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Health Check: 'The story of asbestos shows that it isn't easy to raise awareness of a threat without causing a panic'

Jeremy Laurance
Monday 23 June 2003 00:00 BST
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Every trade succumbs to a bout of navel-gazing from time to time and now it happens to be the turn of my own. There has been an outbreak of articles and opinion pieces on the state of health reporting. The Lancet carries a critical editorial this week and the British Medical Journal has run a series of pieces that have, in the nicest possible way, put the boot in.

The highly-regarded Cardiff University School of Journalism published a survey last month claiming that the public had been "duped" by biased media reporting on the MMR vaccine. Meanwhile the Kings Fund, the health policy think tank, has a survey awaiting publication which is unlikely to offer bouquets.

So what's the problem? A key one is the "scare" story. Scare stories sell papers - MMR, BSE, Sars - editors love them and public health specialists loathe them. Scare stories exaggerate, it is said, they terrify, they never put risks in proper perspective, and are irresponsible.

I was reminded of that charge while attending a sad little press conference on a now little-known cancer called mesothelioma last week. Sad because the number of experts on the platform - five - outnumbered the reporters in the audience - three, including myself.

How a mighty story is fallen, I thought. Mesothelioma, a cancer of the lining of the lung, is caused by asbestos, and 25 years ago asbestos was the mother of all health scares. Press conferences were packed and the substance was being ripped out of buildings everywhere. So great was the panic that schools were closed and office blocks immediately evacuated when even a small patch of the crumbling material was discovered.

It was pretty obvious then and, with the benefit of 20 years of hindsight, it is even clearer now that the panic was overdone. In some cases, perhaps many, ripping out the asbestos caused more harm, by releasing lethal fibres into the air, than leaving it safely sealed in place. Here then was a classic example of a health scare got up by the press that incurred huge economic and social costs.

Yet the death rate would be far worse today but for the, by some accounts, "hysterical over-reaction" 20 years ago.

Nevertheless, in the years since then, tens of thousands of people have died because of this man-made product. More important, people are dying today in ever greater numbers than before. The disease takes 20 to 50 years to kill, claims around 1,700 lives a year and the death rate is expected to continue rising for the next 10 years, peaking at around 2,000 deaths every year.

Professor Julian Peto, an expert on the health impact of asbestos, told the CancerBacup press conference last week that he felt split on the issue. "The hysteria of the 1980s was really rather silly. But at the same time it is a horrendous epidemic. When you have to raise awareness you need a campaign and it is questionable whether the building workers at greatest risk would have been made aware without it."

So the story of asbestos shows it isn't easy to raise awareness of a threat without causing panic. But it reminds us of something else too. In another decade the death rate from mesothelioma will be almost twice that from cervical cancer. If instead of striking older, working class men, as the disease does, it struck young women, then last week's press conference would have been packed to the rafters.

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