14 October 2015
The Collegium Ramazzini releases two special issue commentaries on the pathological diagnosis of the diseases causes by asbestos; and 2) the causation of malignant mesothelioma as related to asbestos exposure in the workplaceThe Collegium Ramazzini, an international academy of 180 scientists from 35 countries, experts in environmental and occupational health, has added two additional commentaries to its twenty-five year record of denouncing the public health hazards of asbestos exposure.
The first, Comments on the 2014 Helsinki Consensus Report on Asbestos, recognizes the work of the 2014 expert committee convened by the Finnish Institute of Occupational Health to update the 1997 and 2000 Helsinki criteria on Asbestos, Asbestosis and Cancer in light of new advances in research. The Collegium however expresses concerns about the sections of the Helsinki report that discuss criteria for pathological diagnosis of the diseases caused by asbestos, specifically:
1) over-reliance on the detection of "asbestos bodies" as indicators of past exposure to asbestos;
2) over-reliance on asbestos fiber counts in lung tissue as an indicator of past exposure to asbestos;
3) use of the Scanning Electron Microscope (SEM) at low magnification as a tool for evaluation of asbestos-related disease; and
4) lack of recognition that chrysotile is the predominant type of asbestos fiber found in pleural mesothelioma tissue.
The Collegium Ramazzini concludes that applying the 2014 Helsinki report recommendations on pathology diagnosis will lead to missed diagnoses of cases of disease caused by asbestos, failure of workers' compensation systems to properly compensate workers who have been exposed to asbestos, and lost opportunities for public health authorities to recognize asbestos hazards and to prevent asbestos-related disease.
The second, Comments on the causation of malignant mesothelioma, rebuts the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma. Referencing the large number of cases of mesothelioma that have been brought to the attention of the Italian courts as possible occupational diseases, the Collegium Ramazzini concludes that risk of malignant mesothelioma is related to cumulative exposure to asbestos in which all exposures - early as well as late - contribute to the totality of risk.
The Collegium Ramazzini rejects as false, mendacious, and scientifically unfounded the claim put forth by the Italian asbestos industry and its expert witnesses that in cases of prolonged exposures to asbestos only the earliest periods of exposure contribute to mesothelioma induction, while all subsequent exposures have no causal role. The Collegium Ramazzini is deeply concerned that acceptance of this false claim will contribute to the unjust denial of workers' compensation and civil damages to affected workers, that it will hinder efforts to diagnose and prevent malignant mesothelioma, and that ultimately it will undermine the health of the public in Italy and in countries around the world.
Related positions of the Collegium Ramazzini on asbestos are available for consultation, including:
- The Global Health Dimensions of Asbestos and Asbestos-Related Diseases (2015).
Chinese, Japanese; Portuguese, and Spanish]
- Asbestos is Still With Us: Repeat Call for a Universal Ban (2010)
- Call for an International Ban on Asbestos: Statement Update (2004)
- Call for an International Ban on Asbestos (1999)
- Chrysotile Asbestos as a Carcinogen (1993)
- Press release 14 October 2015