This x-ray shows possible signs of cancer in the left lung. / © Unsplash
It was the week before Christmas when the phone rang. Half expecting the worst, I was reluctant to answer. I did anyway, and the news was confirmed: my dad's illness was terminal.
My dad contracted mesothelioma, a form of asbestos-related lung cancer, likely resulting from his exposure to asbestos in England many decades prior. The material is a ticking time bomb; the symptoms of asbestos-related diseases often emerging 10 to 40 years after the initial exposure.
Asbestos is a group of naturally occuring fibrous minerals, which until the late twentieth century were used in building materials for insulation, roofing and fireproofing. Luxembourg progressively restricted different uses and types of asbestos, until an outright ban was implemented in 2001.
One tragedy among thousands
In the UK, despite asbestos being banned in 1999, mesothelioma (just one form of asbestos-related cancer) killed 2,544 people in 2020. That's more than die each year in road traffic accidents. My dad was one of those people, his life robbed while the country's health service was scrambling to deal with the unfolding pandemic. One tragedy lost amid thousands of others.
In Luxembourg, statistics are harder to come by. The Accident Insurance Association (AAA) publishes annual figures (pdf in French) of those who contract illnesses at work, which include victims of suspected workplace asbestos exposure. Those figures average around 100 per year in the Grand Duchy, excluding pandemic years where the total is pushed higher from workplace-related Covid cases.
Eurostat, the EU statistics agency, separately publishes summaries (pdf) of asbestos-related occupational diseases. They state that, for the period 2017-2020, around 5% of Luxembourg's reported workplace diseases were linked to asbestos or other mineral fibres. That would amount to just 4 or 5 cases a year.
This doesn't reflect the full scale of the disease. It is often difficult to determine the precise location of exposure, which likely happened many years prior. And asbestos was widely used in all kinds of buildings. Luxembourg has one of the highest concentrations of residential asbestos use in the EU. Only in Belgium and the Baltic states was the material more widely used.
Asbestos is not usually dangerous unless disturbed, such as during construction work or renovation. This means that for most people with exposure in their home, the safest thing to do is to leave it alone. Nevertheless, the World Health Organisation (WHO) estimates (pdf) that there were 45 new cases of mesothelioma in Luxembourg in 2020. The figures are likely higher than the AAA and Eurostat statistics above as they rely on modelling based on mortality rates, rather than only counting those cases where workplace exposure is identified and formally reported.
The WHO also estimates 351 new cases of lung cancer that year. The risk of all forms of lung cancer increases substantially during periods of heavy exposure to asbestos. So at least some of those cases are likely asbestos-related.
A risk into the future
The implication is clear. Despite being banned for use decades ago, the presence of asbestos in Luxembourg's buildings remains a risk into the future. Mesothelioma is a particularly deadly form of cancer, with around 5 people out of 100 surviving five years after diagnosis. For those 45 residents diagnosed with the disease in 2020, the prospects are bleak.
As asbestos gets identified through inspection processes and buildings are demolished and replaced, the risk of asbestos-related diseases will eventually decrease. However, as long as asbestos remains embedded in our structures, the threat persists. The question is, are we prepared to wait for this silent tragedy to unfold over the next several decades?
In 2022, 36 people lost their lives on Luxembourg's roads, an increase from the previous year. The rise was described as a "worrying situation" by a government spokesperson. We rightly expect action to keep our roads safe, and personally invest in purchasing safer vehicles or protection measures such a child car seat.
We should take asbestos risk just as seriously. The WHO put the number of mesothelioma deaths in Luxembourg at seven in 2020, but with survival rates as they are those numbers could climb. More public awareness would be a good start, perhaps prompted by a public information campaign. Other ideas include a nationwide map of asbestos risk, and screening of high-risk individuals.
Similar measures are already being promoted at the European level, with the EU's vision of an 'asbestos-free future'. Let's take the initiative, and aim to make Luxembourg the first EU country with zero asbestos-related deaths. Though the impact may not be immediate, starting now can save many lives in the long run. I understand the anguish that asbestos-related disease brings; it's a burden I wouldn't wish any other family to bear.