The World Health Organization (WHO) has repeatedly called on countries to eliminate asbestos-related diseases (ARDs).1 This goal, from the standpoint of public health and prevention, requires a good estimation of the burden of ARDs which is unfortunately hampered: developing countries lack any meaningful data and developed countries lack data on non-mesothelioma ARDs, e.g., asbestos-related lung cancer and asbestosis. Importantly, many developing countries continue to use asbestos against a background of poor awareness and minimal expertise. Developing countries thus miss a current ‘hidden’ burden and/or are bound to face a substantial ‘future’ burden of ARDs.
The WHO righteously emphasizes that the best way to eliminate ARDs is for countries to stop using asbestos.1 In developing countries, however, economic arguments far outweigh those of public health. In 2015, asbestos was mined in five countries, while in 2014 at least 30 countries imported raw asbestos,2 and presumably a much larger number of countries consumed asbestos-containing products. Hence, although more than 60 countries including Australia have banned all or partial use of asbestos,3 the majority of the world’s population currently live in countries with ongoing asbestos consumption.4
With an aim to assess ARD research directions and possible gaps between global needs, we conducted a bibliometric analysis of all scientific literature since 1991 with ARD-related articles as a subset.5 When the three research areas of clinical, laboratory and public health were compared, ARD research showed strong gravitation towards the clinical area and away from the public health area. While such a trend reflected the general ARD situation in developed countries, each developed country placed variable emphasis on the respective research areas. It is therefore possible that the actual and/or perceived research needs for ARDs differ across countries, including their stance towards the global ARD situation.