Asbestos-related deaths

Over many thousands of years, millions of individuals have been exposed to asbestos. Deaths relating to asbestos continue to be a major problem in developed and developing countries and are due to three diseases, namely malignant mesothelioma, lung cancer and asbestosis. Medico-legal (personal injury) compensation claims due to asbestos represent the most common industrial disease. However, only a small proportion of persons exposed to asbestos develop asbestos-related disease. It should be realized that almost everyone is exposed to environmental background asbestos and asbestos can usually be identified in the lungs of most persons at post-mortem examination by special analytical techniques (mineral analysis).This paper provides an overview for the pathologist of issues related to asbestos-related deaths. Basic mineralogical considerations and exposure patterns are detailed. The spectrum of asbestos-related conditions are described together with their common mimics. The review addresses issues relating to the handling of the ‘industrial’ autopsy examination and provides guidelines for the attribution of asbestos-induced disease, including application of mineral analysis.