[Health hazards: asbestos--a review (author's transl)].

The health hazards caused by asbestos are reviewed and some conclusions are drawn. Asbestos and the materials containing a high percentage of asbestos cannot completely be substituted by other materials without dangerous health effects. It is to be expected that the use of asbestos will still increase. An important health hazard has become evident among asbestos insulation workers. But also in other branches the application of asbestos is widespread. It seems to be difficult to find substitutes meeting the same requirements for using like asbestos. Rock-wool and glass fibres are used more and more in exchange for asbestos. Registers for asbestos workers and asbestos working places are established in several countries. The main causes of death induced by asbestos among asbestos workers are asbestosis. mesothelioma and cancer. For the evaluation and assessment of cancer risk due to asbestos epidemiological studies have to be conducted. Even a short period of exposure to low quantities of asbestos fibres proves to be a health hazard causing certain diseases (diffuse pulmonary fibrosis, pleural hyalinosis, pleural calcifications, mesothelioma) after more than 20 years. For avoiding occupational disease hazards among asbestos workers the dust level on the working place has to be lowered to acceptable concentrations (maximal allowable concentrations). The identification of dust sources of asbestos, the application of practice codes for handling of asbestos, the substitution of asbestos by materials without dangerous health effects, and dust control at source are the most effective directions of hygienic practice. The health protection requires annual medical examinations of all persons exposed to airborne concentrations of asbestos.