[Lessons from a long-term survey on the effects of massive occupational exposure to asbestos. The AMISOL affair 10 years later].

For the past 10 years the authors have followed up a cohort of workers who had been massively exposed to dust in an asbestos textile factory which closed down in 1974. They report on the difficulties of all kinds they encountered during this epidemiological survey. The most original result is that they were able to establish that the radiological and functional manifestations of asbestosis pursue their course after the subjects have ceased to be exposed. Another important point is the early development of lesions in peripheral bronchioles, detected by volume-flow loops. The authors insist on the psycho-social problems at the site of work or in daily life which arise from the use of asbestos or of fibres with similar properties. Social protection, at present well organized, should suppress the risk of asbestosis in Western countries. However, a number of problems remain to be solved, notably those concerning the long-term risk of pleural mesothelioma, the mode of action of the fibers and the immune reactions they induce, and the economic and social consequences of a hypothetical ban on asbestos--a material very difficult to replace. This study embodies, in miniature, all the problems of society associated with asbestos during this second half of the XX th century.