesothelioma deaths.

METHODS: The data on world production, import and export of asbestos were obtained from the British Geological Survey, the US Geological Survey, and the UN Commodity Trade Statistics. We described annual asbestos production, import and export, and estimated the amount of consumption according to national income as well as the trade patterns from 1920 through 2011. Mesothelioma mortality data for 1970-2010 were obtained from the World Health Organization Mortality Database. A mesothelioma mortality prediction model was constructed for males based on the cumulative age-specific asbestos consumption and annual age-sex specific mesothelioma mortality. We used a negative binomial regression model to predict future mesothelioma deaths with data on historical asbestos consumption.

RESULTS: Asbestos consumption in developed countries increased from 1920 to the mid-1970s and then decreased. A decline of asbestos consumption in developing countries was observed from the 1990s but the downward trend stopped in the 2000s and then plateaued. Trade in asbestos-containing products such as asbestos cement, compressed fiber jointing, paper, millboard and felt, and friction materials was concentrated in developing countries from the 2000s. The estimated number of future mesothelioma deaths among males during 2015-2070 ranged from 7,584 to 17,820 per million per year, depending on the future asbestos consumption. World mesothelioma deaths will peak in the 2030s and then decline, however peak periods of mesothelioma deaths in developing countries will be around the 2050s.

CONCLUSIONS: Most of developed countries banned asbestos and showed no consumption of asbestos in recent years, while developing countries still consume a considerable amount of asbestos. Mortality burden of asbestos shifted from developed world to developing world through asbestos business. Asbestos industries are intertwined internationally, which that is why global asbestos ban should be implemented.