From RESPUBLICA on 25th November:

On the 24th of November 1999, the United Kingdom banned the use of asbestos. Twenty years later and this toxic mineral still plagues public health, being linked to multiple diseases including mesothelioma.

But why has asbestos remained such a threat to public health, despite laws which prevent its use? The answer is two-fold.

First, vast quantities remain inside public and private buildings throughout the UK. This is because we used asbestos heavily in construction up until the 1980’s and have been unable, or perhaps unwilling, to remove it from the schools, hospitals, and domestic premises’ where it remains in-situ.

Second, the laws we enact to manage this in-situ asbestos, such as the Control of Asbestos Regulations 2012 (CAR12), do not effectively safeguard the public from harm. Not only do our asbestos laws lag those in many European countries, such as Germany and France, but evidence has pointed to there being widespread non-compliance with CAR12 in the UK.

Yet, the mortality rate from mesothelioma is not the same across the UK but is lower per capita in Scotland than in England or Wales. See this:

A screenshot of a cell phone

Description automatically generated

England has 11 times the population of Scotland so, all things being equal, the mortality rate would be 1 848 in England, but it was 2 134 in 2017, 15% higher. As for Wales with a population around three fifths of Scotland the rate should be around 100 yet was 142 in 2017, 40% higher.

Now, Scotland has an equally if not greater history of industrialisation, especially in ship-building), associated with the use of asbestos (, yet the mortality rate is lower.

Looking more closely, however, we can see that it is the female mortality rate which differs most. The male mortality rate is slightly lower per capita but the female rate is much lower. If we multiply the 22 deaths in 2017 by 11, we get only 242 compared with 358, nearly 50% higher. Might this suggest that the industrial experiences of males in Scotland exposing them to asbestos dust was comparable to that in England but that the experience of women, in the home, was markedly different? Though building standards are often described as stricter in Scotland, I can find no evidence for differences with regard to asbestos.

I appreciate that the explanation will be complex, perhaps uncertain and multifactorial, but has NHS Scotland’s better performance on cancer treatment helped? See:

Over the last ten years, the overall risk of dying from cancer (the age-adjusted cancer mortality rate) has fallen by 10%, a decrease of 12% for males and 7% for females.

Click to access 2019-10-29-Cancer-Mortality-Summary.pdf

82.4% of patients started treatment within the 62-day period from referral to first treatment, up from 81.4% in the previous quarter. The figure for NHS England was 77.8%.

94.7% of patients started treatment within the 31-day from decision to treat to first cancer treatment compared with 94.9% in the previous quarter. The difference is not statistically significant, and the English figures are not directly comparable as they have a two-week target.

Click to access 2019-09-24-CWT-Summary.pdf