National use of asbestos in relation to economic development.

BACKGROUND

National disparities in asbestos use will likely lead to an unequal burden of asbestos diseases.

OBJECTIVES

As economic status may be linked to asbestos use, we assessed, globally, the relationship between indicators of national economic development and asbestos use.

METHODS

For the 135 countries that have ever used asbestos, per capita asbestos use (kilograms per capita per year) was compared with per capita gross domestic product (GDP) in 1990 Geary-Khamis dollars (GKD) for the period 1920-2003. Countries were grouped into three income levels (high, middle, and low) that were adapted from the 2003 World Bank categories.

RESULTS

The historical pattern of asbestos use followed the environmental Kuznets curve in which use by high-income countries peaked when incomes attained 10,000-15,000 GKD and essentially ceased at income levels over 20,000 GKD. Currently, middle- and low-income countries are increasing their use of asbestos, closely following the paths once traced by higher income countries.

CONCLUSIONS

Developing countries have the opportunity to eliminate asbestos use sooner than high-income countries and thus reduce the future burden of asbestos diseases.