Our Work
Santé publique France is tasked with monitoring epidemiological trends in mesothelioma, as well as occupational and non-occupational exposure to asbestos and other suspected risk factors (including studies focused on specific industries or worker populations, etc.). Based on the results produced, Santé publique France advocates for the necessary strengthening of prevention measures regarding the “asbestos” risk.
Epidemiological surveillance through the mandatory mesothelioma reporting system
Reporting of mesothelioma has been mandatory in metropolitan France and overseas territories since January 16, 2012 (Decree No. 2012-47). As part of the new surveillance strategy, the Cerfa form was simplified by an order dated April 20, 2026.
This reporting requirement applies to all physicians (pathologists, pulmonologists, surgeons, oncologists, general practitioners, etc.) who diagnose mesothelioma, regardless of the anatomical location (pleura, peritoneum, pericardium, testicular vagina, etc.).
This mandatory reporting has two objectives:
- to strengthen the epidemiological surveillance of mesotheliomas at all anatomical sites throughout the entire national territory (metropolitan and overseas territories);
- to improve understanding of occupational and environmental exposure factors among individuals with mesothelioma.
Case Definition
The case definition requires the reporting of any new case of malignant mesothelioma of the pleura, peritoneum, pericardium, testicular tunica vaginalis, or other or unspecified sites, diagnosed on or after January 1, 2012:
- based on a histopathological examination (approximately 94% of cases). The date of the biopsy must be specified by the reporting physician;
- based on another diagnostic examination, other than a histopathological examination (clinical, radiological, or ultrasound). The date of diagnosis must be specified by the reporting physician.
Procedure
Are you a physician who has diagnosed a case of mesothelioma? The reporting procedure consists of two steps:
- Fill out the form;
- Promptly send the completed, dated, and signed form via email to the physician responsible for notifiable diseases at the Regional Health Agency (ARS) in your practice region.
The form may also be sent by mail in a confidential envelope marked “medical confidentiality” or by fax to the physician responsible for notifiable diseases at the ARS.
The ARS physician will then process your form and forward it in anonymized form to Santé publique France, which is responsible for the national surveillance of mesotheliomas.
Documents required for the mandatory reporting of mesothelioma cases:
- Reporting form
- Individual patient information sheet: In accordance with the 1978 French Data Protection Act, the patient must be individually informed of their rights by their physician (reporting clinician), who will provide them with the downloadable information sheet.
- Contact information for Regional Health Agencies
From 1998 to 2023, Santé publique France coordinated the national pleural mesothelioma surveillance program
In 1997, France permanently banned the use of asbestos. As early as 1998, the General Directorate of Labor (DGT) and the General Directorate of Health (DGS) entrusted Santé publique France (then the Institute for Public Health Surveillance) with the task of establishing the National Mesothelioma Surveillance Program (PNSM). This initiative, dedicated to the epidemiological monitoring and health effects of asbestos, had the following main objectives:
- to estimate and monitor the national, regional, and departmental incidence of pleural mesothelioma as well as its trends;
- to monitor the survival of patients with pleural mesothelioma;
- to assess asbestos exposure and the proportion of mesotheliomas attributable to asbestos exposure, particularly occupational exposure;
- to identify the occupations and sectors of activity at highest risk and monitor trends in these areas;
- explore other potential risk factors (refractory ceramic fibers, mineral wool, ionizing radiation, etc.);
- assess compensation processes for pleural mesothelioma: (recognition as an occupational disease and claims filed with the Asbestos Victims Compensation Fund (FIVA));
- improve the histopathological diagnosis of pleural mesothelioma in France.
Between 1998 and 2023, the PNSM covered between 14 and 20 metropolitan departments and the area surrounding Lille, representing approximately 18 million inhabitants (28% of the French metropolitan population).
Driven by a multidisciplinary collaboration between experts and researchers, the program has resulted in nearly sixty publications. Its main findings are available in the report summarizing the PNSM’s 20-year track record.
At the end of 2023, the program concluded and transitioned into a national mesothelioma surveillance system, which is scheduled to be rolled out nationwide in 2026.
Conducting studies
Santé publique France has conducted ad hoc studies on:
- Occupational exposures based on 20 years of PNSM activity:
- a review of 20 years of monitoring;
- analyses in the construction sector;
- analyses in the national education sector.
- The proportion of cancers attributable to occupational exposure to asbestos was also assessed as part of the Matgéné program
- Environmental exposures:
- Pilot study based on surveys conducted as part of the Mesothelioma Surveillance Program (report on 20 years of PNSM activity and Mesothelioma Surveillance Program bulletin).
- Risk assessment studies focusing on specific situations of non-occupational asbestos exposure. These studies examine the environmental exposure of populations living near either natural outcrops or former industrial sites where asbestos was mined or processed.
- Summary of studies on the health consequences of environmental exposure to asbestos
- Recourse to the Asbestos Victims Compensation Fund (FIVA):
- based on PNSM data;
- among retired craftsmen in the ESPrI cohort, France, 2002–2016.
Preventing Asbestos Exposure
Santé publique France issues recommendations for strengthening prevention
Santé publique France advocates for the necessary strengthening of prevention measures regarding asbestos risks and for providing information on how to access existing medical and social support systems.
Regarding current asbestos exposure
It is essential to implement targeted information and prevention initiatives regarding current asbestos exposure, reaching workers, young people in training, healthcare professionals, and the general public:
- Among professionals in sectors identified as the most exposed (such as the construction industry) and among young people in these sectors who are in training: inform them and ensure existing prevention measures are enforced.
- Do not overlook exposure through buildings (construction materials containing asbestos): for example, workers in the education sector.
- Better inform healthcare professionals about the risks of asbestos.
- Inform the general public about asbestos risks and protective measures, particularly risks associated with DIY projects and exposure near dilapidated or deteriorating buildings, without neglecting the deterioration of agricultural buildings…
Santé publique France emphasizes the importance of implementing asbestos removal plans to eliminate exposure in public facilities and to establish a national database of these plans, as provided for in the 2015–2019 National Environmental Health Plan (PNSE 3), PNSE 4 (2021–2025), and PNSE 5 (forthcoming), in which Santé publique France participated. This work led to the establishment of the Interministerial Asbestos Action Plan 1 (PAIA 1 – 2016–2018) and PAIA 2 (forthcoming), which prioritizes the removal of asbestos-containing materials, particularly from the roofs of agricultural buildings, industrial brownfields, schools, and other high-risk buildings open to the public.
Furthermore, to better understand potential passive indoor exposures, a national centralization of technical asbestos assessments (DTA) is also recommended.
This data is essential for advancing national knowledge regarding environmental exposures among people with mesothelioma.
Regarding the use of medical-social recognition mechanisms
It is essential to implement information campaigns on medical-social recognition mechanisms and appeal procedures, targeting both healthcare professionals and patients:
- Better inform healthcare professionals (medical and paramedical) about the occupational disease recognition criteria and the processes for seeking compensation.
- Better inform patients about their rights to compensation:
- recognition of occupational diseases (tables of occupational diseases on the InRS website);
- compensation fund for asbestos victims.
In relation to
thematic dossier
Reportable diseases
The surveillance system for reportable diseases relies on the transmission of data by physicians and laboratory professionals (both in private practice and in hospitals) to the relevant staff at...
Asbestos
thematic dossier
Asbestos can cause various diseases, including cancers (bronchopulmonary cancer, mesothelioma). Widely used until it was banned in France in 1997, it is still very common in buildings.
