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A heated argument about asbestos

In this issue of the Canadian Medical Association Journal, Dr. Philip Landrigan and colleagues from the Collegium Ramazzini call for an immediate ban on all mining and use of asbestos. The topic has economic implications, because Canada is the world’s second largest producer of the mineral. The Collegium, whose mission is to translate scientific data into public policy in the areas of environmental and occupational medicine, states that the dangers and availability of substitute materials are sufficient reasons for such a ban. The authors argue that a worldwide ban is the only way to eliminate the burden of disease and death caused by exposure to asbestos: “The health risks of asbestos exposure are not acceptable in either industrially developed or newly industrializing nations. Moreover, suitable, safer substitutes for asbestos are available.”

In a related commentary, Dr. Michel Camus argues that, while the logic of the Collegium is indisputable, the premise of its argument is not.

“The Collegium’s call to ban asbestos is insufficient in all respects,” writes Camus. “A ban must be assessed more thoughtfully following a comparative risk approach before being adopted. The progressive introduction of safe, efficient substitutes should proceed apace but with evidence-based safety assurance, in concordance with the precautionary principle.”

In another commentary, Dr. Jack Siemiatycki notes that a worldwide ban based on the Collegium’s assertions may be premature. He recommends that the proposed ban be considered by an international panel comprising individuals from a variety of fields who could give full consideration to its broad implications.

A call for an international ban on asbestos
-– P. Landrigan et al

A ban on asbestos must be based on a comparative risk assessment
-– M. Camus

Should Canadian health care professionals support the call for a worldwide ban on asbestos?
-– J. Siemiatycki

Contacts: Dr. Philip Landrigan, Department of Community Medicine, Mount Sinai School of Medicine, New York; tel. 773 702-2453

Dr. Michel Camus, Montreal; tel. 514 850-0157

Dr. Jack Siemiatycki, Professor, INRS- Institut Armand-Frappier, Université du Quebec, Laval, Que. tel. 450-686-5676

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