Asbestos and health

In the European Union asbestos is classified as a Category 1A carcinogen, and it accounts for up to 78% of the occupational cancer cases recognised in the Member States.^[1] The diseases appear decades later, so they also affect people who worked with asbestos long ago.

According to the WHO, occupational exposure to asbestos causes more than 200,000 deaths worldwide every year, accounting for over 70% of all work-related cancer deaths. The most effective way to prevent these diseases is to stop using all types of asbestos.^[2]

How asbestos enters the body

The body can neither break down nor clear long fibres: immune cells (macrophages) cannot fully “eat”, or phagocytose, them. The damage is caused both by the fibre’s mechanical action (tissue irritation, scarring, abnormal cells) and by chemical effects and changes in immunity.^[3] Long, thin fibres are considered the most dangerous: longer than 5 µm, thinner than 3 µm and with a length-to-width ratio greater than 3:1.^[3][5]

Is there a safe dose?

No. The EU directive states that asbestos is carcinogenic at any dose and that it is scientifically impossible to set a threshold below which it would not affect health.^[1] The occupational exposure limit set for workplaces is not a “safe level”. It is a compromise between risk and technical feasibility.^[1] The risk increases with the duration and intensity of exposure.^[5]

Under the EU CLP Regulation, asbestos carries the hazard statements H350 (may cause cancer) and H372 (causes damage to organs through prolonged or repeated exposure).^[5]

Diseases

Why diseases appear years later

The time from exposure to the first signs of disease is called the latency period. For asbestos-related diseases it is usually 10 to 40 years or more.^[5][7]

Sources: asbestosis^[6], pleural plaques and mesothelioma^[5], lung cancer^[7].

That is why the fact that “nothing happened” after breaking up slate proves nothing.

Asbestos and smoking

A person who has worked with asbestos and smokes has a risk of lung cancer 9–10 times higher than a non-smoking colleague.^[3] The effects of the two factors multiply.^[7] Smoking does not affect mesothelioma.^[3] Latvian regulations also require workers to be told about the heightened effect of asbestos on smokers.^[10]

The situation in Latvia

The real number is probably considerably higher. If a patient had been exposed to several kinds of dust, such as cement and asbestos, as at the Brocēni slate works, they were registered under the general diagnosis of “pneumoconiosis”, without asbestosis being specified.^[3]

The incidence of mesothelioma in Latvia is comparatively low, similar to that in other countries without asbestos mines. However, cases are difficult to link to exposure, because as recently as 2015 they were practically never linked to occupation (a few have been confirmed only after death).^[3]

Asbestosis, mesothelioma, lung cancer and pleural diseases have been on Latvia’s list of occupational diseases since 2006, while laryngeal cancer has been recognised since the 1990s.^[5] Yet the rate of recognised asbestosis in Latvia was only 0.3, compared with 2.1 in Poland and 14.9 in Slovenia.^[5] This points to under-diagnosis rather than a lower incidence. In 2024, too, specialists noted that the diagnosis of asbestos-related diseases and their attribution to working conditions in Latvia effectively do not work.^[11]

Health checks

The employer must provide mandatory health checks for everyone who is exposed to asbestos at work.^[10] Under Cabinet Regulation No. 219 “Procedures for Mandatory Health Examinations”:^[12][3]

• Frequency: once a year, because asbestos is a carcinogen.
• Specialists: an occupational physician and an ENT specialist (otolaryngologist).
• Tests: full blood count, lung function (spirometry) and a chest X-ray.
• Specialists recommend continuing surveillance after exposure has ended, as the latency period can be 30–40 years.^[3][8]

The employer keeps records and examination results for 40 years after exposure has ended.^[10] Chest X-rays and CT scans can reveal early changes, but they do not show recent exposure, and the fibres themselves are not visible on the images.^[3]

What to do after exposure

• Do not panic. The risk increases with the duration and intensity of exposure, so after a single brief exposure it is small, but not zero.^[5][8]
• Tell your GP about the exposure: when, for how long and during what work. Medical surveillance includes a review of your work and medical history, lung function tests and a chest X-ray.^[3]
• If you smoke or have smoked, ask your doctor about lung screening with low-dose computed tomography (CT). International experts recommend it for people with asbestos exposure and a smoking history.^[8]
• Stop the exposure: from now on, work wet and with a P3 respirator, or leave the job to specialists.^[13]
• Stop smoking. Combined with asbestos, it increases the risk of lung cancer 9–10 times.^[3]
• See a doctor if you have a persistent cough, increasing breathlessness, chest pain or unexplained weight loss.^[3]

This page is for educational purposes and is no substitute for medical advice.