Individuals from 8 countries participated in an International Expert Meeting on Asbestos, Asbestosis and Cancer in Helsinki during January of 1997. The purpose of the gathering was to discuss disorders of the lung and pleura in association with asbestos and to agree on state of the art criteria for their diagnosis and attribution with respect to asbestos. Occupational exposures to asbestos dust have been widespread in all industrial countries and these continue due to material that is already in place. Reliable work histories provide the most practical and useful measure of exposure. The clinical diagnosis of asbestos related disease is based on a detailed interview of the patient and occupational data on asbestos exposure and appropriate latency, signs and symptoms, radiological and lung physiology findings, and selected cytological, histological and other laboratory studies. Specific information was discussed concerning asbestosis, pleural disorders, mesothelioma, and lung cancer. Several areas were cited for future research including the assessment and quantification of exposure to asbestos, job exposure data analysis, chrysotile fiber burdens in lung tissue relative to the risk of lung cancer, lung cancer related to mineral fibers other than asbestos, improvements in the ILO system for radiological diagnoses, standardizing diagnostic tools, multicenter studies on biomarkers for detecting early asbestos disease, and the investigation of asbestos associated tumors other than lung cancer and mesothelioma, such as laryngeal carcinoma and renal carcinoma.