Between 1999 and 2017, Ohio recorded 12,697 asbestos-related deaths. That number includes 2,353 mesothelioma deaths and 996 asbestosis deaths. In Sandusky County alone, 104 people died from asbestos-related illness during that period. These deaths occurred in our lifetimes, in our communities, among our neighbors.

Yet if you tried to find a comprehensive national registry tracking who was exposed to asbestos, where they worked, when the exposure occurred, and what health outcomes followed, you would find nothing. The United States maintains no national mesothelioma registry and no centralized database of asbestos exposure. Countries like Australia, New Zealand and the United Kingdom maintain such registries. America does not.

What we lost by not tracking

The absence of a national registry means we are fighting asbestos-related disease with incomplete information. Approximately 3,000 Americans are diagnosed with malignant mesothelioma annually. Occupational asbestos exposure is the primary risk factor, yet roughly 20 percent of cases cannot be linked to a known exposure because the data does not exist.

Ohio’s overall asbestos-related death rate between 1999 and 2017 was about 5.8 deaths per 100,000 population, higher than the national average of 4.9 per 100,000. That elevated rate reflects the state’s industrial history in steel mills, factories, power plants and construction. Asbestosis and mesothelioma can develop 20 to 50 years after exposure. By the time symptoms appear, the damage is irreversible. Without systematic tracking, we cannot identify high-risk individuals early, monitor disease trends in real time, or target prevention efforts effectively. Instead, we rely on fragmented data from CDC death records, Environmental Working Group estimates, and scattered local health department reports.

The Scope of What Remains Undocumented, a national database of documented asbestos-exposure sites lists 9,479 facilities across 65 cities, compiled from historical records of the EPA, OSHA and the Department of Labor. That documentation exists, but it is scattered across multiple datasets with no unified public access.

We have no systematic way to connect those exposure events to the workers who were present or to the health outcomes they experienced decades later. National estimates suggest 12,000 to 15,000 asbestos-related deaths occur annually in the United States from mesothelioma, asbestosis, and related cancers. The exact count varies by methodology because we lack the infrastructure to track it accurately. When surveillance data are incomplete, we undercount exposures and health outcomes, especially in regions with limited public health capacity.

Compounding the problem

Between 14 percent and 50 percent of mesothelioma diagnoses may be incorrect due to misdiagnosis. Due to its rarity, many clinicians have limited experience recognizing the disease, and its symptoms can resemble those of other respiratory problems. Creating a national registry would improve case tracking, expedite referrals to specialists and reduce diagnostic errors.

Although many veterans were exposed to asbestos during military service, the VA’s current exposure tracking infrastructure does not systematically collect asbestos exposure data. Unlike a comprehensive exposure registry, the Airborne Hazards and Open Burn Pit Registry focuses on a narrow set of airborne hazards. Data from toxic exposure screening indicate that many asbestos-exposed veterans are not included in formal registries.

Attempting to link the illnesses of veterans to their military service becomes more difficult without having centralized exposure records.

What other countries do

In Australia, New Zealand and the United Kingdom, asbestos exposure registries track exposure histories, disease outcomes and risk factors. Public health officials can use these registries to estimate disease incidence accurately, identify emerging trends and allocate resources more efficiently. Researchers can use data from these studies to examine long-term health effects and to develop improved treatments.

Patients and families receive clear documentation of their exposure, which can support compensation claims and disability claims.

A peer-reviewed feasibility study confirms the absence of such a registry in the United States. It outlines how other countries have successfully implemented them, demonstrating that what America lacks is not technical capacity but political will.

Cost of continued inaction

Asbestos exposure decades ago continues to contribute to mesothelioma deaths each year, according to CDC data. Every year without a registry means another year of missed opportunities to identify high-risk individuals, another year of diagnostic delays, another year of families struggling to prove exposure that should have been documented from the start.

The workers in Ohio’s steel mills, factories and construction sites deserved better protection. Their families deserve better answers. Future workers deserve a system that tracks exposure and monitors health outcomes so that when disease appears, we can respond quickly.

A national asbestos exposure registry would not bring back those who have already died. Still, it would honor their memory by ensuring the next generation does not suffer the same fate in silence.

(Sharp is the chief of financial operations at Environmental Litigation Group P.C., where he manages the financial operations of cases involving toxic exposures and works with individuals affected by environmental contamination.)