[Catastrophe and public health: reasons for an impasse]

ANOTHER PUBLIC HEALTH CRISIS: Coming into public view after the AIDS transfusion and the mad cow crises, asbestos-related health risks have provoked an atmosphere of panic incompatible with calmly planned public health prevention programs. The avalanche of passionate reactions has led to an inextricable dead-end situation. SCAPEGOATS: Faultfinders have accused a long list of scapegoats--scientists, physicians, experts, public health officials, industrial leaders and the media--but court actions do not favor rigorous analysis of health safety dispositions. What is needed is a pondered examination of the sinister chain of events which has made such a wasteful situation possible. MEETING PUBLIC DEMANDS: Prohibiting asbestos cannot solve the problem once and for all. Asbestos removal programs must be conducted in terms of a solid risk/benefit analysis and more generally, management of environment-related health risks must be based on specific and credible measures. Without a real rehabilitation of environmental medicine, there is a genuine risk of seeing crisis situations override public health decision making.