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Asbestos is a carcinogenic mineral banned in Colombia since 1 January 2021; however, there is a considerable amount of asbestos-containing building materials (ACBM) installed across the country in products such as roof tiles, tanks, pipes, and downspouts. Installed ACBM represent an exposure risk when the mineral fibers are released into the air through deterioration, damage, or disturbance of the cement matrix within which the asbestos is contained. Due to potential detrimental impacts on human health, safe management and correct handling of ACBM is a matter of vital importance. This article proposes evidence-based environmental management guidelines, aimed at public policymaking, for the removal and final disposal of installed ACBM in Colombia. A descriptive study was carried out, with a qualitative approach, based on an integrative literature review of international practices applied in the removal and disposal of installed ACBM. Forty scientific publications were reviewed, as well as the regulations for removal, transport, and final disposal of installed asbestos-cement from Australia, the USA, Italy, Chile, the UK, and Canada. Guidelines for the removal and final disposal of installed ACBM are proposed, suggesting the following stages: (a) diagnosis and management plan of installed ACBM, (b) removal of installed ACBM, (c) transport of ACBM waste, and (d) final disposal of ACBM waste. Expert opinion was collected to assess the local feasibility of the proposed guidelines. These guidelines may help direct national and regional agencies to establish comprehensive strategies with clear, measurable, and achievable goals for future replacement of installed ACBM. Integr Environ Assess Manag 2023;19:1079-1088. © 2023 SETAC., (© 2023 SETAC.)

Asbestos (all forms, including chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite) is carcinogenic to humans and causally associated with mesothelioma and cancer of the lung, larynx, and ovary. It is one of the carcinogens most diffuse in the world, in workplaces, but also in the environment and is responsible for a very high global cancer burden. A large number of countries, mostly with high-income economies, has banned the use of asbestos which, however, is still widespread in low- and middle-income countries. It remains, thus, one of the most common occupational and environmental carcinogens worldwide. Italy issued an asbestos ban in 1992, following the dramatic observation of a large increase in mortality from mesothelioma and other asbestos-related diseases in exposed workers and also in subjects with non-occupational exposure. A mesothelioma registry was also organized and still monitors the occurrence of mesothelioma cases, conducting a case-by-case evaluation of asbestos exposure. In this report, we describe two Italian communities, Casale Monferrato and Broni, that faced an epidemic of mesothelioma resulting from the production of asbestos cement and the diffuse environmental exposure; we present the activity and results of the Italian mesothelioma registry (ReNaM), describe the risk-communication activities at the local and national level with a focus on international cooperation and also describe the interaction between mesothelioma registration and medical services specialized in mesothelioma diagnosis and treatment in an area at high risk of mesothelioma. Finally, we assess the potential application of the solutions and methods already developed in Italy in a city in Colombia with high mesothelioma incidence associated with the production of asbestos-cement materials and the presence of diffuse environmental asbestos pollution.