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Asbestos exposure: challenges for Australian clinicians

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The unique properties of asbestos that still make it valuable for industry make it extremely hazardous to health

Due to the extensive past use of asbestos in Australia, known exposure is common and causes anxiety, especially because of the acknowledged increased risk of thoracic malignancies. With the increasing use of computed tomography for routine diagnostic purposes, more people are being identified with pleural plaques from minor asbestos exposure. This has led to increased concerns about the risks of more serious asbestos-related diseases (ARDs) developing, and has resulted in an increased number of diagnostic tests being performed, even though the presence of pleural plaques is not as such a risk factor for (pleural) malignant mesothelioma (MM) or bronchogenic cancer.1 Nevertheless, anxiety2 and the inability to reduce MM risk following exposure3 or to halt progression of established asbestosis result in significant health care problems and expenditure.

Although overall rates of MM in Australia have levelled off at around 50 per million per annum in men and tenfold less in women,4 the pattern of exposure of patients with MM is changing.5 Three waves of disease have been described: disease resulting from exposure to asbestos in the mining and milling of ore…