Asbestosis and Asbestos-Related Lung Cancers in India: An Urgent Call for National Policy Reform

Dear Editor, Asbestosis, caused by prolonged inhalation of asbestos fibers, persists as a significant occupational and environmental health hazard in India. With its long latency period and fatal progression, asbestos exposure remains a silent cause of morbidity and mortality. The World Health Organization has categorically classified all forms of asbestos, including chrysotile, as carcinogenic with no safe level of exposure, urging countries worldwide to institute a complete ban.[1] Despite this, India continues to import and use chrysotile asbestos, most commonly in construction and industrial applications. The justification citing controlled “wet process” technology and occupational safety measures fails to account for real-world exposure scenarios, especially in informal sectors where occupational safeguards are grossly inadequate.[2,3] Additionally, demolition activities and environmental dispersal of asbestos fibers heighten the risks for both workers and surrounding communities.[4] The Mines Act (1952) recognized asbestos-related diseases as notifiable due to their cancer-causing potential.[5] Indian physician-led studies by 2005 confirmed the carcinogenicity of all asbestos types, establishing the absence of a safe threshold of exposure.[2,4] However, conflicting narratives, including those from the Indian Council of Medical Research, persist, citing insufficient longitudinal epidemiological data.[3] Such restrictive interpretations overlook the prolonged latency of disease manifestation, inadequate protective measures, and the chronic underestimation of exposures in informal industries. Moreover, independent investigations by the Central Pollution Control Board have highlighted associations between asbestos exposure and a spectrum of lung cancers in Indian workers, reinforcing the urgent need for decisive policy reform.[2,5] Kerala’s bold move in 2009 banning asbestos roofing products serves as an example at the state level, but absence of a nationwide prohibition undermines broader public health protection.[1,4] The continued use of asbestos represents a major policy gap in India’s occupational and environmental health agenda, with economic interests often overshadowing health priorities. Considering the irreversible and preventable consequences of asbestos-related diseases, a comprehensive nationwide policy is imperative, including an outright ban on asbestos use, stricter enforcement of occupational protection standards, and environmental decontamination of contaminated sites. Table 1 highlights the key problems, preventive measures, and future directions for asbestos-related health challenges in India.Table 1: Key problems, preventive measures, and future directions for asbestos-related health challenges in IndiaDelay in implementing such reforms risks perpetuating avoidable morbidity and mortality in India’s large at-risk populations. Asbestos stands as a persistent and controllable public health threat, and urgent government action is warranted to end this silent epidemic. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.