Asbestos: environmental health inequalties between developed and developing nations

Global consumption of asbestos is estimated to be about 2 million tons in 2009 (Frank and Joshi, 2014). Every 20 tons of asbestos produced and consumed kills a person somewhere in the world (Furuya et al., 2018). Asbestos-caused cancer was identified in the late 1930s but despite today's overwhelming evidence of the strong carcinogenicity of all asbestos types, it is still widely used globally. Over the past few decades, there has been a significant decline in cancers attributable to environmental and occupational carcinogens of asbestos in high-income countries. However for low- to middle-income countries, these exposures are likely to increase as industrialization expands and populations grow (Hashim, 2014). In addition to non-occupational factors, such as tobacco smoking, malnutrition, and infectious diseases, less-developed countries face occupational and environmental carcinogens that significantly contribute to cancer incidence and mortality burden. Asbestos use is banned in 55 countries. However, the reality shows that following the ban of new productions and uses of asbestos-containing materials (ACM) in a developed nation, a significant surge of imported ACM is reported in the developing nations. Alarmingly, asbestos products are still popular in developing countries include those construction products such as roofing corrugated asbestos-cement sheet and shingles, thermal insulation, asbestos cement pipe and fittings, vinyl carpets and brake shoe and clutch linings, etc (Harris and Kahwa, 2003). Nonoccupational exposure to ACM and asbestos-related diseases (ARDs) have been a global concern for decades. However, ACM usage is increasing in developing countries while no regulation is in place and the assessment of health impact remains obscure. Despite the ban for its use in a number of countries particularly developed nations, rates of asbestos use are rising in developing countries where it meets immediate demands for housing, building materials, and employment. In spite of the severe health warnings and considerable hazards, asbestos is still widely used in many developing countries for constructions of schools, residential and office buildings, especially within the African Region. This is primarily due to the lack of comprehensive legislation and enforcement policies, nonexistence of public awareness and health priority matters. Therefore, Identifying asbestos uses and epidemiological studies accounting for socio-cultural and economic analyses in pursuit of establishing reliably policy that protect the health effects of ACM in developing countries such as Ethiopia is an important research endeavor with broad relevance to science and public health. (author)