Asbestos Ban in Sweden Leads to Drop in Mesothelioma

The strict ban on asbestos more than 30 years ago in Sweden has produced a tangible decline in mesothelioma throughout the country.

It has also helped fuel the growing debate about establishing a similar asbestos ban in the U.S. and Canada.

“There is no good argument to use asbestos, anymore,” senior professor Bengt Jarvholm, of the department of Public Health and Clinical Medicine at Umea University in Sweden, told Asbestos.com. “Especially [using it] in an industrialized country.”

No Argument for Not Banning Asbestos in US

Jarvholm has spent much of his career studying the impact of asbestos exposure in Sweden’s construction industry. He co-authored a recent article in the Scandinavian Journal of Public Health that detailed the emerging evidence about the decline in mesothelioma incidence since the ban.

“Yes, I’m surprised [the U.S. hasn’t banned asbestos],” he said. “There are other, less dangerous substances to use. There is no real argument, apart from pure economic ones, to keep using it.”

Asbestos exposure is the primary cause of mesothelioma, a rare and aggressive cancer with no cure. It is diagnosed in an estimated 3,000 Americans annually.

It can also lead to a host of other serious respiratory issues, including asbestosis and lung cancer. Experts estimate asbestos is responsible for 10,000 deaths annually in the U.S.

Although the use of asbestos in the U.S. has dropped significantly from its peak in the 1970s, it remains legal to use in a variety of industries. The U.S. Environmental Protection Agency issued an Asbestos Ban and Phase Out Rule in 1989, but it was overturned by the legislature two years later, allowing the regulated use of asbestos to continue in the country.

Sweden Paved Path to Ban Asbestos

Asbestos is banned in more than 50 countries. The Nordic countries were among the first to ban it. Iceland (1982), Sweden (1982) and Norway (1983) served as pioneers in reducing asbestos use and lowering the incidence rate of mesothelioma, laying the groundwork for other nations to follow.

The difficulty in measuring the positive effects of a ban is the lengthy latency period (20-50 years) between first exposure and definitive diagnosis.

“Yes, a ban [in the U.S.] would lead to a drop in mesothelioma cases, but it would take several decades before you could measure it,” Jarvholm said. “Our analysis clearly shows that the ban and other restrictions in the mid-70s and early ’80s have decreased the risk.”

According to the study, Swedish men and women born between 1935 and 1949, whose working lives coincided with the boom in asbestos use, were at a much higher risk for developing an asbestos-related disease than those born after 1950.

Using specific five-year birth cohorts, the study also showed those born from 1955 to 1959, and who started working before the ban, were four times more likely to be diagnosed with mesothelioma than those born from 1960 to 1965.

Ban on Asbestos Prevents Mesothelioma Cases in Sweden

Jarvholm scoffed at the popular argument that finding an asbestos alternative is often difficult and expensive.

“When the discussion was hot in Sweden in the 1970s, some people said it could not be replaced in brake linings. However, it was quickly replaced, and even improved, when the market demanded it,” he said. “Industry needs pressure from both the market and from regulations.”

The authors estimated the decreased use of asbestos has prevented at least 12 cases of asbestosis annually in those under the age of 57. They believe 121 cases of mesothelioma were avoided among Swedish men born between 1955 and 1979.

“It is reasonable to assume that similar interventions in other countries will decrease the occurrence of pleural mesothelioma,” the authors concluded. “The impact will depend on the proportion of the population exposed, and the magnitude of the exposure.”

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