title: The global spread of asbestos.
abstract: BACKGROUND
  Asbestos continues to be used in large quantities around the world and to be an important commodity in global trade.
  
  
  OBJECTIVE
  To assess and quantify current global patterns of asbestos production, export and use; to examine global patterns of asbestos-related disease; and to examine barriers to an asbestos ban.
  
  
  METHODS
  Review of the biomedical literature describing patterns of asbestos exposure and disease; review of documents from national governments, UN agencies, and NGOs on asbestos production and use.
  
  
  RESULTS
  Despite widespread knowledge of the hazards of asbestos and bans on any use of asbestos in more than 50 countries, an estimated 2 million tons of asbestos continue to be used around the world each year. Although this amount is significantly less than peak annual consumption of nearly 5 million tons two decades ago, significant amounts of asbestos are still used in India, China, Russia, and some developing countries. This use of asbestos is responsible for disease today and will cause still more asbestos-related disease in the years ahead. Real and artificially manufactured controversies regarding asbestos such as arguments about the relative hazards of different asbestos fiber types and fiber sizes have impeded bans on asbestos.
  
  
  CONCLUSIONS
  All forms of asbestos pose grave dangers to human health. All are proven human carcinogens. There is no continued justification for the use of asbestos. Its production and use should be banned worldwide.
authors.affiliation: Drexel University School of Public Health, Philadelphia, Pennsylvania. Electronic address: alf26@drexel.edu.
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Frank
authors.affiliation: Centre for Occupational and Environmental Health, Maulana Azad Medical College, New Delhi, India.
authors.forename: T K
authors.initials: TK
authors.lastname: Joshi
mesh_terms: D001194:Asbestos / Q000191:economics* / Q000633:toxicity*; D002273:Carcinogens / Q000633:toxicity*; D014943:Global Health; D006801:Humans; D008906:Mining / Q000706:statistics & numerical data; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*
chemical_list: D002273:Carcinogens; D001194:Asbestos
keywords: Latin America; asbestos; asbestos-related diseases; international scientific cooperation