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Malignant mesothelioma in females: the institutional failure by WHO and IARC to protect the public health

Malignant mesothelioma in females
A Commentary, published in The Journal of Scientific Practice and Integrity (JoSPI) on August 11,
2023, calls to task both the World Health Organization (WHO) and the International Agency for
Research on Cancer (IARC). It shines a light on their failure to recognize and correct the
misrepresentation of malignant mesothelioma (MM) risk in females exposed to asbestos in Chapters
2 of the Fourth and Fifth Editions of the Blue Book series published in 2015 and 2021, respectively.
The title of the Commentary is “Malignant mesothelioma in females: the institutional failure by
WHO and IARC to protect the public health.” The authors are Xaver Baur, Arthur L. Frank, Corrado
Magnani, L. Christine Oliver, and Colin L. Soskolne. The article is accessible at the following link: A PDF copy is also attached for ease of access.
The inaccurate statements about the proportion of malignant mesotheliomas attributable to
asbestos in females are as follows: “only about 20%” in North America and France and “<50%” in
western Europe and Australia (Fourth Edition); and “only 20-40%” in the USA and France (Fifth
Edition). That these figures misrepresent the science was shown in a previously published
Commentary by the authors of this more recent Commentary (Bauer X et al. Am J Ind Med. 2021) at
Males and females are at close-to-equal risk for malignant mesothelioma following exposure to
asbestos. What is different is the way in which the exposure had occurred. For males, it is more likely
to have been occupational. For females, asbestos exposure is more likely to have occurred through
household contact or environmental exposures. Carefully detailed exposure histories are needed to
ferret out a history of asbestos exposure and to place physicians and patients on notice about
associated risk for the occurrence of malignant mesothelioma, an aggressive highly fatal and often
misdiagnosed (early on) tumour. Ironically, the Blue Book series has pulmonary physicians,
oncologists, thoracic radiologists, epidemiologists, and cancer registrars as an important audience.
The authors of the most recent Commentary attempted to correct the record by communicating
directly with the authors of the two Chapters as well as the editors of the Fourth and Fifth Editions
of the WHO Classification of Tumours. A corrigendum was requested. In the absence of an
acceptable response, we approached the IARC Editorial Board. Failing to achieve a satisfactory
outcome, we bring our failed attempts and the potential consequences to public attention.
In our efforts to correct the inaccuracies, we discovered what can be described only as gender bias in
the attribution of malignant mesothelioma in females. Identified as a likely contributing factor were
undisclosed conflicting interests. The victims here are at-risk females, their families, and the public
writ large.
Protecting the public’s health, preventing disease, and promoting well-being in a social justice
context must be the unambiguous goal of education and research in occupational and
environmental health. Even our most august institutions should be open to correction.
DIRECT ANY QUESTIONS TO THE SENIOR AUTHOR, Xaver Baur, at: mailto:This email address is being protected from spambots. You need JavaScript enabled to view it.

Collegium Ramazzini statement on Russia's war on Ukraine   

Collegium Ramazzini Statement on Russia’s War on Ukraine
The Collegium Ramazzini is an international scientific society that examines critical issues in
occupational and environmental medicine with a view towards action to prevent disease and
promote health. The Collegium derives its name from Bernardino Ramazzini, the father of
occupational medicine, a professor of medicine of the Universities of Modena and Padua in the
late 1600s and the early 1700s. The Collegium is comprised of 180 physicians and scientists
from 35 countries, each of whom is elected to membership. The Collegium is independent of
commercial interests.
The Collegium Ramazzini joins its scientific colleagues around the world in condemning
Russia’s war of aggression against Ukraine. The Russian invasion is a violation of Article 2 of
the UN Charter, which states that “all States have the obligation to refrain in their international
relations from the threat or use of force against the territorial integrity or political independence
of any State.” Russia’s invasion has resulted in more than 100,000 military and an untold number
of civilian deaths and injuries, and displaced over 12 million people. Attacks on civilian
populations have destroyed more than 100,000 private homes, 15,000 apartment buildings, 1,118
schools, and 978 medical facilities. In addition, 27% of Ukraine is contaminated with landmines
and unexploded ordnance, which will continue to pose hazards for decades.
As public health humanitarians, we condemn Russia’s acts of terror against civilians. In
addition to Russia’s killing and injuring civilians with indiscriminate weapons and targeted
attacks, we condemn the deliberate targeting of civilian energy and water infrastructure,
destruction of schools and health-care facilities, use of sexual violence as a weapon, deportation
of children, and atrocities committed against civilians in Bucha, Izium and elsewhere. We
condemn the attempts to destroy Ukraine’s cultural heritage by destroying churches and
museums and looting Ukrainian art and cultural artifacts.
As scientists investigating the interface of environmental pollution and human health, we
condemn Russia for its devastating damage to Ukraine’s environment, including air, water, and
soil pollution; conflict-related fires; toxic releases and spills; flooding of mines; and habitat and
ecosystem destruction. The 1998 Statute of the International Criminal Court treats armed attacks
that cause widespread, long-term and severe damage to the environment as war crimes. We
condemn Russia’s military seizure of the Zaporizhzhia Nuclear Power Plant (ZNPP), the first-
ever takeover of a nuclear power plant, which is prohibited by the Protocol 1 Amendment to the
Geneva Conventions. The military takeover increases the risks radiation exposure to nuclear
plant workers and the general population. A radiation release from the ZNPP as a result of
military activities could spread over two million square kilometers and expose one million
people to radiation.
As an academy of experts that promotes the fundamental right to a safe and healthful
work environment, we condemn Russia for worsening economic instability in Ukraine. Nearly
five million jobs have been lost since the war began and real wages have dropped by over 11%.
Sixty percent of those who fled to other regions of Ukraine are still out of work. The war
threatens to lower labor standards and has weakened enforcement of occupational regulations,
creating unsafe working conditions that further jeopardize the security and safety of civilians at

As advocates for global health, we condemn Russia’s use of energy and food as weapons.
Russia’s cutoff of oil and gas to Europe has resulted in an energy crisis and surge in fuel costs

globally. Russia’s military takeover of Ukraine’s agricultural land, destruction of grain storage
facilities, and impairment of shipments from Ukrainian seaports threatens the food security of
400 million people, especially in Africa and Asia. Russia’s invasion of Ukraine has resulted in an
estimated $2.8 trillion in lost global output by the end of 2022. These are funds that could have
been used for health care, food security, and the climate crisis.
We insist that Russia immediately withdraw from Ukraine’s occupied territories and halt
its aggression.
We urge the global community to support Ukraine in its post-war recovery and
The Collegium is committed to assist Ukraine in efforts to achieve lasting peace, health,
and sustainable development.