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Why does the HSE continue to misrepresent the risks of asbestos?

By Charles Pickles, Founder of the Airtight on Asbestos campaign.

Asbestos is the UK’s number one occupational killer. Thousands of people continue to die every year from asbestos related diseases including mesothelioma, a cancer for which there is no cure. Despite its ban in 1999 asbestos remain present in many buildings across the UK including hospitals and schools. Worryingly, there is growing evidence that many nurses, teachers, and former pupils are dying from exposure to asbestos in buildings riddled with asbestos.

A new report by the charity Mesothelioma UK, finds that there are substantial benefits to both public health and public finances to be realised by removing asbestos from schools and hospitals. It shows that a 10-year removal programme would benefit the UK economy to the tune of around £11.6 billion and benefit the Exchequer by around £3.6 billion.[1]

These savings were calculated using a number of assumptions, one of which concerns the death rates relating to asbestos. The HSE science division estimates the ratio of mesothelioma deaths to other asbestos related deaths as 1 to 8.[2] So for every death resulting from mesothelioma we can assume a further eight deaths from other lung cancers and asbestos related disease. It is on this basis that the costs and benefits of removing asbestos from buildings have been assessed.

However, despite their own evidence, the HSE continues to underreport deaths resulting from asbestos. Official figures show that in 2021 there were a total of 4,536 asbestos related deaths, of which 2,268 reported deaths were from mesothelioma.[3] This is a ratio of 1 to 1.

The real number of deaths, according to the HSE’s research, should be 20,412 per annum. So why does the HSE continue to misrepresent these figures to government? The effect of which is to diminish the scale of the asbestos epidemic by a statistical slight of hand.

The HSE, and government, is relying on the fact that statistical arguments are too complicated for most people to get their heads around and too dull for the media to take notice. It’s an effective strategy. But anyone prepared to look into this will find a number of devices designed to suppress the numbers.

Official figures, compiled by the ONS for the HSE, do not include all those who died over the age of 75 which if included would more than double the number of asbestos related deaths, since more than half of all sufferers die over the age of 75. It is also worth noting that due to the Covid pandemic, death records for mesothelioma and other asbestos related disease will be suppressed during this period.

When it comes to analysing deaths by former occupation the HSE use a ‘deeply flawed’ index of relative risk where the calculation of expected deaths for all occupations is influenced by the number of deaths that occurred in heavily exposed occupations, such as construction.[4] This overlooks the fact that the proportion of deaths among female nurses and teachers is significantly higher than would be expected in the general female population.

Another related issue is the assessment of risk which the HSE deploys for different types of asbestos. The risk of developing a disease by exposure to amosite (a brown asbestos) is ranked twice as high as other forms of asbestos by the HSE, when the risks are known to be 100 times greater. This grossly underrepresents the dangers of amosite and justifies a more relaxed regulatory regime for the general management of asbestos in buildings. 

The current method of reporting deaths, as well as the risk of death from exposure to asbestos, needs urgent reform so that we can begin to establish a true and accurate record. This is essential not only in framing the terms of the debate about the dangers of asbestos but in designing policies and regulations that can effectively eliminate the risks. One of the assumed reasons for the government’s reluctance to engage in this debate is the potential costs of a removal programme. By using accurate figures, it is clear that there are significant benefits to the state in removing asbestos from buildings.

[1] Clearing The Air: The costs and benefits of removing asbestos from UK schools and hospitals, Mesothelioma UK, 2023

[2] Darnton L. Quantitative assessment of mesothelioma and lung cancer risk based on Phase Contrast Microscopy (PCM) estimates of fibre exposure: an update of 2000 asbestos cohort data. Environ Res. 2023 Aug 1;230:114753. doi: 10.1016/j.envres.2022.114753. Epub 2023 Mar 23. PMID: 36965802.

[4] See Robin Howie’s evidence to the Work and Pensions select committee inquiry about the management of asbestos


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