Mesothelioma: experts lift the lid on global "silent epidemic" research needs

There is a great and urgent need for diagnostic and therapeutic technologies to help manage mesothelioma and other diseases related to exposure to asbestos. And as the world faces a "global explosion" in mesothelioma, far greater political and public awareness internationally of the dangers is crucial.
This is the message that leading asbestos experts and mesothelioma clinicians and researchers took to the UK's All Party Parliamentary Group (APPG) on Occupational Safety and Health last week, during a meeting at the Palace of Westminster to define a plan of action for the development of R&D and to ensure it receives dedicated funding.
The centrepiece of the initiative is the creation of a national asbestos-related diseases research centre (NCARD) in the UK. The centre would be modelled on the Australian NCARD (established two years ago), with a view to co-ordinating R&D in the UK and Ireland across a range of medtech specialisms: diagnostics, theranostics, surgical techniques, radiation therapy and pharmacological therapies.
Mesothelioma mortality already rivals that of ovarian cancer in the UK, yet does not rate a mention in the one-year review of the Cancer Reform Strategy (CRS), published last week.
However, the need for early diagnosis (through pre-symptomatic screening) and treatment, is potentially huge, according to emerging evidence that a range of UK public buildings are presenting a risk of exposure. Asbestos awareness groups are pressuring the government to conduct surveys of schools, in particular, alleging evidence of significant levels of airborne asbestos contamination in some of them.
Among the arguments that the APPG would take to parliamentary debates on the R&D need is the lack of acknowledgement of the problem. The UK imported an estimated 5 million tonnes of the material before its hazardous nature was discovered, leading to a ban on its use and tight control regulations.
"World faces mesothelioma explosion"
The mesothelioma is the dense white encircling tumor mass arising from the visceral pleura. These are big bulky tumors that can fill the chest cavityPhoto: rates among former importers of asbestos, such as the UK, should ostensibly peak over the next decade, following the implementation of health and safety controls. But for the developing countries importing contaminated construction waste, the clock has only just started.
The world is facing a veritable explosion in cases, the APPG was told. In the coming decades, Asia is expected to have some 1.2 million cases of the disease, as a result of inadequately regulating the management, storage and public awareness of imported material. India alone is said to have imported 300,000 tonnes of asbestos in 2007.
But in order to ensure early detection, far greater public – and political – awareness of the dangers associated with asbestos, and hence of all possible cases of past and present exposure, is paramount.
Clinica urges UK to show leadership
The UK has a chance to become a global leader on all issues surrounding asbestos. But it must first tackle the ignorance and political inaction – the sheer dereliction of duty, Clinica believes – of policy-makers and regulators in this area, and in turn the lack of public awareness.
It may well be two years behind Australia in recognising the urgency of research into asbestos-related disease diagnosis and care – if, indeed, the aims of last week's APPG meeting prove successful. But the government of the UK, as one of the world's leading former users of asbestos, can still show just how important it is to openly assess the risk of exposure to the occupants of all sorts of public buildings and their families; and to act accordingly, in terms of immediately taking all necessary evacuation, containment and removal measures.
However daunting, disruptive and costly the necessary measures may be, the UK should tell the world just how necessary and how cost- and clinically effective they are – that there can hardly be a clearer example of preventive healthcare. But if the situation at the Palace of Westminster alone is anything to go by, there is little hope of this right now.

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