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The fact that workers from a US shipyard are experiencing an excess of diffuse malignant mesothelioma of the pleura and peritoneum from their exposure to asbestos in the years 1950–64, as reported by Krstev and colleagues in this issue (see page 651),1 is at first glance not surprising. In their cause-of-death follow-up study of 4700 men and women who built and maintained seagoing vessels, they observed excess deaths from diffuse malignant mesothelioma and respiratory cancer, which they attribute to asbestos fibres at the shipyard.
Asbestos originates underground as a fibrous crystalline mineral, is mined and then crushed in mills into a powder of very thin and durable fibres. During the 20th century it was transported worldwide to industrial shipyards and factories for use as a heat insulator, fireproof material, and in a multitude of other economically useful applications. It is ironic, given its adverse health effects, that asbestos was often used to protect lives. For example, many theatres in the US prominently labelled …
Competing interests: The author has testified for asbestos-exposed patients in worker compensation hearings and served as an expert witness for patient plaintiffs in lawsuits against asbestos manufacturers.