Epidemiologia e Prevenzione. 2007 Jul-Aug;31(4 Suppl 1):53-74. [Link]
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A thought back on the "epic of asbestos" scanning the fundamental steps, from the "discovery" of the adverse effects for the workers. A first phase, the "asbestosis one" concluded in Britain in the early thirties with the issue of a technical legislation is described. It was the first regulation shared by the Unions and the asbestos companies, some of which were or will then become leaders all over the world. The main effect of this legislation enforcement is the reduction of the exposure in some units of the asbestos textile industry; no effects were observed instead in other asbestos industrial divisions where it’s consumption for insulations and asbestos cement increased massively. The second phase lasting approximately thirty years next sees together to a formidable diffusion of all the asbestos fibres including the crocidolite ones, advertised and accepted like "indispensable" for the economical and social development, an absolute leadership of the companies in the management of health effects information for the workers and therefore also those on the pulmonary cancerogenicity. Such selfish and aggressive leadership, receives in return from government, labour and consumers organizations just inertia, impotence and incredulity. This attitude will also continue in the third phase, beginning in the early sixties of the last century. The time period will be dominated by mesothelioma with all its new and terrible meanings, the dangerousness of asbestos exposure especially to the blue one even at lower levels than those observed in the past for other pathologies and the long latency before the appearance of the effects. Discussing about asbestos substitutes was out of the agenda, indeed just in the period where the mining and the consumption of asbestos touched the highest levels. The initiatives assumed in some countries like the auto limitation of the use of crocidolite and a more rigorous reduction of the occupational exposures will only turn out useful in order to lower the risk for asbestosis and, probably, the one for pulmonary tumour. In the United States, the judicial litigation for compensation between the workers and the companies begins. The same phenomenon will characterize also in the other countries industrializes the fourth phase of the epic, until our days; it is just in these years, and especially during the eighties, that industry starts thinking about the substitution of asbestos; the lively public debate will favour initiatives oriented to obtain economic compensation for damages caused by past occupational and environmental exposures. These legal actions will carry to bankruptcy all the asbestos companies and later to the ban of asbestos. The judicial debates will also uncover "confidential" information useful to better reconstruct the epic, to formulate more dispassionate historical judgments and to allow everyone on answering to more complex questions and more important than how much generally it was previously believed; all this should happen contextualizing the ages in which the scientific acquaintances on the effects of asbestos have been published and disproving prejudgments, able to affect some conclusions of the past.