Surveillance of Non-Malignant Asbestos-Related Diseases in an Exposed Population: A Scoping Review

Abstract

Background: Asbestos remains a significant global public health issue, with approximately 255,000 deaths attributed to exposure each year, primarily through occupational contact. Mesothelioma rates continue to rise, particularly in areas with a history of industrial exposure. Despite this burden, many countries lack reliable surveillance systems. Colombia has clusters like the one observed in Sibaté, highlighting the urgency of establishing structured, evidence-based surveillance systems. Objective: The aim is to synthesize international experiences to guide the design and implementation of surveillance strategies in Colombia and other low- and middle-income countries facing similar challenges. Methods: Following the JBI methodology for scoping reviews, comprehensive searches were conducted in Medline (PubMed), Embase, the Cochrane Library (OVID), and Google Scholar. Only English-language articles were included, and no time restrictions were applied. Results: Fourteen studies from 11 countries were included, with the majority coming from Italy, followed by Colombia and Brazil. Three main themes emerged: (1) numerous cohort studies reported increased risks of mesothelioma and lung cancer among asbestos-exposed workers, supporting the need for long-term follow-up; (2) structured surveillance systems-such as Italy's ReNaM and Brazil's Datamianto-demonstrated effective models combining data integration, regular medical evaluations, and policy enforcement; (3) considerable variability in surveillance design, target populations, and reporting standards, especially between high-income and resource-limited settings, highlighting the lack of global standardization. Conclusions: Structured, context-specific surveillance programs are essential to identify and manage the health burden of asbestos exposure. International models offer practical frameworks that could be adapted to Colombia's needs. Investing in such systems would strengthen public health responses, improve early detection of asbestos-related diseases (ARDs), and support environmental and occupational justice in affected communities. The included studies do not mention monitoring according to the degree of exposure.

Keywords: epidemiological monitoring; occupational health; public health surveillance; registry systems; toxic exposure.

Figure 1

Deaths from occupational asbestos exposure, global and countries of interest, from 1990-2021 for both sexes and all ages IHME [3].

Figure 2

Worldwide distribution of analyzed articles. *The number of countries differs because one article was conducted across three countries. [Table: see text]