Abstract A21: Environmental exposure to asbestos and mesothelioma in Colombia: A scoping review

Although over 60 countries have banned asbestos worldwide, in Colombia, asbestos-containing products are still imported, chrysotile mining occurs, and industrial plants using asbestos are still active. Indeed, Colombia ranks among the top ten producers of asbestos worldwide (La Dou et al., 2010) and among the top four consumer countries in Latin America (Marsili et al., 2014, 2016). Occupational exposure to chrysotile in brake repair shops in Bogota has been documented (Cely-Garcia et al., 2012, 2016), with reports of pleural calcifications and plaques in some workers (Cely-Garcia et al., 2015), but without alterations in pulmonary function tests. Environmental exposures in communities living close to asbestos plants and mines are yet to be addressed. This scoping review of the scientific and grey literature assesses the importance of asbestos and mesothelioma in the Colombian population in the context of a permissive legislation. Our hypothesis is that, although occupational asbestos exposures occur, environmental exposures may be increasing the incidence of asbestosis and mesothelioma in the general population. According to IARC estimates, in Colombia, 88 new cases of mesothelioma were diagnosed in 2018, representing 0.1% of the total number of new cancer cases, with 72 deaths caused by this malignancy, representing 0.17% of mortality due to cancer (GLOBOCAN, 2018). Mesothelioma is more common in men with a 1.8 men:women ratio (Atlas de Mortalidad por Cancer en Colombia, 2014). However, no studies have systematically addressed the incidence of this cancer in occupational settings and in the general population. Under-reporting of the diagnosis of mesothelioma in Colombian cancer registries is possible. This is particularly important, as there are increasing clinical and community reports of nonoccupational mesothelioma cases in specific Colombian communities (Galeano, 2019). This scoping review is timely as asbestos legislation in Colombia is still evolving. To protect workers, in 1998 the Colombian Congress ratified the 1986 International Labor Organization’s agreement to prevent and control health risks due to occupational exposures to asbestos (Law 436 of 1998). The Colombian Ministries of Labor and Health followed up with legislative actions between 2001 and 2011. In contrast, to protect citizens, in 2007 the Colombian Congress considered a proposed law to ban the import, manufacturing, distribution, sale, and use of asbestos, legislation yet to be approved. However, in March 2019, in response to a lawsuit, a judge ordered the Colombian Ministries of Health and Work to create legislation to substitute asbestos nationwide by 2024. We conclude that, in Colombia, there is a lack of studies assessing asbestos exposures in workers and the general population, and that, in light of a continuous commercial use of asbestos, research on health effects, including mesothelioma incidence and prevention, is needed. Citation Format: Otto H. Sanchez, Marcela E. Varona, Ana I. Gomez, Leonardo Briceno, Angela F. Espinosa. Environmental exposure to asbestos and mesothelioma in Colombia: A scoping review [abstract]. In: Proceedings of the AACR Special Conference on Environmental Carcinogenesis: Potential Pathway to Cancer Prevention; 2019 Jun 22-24; Charlotte, NC. Philadelphia (PA): AACR; Can Prev Res 2020;13(7 Suppl): Abstract nr A21.