{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:07:50Z","timestamp":1779127670958,"version":"3.51.4"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Asbestos exposure remains a persistent occupational hazard in China, yet updated national estimates of asbestos-related diseases (ARDs) after 2019 are scarce. This study quantified long-term trends and demographic patterns of ARDs from 1990 to 2023 using Global Burden of Disease data and joinpoint regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for asbestosis and asbestos-attributable cancers (mesothelioma, tracheal\/bronchus\/lung cancer, laryngeal cancer, and ovarian cancer). Absolute numbers and age-standardized rates were assessed overall and stratified by sex and age. joinpoint regression identified significant temporal inflection points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The absolute burden of ARDs increased continuously from 1990 to 2023. Age-standardized prevalence and incidence rates of asbestosis peaked in 2001, while mortality and DALY rates peaked in 2004. Major turning points for asbestos-attributable cancers occurred around 2010\u20132011, marking historical peaks followed by declines. A modeled increase in mortality and DALYs was observed from 2020 to 2022 across nearly all ARDs. Males consistently demonstrated higher burdens than females, and older adults (\u226565 years) carried the greatest burden, with a secondary mesothelioma peak at 55\u201359 years in males.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although ARD indicators have declined from historical peaks, a statistically modeled increase was observed in 2020\u20132022, warranting continued public-health attention. These findings aim to provide evidence for clinicians, epidemiologists, and policymakers to strengthen occupational disease prevention, reinforce labor protection laws, and improve asbestos-control policies in China.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0349392","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:26:46Z","timestamp":1779125206000},"page":"e0349392","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disease burden of asbestos-related diseases in China (1990\u20132023) based on GBD estimates: A call for stronger labor protection laws"],"prefix":"10.1371","volume":"21","author":[{"given":"Duo","family":"An","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zherui","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1538-2453","authenticated-orcid":true,"given":"Chenxiao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shichang","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7642-7316","authenticated-orcid":true,"given":"Hanchao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"2","key":"pone.0349392.ref001","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1177\/10482911221084382","article-title":"Explaining the Invisibility of Asbestos-Related Diseases in the Taiwan Workers\u2019 Compensation System","volume":"32","author":"Y Cheng","year":"2022","journal-title":"New Solut"},{"issue":"9","key":"pone.0349392.ref002","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1002\/ajim.23629","article-title":"Asbestos exposure and asbestosis mortality in Italian cement-asbestos cohorts: Dose-response relationship and the role of competing death causes","volume":"67","author":"P Girardi","year":"2024","journal-title":"Am J Ind Med"},{"issue":"35","key":"pone.0349392.ref003","article-title":"Occupational burden of asbestos-related diseases in Korea, 1998-2013: asbestosis, mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer","volume":"33","author":"DM Kang","year":"2018","journal-title":"J Korean Med Sci"},{"issue":"1","key":"pone.0349392.ref004","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1186\/s12889-022-14437-6","article-title":"A comparative study of the disease burden attributable to asbestos in Brazil, China, Kazakhstan, and Russia between 1990 and 2019","volume":"22","author":"J Chen","year":"2022","journal-title":"BMC Public Health"},{"key":"pone.0349392.ref005","doi-asserted-by":"crossref","first-page":"108534","DOI":"10.1016\/j.lungcan.2025.108534","article-title":"The global burden of mesothelioma and its association with asbestos bans, 1990-2021: a population-based study","volume":"203","author":"W Jin","year":"2025","journal-title":"Lung Cancer"},{"issue":"5","key":"pone.0349392.ref006","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/s00432-024-05802-6","article-title":"Global burden of mesothelioma attributable to occupational asbestos exposure in 204 countries and territories: 1990-2019","volume":"150","author":"Z Chen","year":"2024","journal-title":"J Cancer Res Clin Oncol"},{"issue":"18","key":"pone.0349392.ref007","doi-asserted-by":"crossref","first-page":"305","DOI":"10.46234\/ccdcw2020.078","article-title":"Distribution of Asbestos Enterprises and Asbestosis Cases \u2014 China, 1997\u22122019","volume":"2","author":"M Chen","year":"2020","journal-title":"China CDC Weekly"},{"issue":"8","key":"pone.0349392.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0330878","article-title":"Burden of laryngeal cancer attributable to occupational asbestos exposure in China: A comprehensive analysis from 1990 to 2021","volume":"20","author":"B Chen","year":"2025","journal-title":"PLoS One"},{"key":"pone.0349392.ref009","doi-asserted-by":"crossref","first-page":"1136596","DOI":"10.3389\/fpubh.2023.1136596","article-title":"Burden of ovarian cancer in China from 1990 to 2030: A systematic analysis and comparison with the global level","volume":"11","author":"Y Wang","year":"2023","journal-title":"Front Public Health"},{"issue":"16","key":"pone.0349392.ref010","doi-asserted-by":"crossref","first-page":"3883","DOI":"10.3390\/cancers14163883","article-title":"Burden of Lung Cancer Attributable to Occupational Carcinogens from 1990 to 2019 and Projections until 2044 in China","volume":"14","author":"Y Fan","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"6","key":"pone.0349392.ref011","first-page":"417","article-title":"Analysis of the disease burden of pneumoconiosis globally and in China from 1990 to 2019","volume":"41","author":"X Chen","year":"2023","journal-title":"Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi"},{"issue":"10258","key":"pone.0349392.ref012","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"CJL Murray","year":"2020","journal-title":"The 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International programme on chemical safety, asbestos. 2025. 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