Why some, but not all, countries have banned asbestos

Introduction
This study tried to explain why some countries have banned asbestos while others have not. We hypothesized that increased social cost of mesothelioma, capacity of health-related infrastructures, and policy diffusion from adjacent countries were related to asbestos ban policy adoption process

Methods
Mesothelioma death rate was calculated using WHO mortality database. Rankings in overall health system attainment and occupational health and safety infrastructure, as a surrogate for capacity of health-related infrastructures, were obtained from World Health Report,1997 and World Social Security Report, 2010.

Results
The average mesothelioma death rate was significantly higher for countries with asbestos ban than with no-ban (4.59 vs 1.83 / million). No-ban countries were positioned in lower ranks of health-related infrastructures. Among European countries, there was a tendency that asbestos ban policy was diffused.

Discussion
Increased social cost of mesothelioma could be a trigger to recognize the necessity of asbestos ban policy. Country’s capacity of health-related infrastructures may enable to demand from the victims' side. Asbestos ban policy from adjacent countries might facilitate alternative solutions.