Mortality in chrysotile asbestos workers in China.
OBJECTIVE
China has been the world's top chrysotile asbestos consumer and producer. However, the national mortality rate for asbestos-related diseases, particularly from malignancies, is unknown. This review elaborates recent studies on cancer mortality and nonmalignant respiratory diseases in Chinese chrysotile asbestos workers.


RESULTS
Studies conducted in asbestos products factory workers and miners have demonstrated strong associations between exposure to chrysotile and mortality rates for lung cancer and nonmalignant respiratory diseases. Mortality rates for lung cancer and nonmalignant respiratory diseases in both asbestos workers and miners are four and three times higher, respectively, than expected, which are greater than those seen in studies from western countries, likely a reflection of heavier exposures and less effective protection for workers. An increased risk of gastrointestinal cancer was also detected in chrysotile miners. There have been surprisingly few reported cases of mesothelioma, however, which could, at least partially, indicate a problem in diagnosis.


CONCLUSIONS
Given the substantially increased death risks for lung cancer and nonmalignant respiratory diseases, urgent efforts must be made to implement occupational health and safety regulations and decrease workers' exposures to prevent a future heavier disease burden. Meanwhile, improvements in diagnostics and systematic recording of the incidence and mortality of asbestos-related diseases are needed.
JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China. xrwang@cuhk.edu.hk
Xiaorong
X
Wang
Midori N
MN
Courtice
Sihao
S
Lin
D017632:Asbestos, Serpentine / Q000009:adverse effects*; D001195:Asbestosis / Q000209:etiology / Q000401:mortality*; D002681:China / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors
D017632:Asbestos, Serpentine