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Asbestos was mainly used in various industries. So, everyone can exposure to asbestos in the environmental and occupational settings. However, most of the countries banned using the asbestos, but asbestos exists in the structure of old buildings and industries. In this study, the concentration of asbestos in indoor and outdoor was evaluated using the systematic review and meta-analysis approach. Also, the probabilistic cancer risk of exposure to asbestos in the air was estimated by a Monte Carlo simulation (MCS) using Crystal Ball software and the recommended method of Environmental Protection Agency (EPA). The research reports of databases show that all of the studies have belonged to Iran and Turkey. Meta-analysis showed that the pooled concentration of asbestos in the outdoor air of Iran and Turkey was 0.01 f/mL and 0.017 f/mL, respectively. The pooled concentration of asbestos in the outdoor air of traffic, urban and rural subgroups was 0.021 f/mL, 0.006 f/mL, and 0.017 f/mL, respectively. The pooled concentration of asbestos in the indoor air of Iran and Turkey was 1.777 f/mL and 0.403 f/mL, respectively. The pooled concentration of asbestos in the indoor air of rural and workplace subgroups was 0.538 f/mL and 1.593 f/mL, respectively. Risk assessment shows that the percentile 95% of cancer risk (CR) in Iran and Turkey due to inhalation exposure to asbestos in the indoor air was 1.01E-1and 2.01E-1, respectively. Also, the percentile 95% of CR in the rural and urban regions was 2.45E-1and 9.23E-1, respectively. According to EPA method, when CR is higher than E-4 value (1 in 10,000 f/mL) exposed population are at the considerable risk. The exposed population in Iran and Turkey were at the considerable cancer risk due to exposure asbestos. Therefore, risk management is necessary in Middle East countries especially, Iran and Turkey.

Concentration and cancer risk assessment of asbestos in Middle East countries: a systematic review- meta-analysis