{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:44:17Z","timestamp":1787031857702,"version":"build-2736575974"},"reference-count":49,"publisher":"Ubiquity Press, Ltd.","issue":"1","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["89"],"abstract":"<jats:p>Background: Asbestos, a durable fibrous silicate once widely used for its thermal resistance, remains in use in countries like India and China despite being banned in over 70 nations and classified as a Group 1 carcinogen by IARC. Prolonged occupational exposure causes asbestosis, lung cancer, and malignant pleural mesothelioma, but in Low and Middle-Income Countries (LMICs) the true burden is underreported due to weak regulation, low awareness, limited diagnostics, and inadequate occupational health systems.\nObjectives: This review aimed to examine the epidemiological patterns and diagnostic challenges of Asbestos-Related Disease (ARDs) in emerging economies, with a focus on the applicability and limitations of existing and emerging diagnostic strategies.\nMethods: We conducted a narrative review of peer-reviewed literature, global databases (WHO, IARC), and recent cohort and cross-sectional studies, sourcing articles through structured keyword searches in PubMed, Scopus, and Google Scholar. Diagnostic approaches were compared across diverse healthcare settings, emphasizing radiological, histopathological, and functional tools. The review also assessed the utility of newer technologies, including low-dose CT (LDCT), ultra-low-dose CT (ULDCT), magnetic resonance imaging (MRI), FDG-PET is Fluorodeoxyglucose Positron Emission Tomography (FDG-PET), breath biomarkers using gas chromatography-mass spectrometry (GC-MS), and digital tomosynthesis (DTS).\nFindings: LDCT and ULDCT showed superior sensitivity for early detection of pleural abnormalities like circumscribed pleural plaques and diffuse thickening, yet distinguishing benign from malignant lesions remains difficult without biopsy. Diffusion capacity of the lungs for carbon monoxide (DLCO) emerged as a sensitive but nonspecific pulmonary function marker. Histopathological confirmation of mesothelioma remains the gold standard but is rarely accessible in low-resource settings.\nConclusion: Addressing the diagnostic gap in ARDs in LMICs requires systemic strengthening of occupational health surveillance, better regulatory enforcement, expanded access to advanced diagnostic tools, and targeted clinician training. Without urgent intervention, the burden of asbestos exposure will remain an escalating public health crisis.<\/jats:p>","DOI":"10.5334\/aogh.4871","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T13:31:16Z","timestamp":1758202276000},"page":"65","source":"Crossref","is-referenced-by-count":3,"title":["Challenges in Identifying and Diagnosing Asbestos-Related Diseases in Emerging Economies: A Global Health Perspective"],"prefix":"10.5334","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7269-7130","authenticated-orcid":false,"given":"Priyanka","family":"Roy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7051-5540","authenticated-orcid":false,"given":"Ankita","family":"Raheja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9454-3530","authenticated-orcid":false,"given":"Khushi","family":"Prajapati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1092-9668","authenticated-orcid":false,"given":"Shubhajeet","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4106-409X","authenticated-orcid":false,"given":"Mainak","family":"Bardhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur L.","family":"Frank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"issue":"4","key":"key20250918133114_r1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.aogh.2014.09.016","article-title":"The global spread of asbestos","volume":"80","year":"2014","journal-title":"Ann Glob Health"},{"key":"key20250918133114_r2","volume-title":"Asbestos Chrysotile, Amosite, Crocidolite, Tremolite, Actinolite, and Anthophyllite","author":"International Agency for Research on Cancer","year":"2012"},{"key":"key20250918133114_r3","doi-asserted-by":"crossref","first-page":"S200","DOI":"10.1016\/j.yrtph.2007.10.004","article-title":"Assessment of the pathogenic potential of asbestiform vs. nonasbestiform particulates (cleavage fragments) in vitro (cell or organ culture) models and bioassays","volume":"52","year":"2008","journal-title":"Regul Toxicol Pharmacol"},{"issue":"9654","key":"key20250918133114_r4","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1016\/S0140-6736(08)61821-8","article-title":"Asbestos\u2011related disease\u2014a preventable burden","volume":"372","author":"The Lancet","year":"2008","journal-title":"Lancet"},{"key":"key20250918133114_r5","unstructured":"Sokolove Law. Anniversary of U.S. Asbestos Ban: 35 Years Later, Americans Still Lack Protections. Accessed July 11, 2025. https:\/\/www.sokolovelaw.com\/blog\/1989-usa-asbestos-ban-lifted-1991\/."},{"issue":"1","key":"key20250918133114_r6","doi-asserted-by":"crossref","first-page":"108","DOI":"10.5334\/aogh.2575","article-title":"Prevalence of asbestos\u2011related disease among workers in Sri Lanka","volume":"85","year":"2019","journal-title":"Ann Glob Health"},{"key":"key20250918133114_r7","unstructured":"International Ban Asbestos Secretariat. Asbestos Profile: India. Accessed August 20, 2025. https:\/\/ibasecretariat.org\/prof_india.php."},{"key":"key20250918133114_r8","unstructured":"International Labour Organization. Convention C162 \u2011 Asbestos Convention, 1986 (No. 162). Accessed February 15, 2025. https:\/\/normlex.ilo.org\/dyn\/nrmlx_en\/f?p=NORMLEXPUB:12100:0::NO::P12100_INSTRUMENT_ID:312307."},{"key":"key20250918133114_r9","unstructured":"Basel Convention. The Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their. Accessed February 15, 2025. https:\/\/www.basel.int\/theconvention\/overview\/tabid\/1271\/default.aspx."},{"issue":"8","key":"key20250918133114_r10","doi-asserted-by":"crossref","first-page":"e341","DOI":"10.1016\/S2542-5196(19)30109-3","article-title":"Implementation of national policies for a total asbestos ban: A global comparison","volume":"3","year":"2019","journal-title":"Lancet Planet Health"},{"key":"key20250918133114_r11","doi-asserted-by":"crossref","first-page":"107980","DOI":"10.1016\/j.envint.2023.107980","article-title":"The prevalences and levels of occupational exposure to dusts and\/or fibres (silica, asbestos and coal): A systematic review and meta\u2011analysis from the WHO\/ILO joint estimates of the work\u2011related Burden of disease and injury","volume":"178","year":"2023","journal-title":"Environ Int"},{"issue":"2","key":"key20250918133114_r12","doi-asserted-by":"crossref","first-page":"e2037530","DOI":"10.1001\/jamanetworkopen.2020.37530","article-title":"Association of 13 occupational carcinogens in patients with cancer, individually and collectively, 1990\u20132017","volume":"4","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"7","key":"key20250918133114_r13","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1289\/ehp.1002285","article-title":"The case for a global ban on asbestos","volume":"118","year":"2010","journal-title":"Environ Health Perspect"},{"issue":"6","key":"key20250918133114_r14","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1164\/rccm.200310-1436ST","article-title":"Diagnosis and initial management of nonmalignant diseases related to asbestos","volume":"170","author":"American Thoracic Society","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"key":"key20250918133114_r15","unstructured":"World Health Organization. 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WHO Global Plan of Action on Workers\u2019 Health (2008\u20112017): Baseline for implementation: Global country survey 2008\/2009: Executive summary and survey findings. 2013. 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October 6\u20137, 2000","volume":"10","year":"2004","journal-title":"Int J Occup Environ Health"},{"key":"key20250918133114_r38","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/CPM.0b013e318235181f","article-title":"Asbestos\u2011related lung disease an update","volume":"18","year":"2011","journal-title":"Clin Pulm Med"},{"key":"key20250918133114_r39","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1046\/j.1365-2303.2000.00247.x","article-title":"The cytology of malignant mesothelioma","volume":"11","year":"2000","journal-title":"Cytopathology"},{"key":"key20250918133114_r40","first-page":"195","article-title":"Health and work: What physicians need to know","volume":"21","year":"2021","journal-title":"Clin Med (Lond)"},{"key":"key20250918133114_r41","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/0019-5278.116371","article-title":"Occupational history: A neglected component of history taking","volume":"17","year":"2013","journal-title":"Indian J Occup Environ Med"},{"key":"key20250918133114_r42","unstructured":"Supernova Rotecting Your World. Can Lung Cancer Caused by Asbestos Exposure be Misdiagnosed or Mistaken for Other Types of Lung Cancer? \u2013 Understanding the Risk and Implications. 2023. Accessed August 21, 2025. https:\/\/asbestos-surveys.org.uk\/asbestos\/the-link-between-asbestos-and-lung-cancer\/can-lung-cancer-caused-by-asbestos-exposure-be-misdiagnosed-or-mistaken-for-other-types-of-lung-cancer\/."},{"key":"key20250918133114_r43","first-page":"6083","article-title":"Silico\u2011tuberculosis amidst COVID\u201119 pandemic: Global scenario and Indian perspective","volume":"84","year":"2023","journal-title":"Ann Med Surg (Lond)"},{"issue":"4","key":"key20250918133114_r44","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.crad.2012.05.022","article-title":"Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos\u2011related pleuropulmonary disease","volume":"68","year":"2013","journal-title":"Clin Radiol"},{"issue":"53","key":"key20250918133114_r45","doi-asserted-by":"crossref","first-page":"91593","DOI":"10.18632\/oncotarget.21335","article-title":"Breath analysis by gas chromatography\u2011mass spectrometry and electronic nose to screen for pleural mesothelioma: A cross\u2011sectional case\u2011control study","volume":"8","year":"2017","journal-title":"Oncotarget"},{"key":"key20250918133114_r46","first-page":"219","article-title":"Point\u2011of\u2011care ultrasound (POCUS): Unnecessary gadgetry or evidence\u2011based medicine?","volume":"18","year":"2018","journal-title":"Clin Med (Lond)"},{"key":"key20250918133114_r47","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1177\/0748233716686916","article-title":"Chest ultrasonography in health surveillance of asbestos\u2011related lung diseases","volume":"33","year":"2017","journal-title":"Toxicol Ind Health"},{"key":"key20250918133114_r48","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s12245-008-0053-z","article-title":"Development of an ultrasound training curriculum in a limited resource international setting: Successes and challenges of ultrasound training in rural Rwanda","volume":"1","year":"2008","journal-title":"Int J Emerg Med"},{"key":"key20250918133114_r49","doi-asserted-by":"crossref","first-page":"520","DOI":"10.21037\/tlcr.2018.04.09","article-title":"Breath analysis as a diagnostic and screening tool for malignant pleural mesothelioma: A systematic review","volume":"7","year":"2018","journal-title":"Transl Lung Cancer Res"}],"container-title":["Annals of Global Health"],"original-title":[],"link":[{"URL":"https:\/\/account.annalsofglobalhealth.org\/index.php\/up-j-agh\/article\/download\/4871\/4429","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.annalsofglobalhealth.org\/index.php\/up-j-agh\/article\/download\/4871\/4431","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.annalsofglobalhealth.org\/index.php\/up-j-agh\/article\/download\/4871\/4429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T06:28:37Z","timestamp":1758263317000},"score":1,"resource":{"primary":{"URL":"https:\/\/account.annalsofglobalhealth.org\/index.php\/up-j-agh\/article\/view\/4871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,20]]}},"URL":"https:\/\/doi.org\/10.5334\/aogh.4871","relation":{},"ISSN":["2214-9996"],"issn-type":[{"value":"2214-9996","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]}}}