Headlines

Asbestos: Monitoring Remains NecessaryThe latest weekly epidemiological bulletin from the French Institute for Public Health Surveillance is devoted to asbestos.The editorial notes that, in addition to the long-known asbestos-related diseases (pulmonary fibrosis or asbestosis, pleural fibrosis, bronchopulmonary cancers, and mesotheliomas of various sites), new cancer sites (larynx and ovary) were identified in the latest assessment by the International Agency for Research on Cancer (IARC). The role of asbestos in the development of various digestive cancers remains a subject of debate. Methods for population-based surveillance regarding the risk of bronchopulmonary cancer are discussed, given that the benefit of screening via chest computed tomography (CT) has been demonstrated in the National Lung Screening Trial (NLST) in the United States among smoking populations.In the articles, a study based on recent epidemiological data and matrices developed as part of the Matgéné program has updated estimates of attributable risk. The burden of asbestos-related occupational cancers remains significant, with between 2,200 and 5,400 cases per year in France, primarily affecting men. The National Mesothelioma Surveillance Program (PNSM), which covers 21 departments and 30% of the French population, shows an increase in incidence among men in 2009–2011 compared to 1998–2000, suggesting that the peak incidence has not yet been reached in men. The increase in mesothelioma among women underscores the importance of documenting female cases for which no asbestos exposure has been identified (35.2% versus 12.7% among men). Mandatory reporting of mesothelioma was instituted to conduct these etiological investigations. In 2012, 46% of mesothelioma cases were reported in France, with significant regional disparities. Exposure among tradespeople is high (64% of retired tradespeople), particularly in the construction sector, as many asbestos-containing materials remain in place. The medical-social compensation system is very likely underutilized for both bronchopulmonary cancer and pleural mesothelioma (60% of occupational disease claims among those affected), as is the Asbestos Victims Compensation Fund (FIVA) established under the National Asbestos Management Plan (PNSM) (58% of claims among eligible beneficiaries).The issue of "asbestos" remains more relevant than ever in France.