Although the use of asbestos has been banned in several industrialized countries, many workers continue to be exposed in asbestos repair and removal work, and asbestos is still widely used in various newly industrialized, rapidly developing countries. According to the most recent World Health Organization estimates, more than 107,000 people die each year from asbestos-related lung cancer, mesothelioma, and asbestosis resulting from exposure at work. The asbestos epidemic is far from over. The expert meeting on "asbestos, asbestosis, and cancer" was convened in Helsinki in 1997 and consisted of 19 participants from eight countries. This meeting had the goal to "discuss disorders in association with asbestos and agree upon state of the art criteria for diagnosis and attribution with respect to asbestos". This report summarizes the results of a project, organized by the Finnish Institute of Occupational Health (FIOH), to update the 1997 and 2000 Helsinki criteria documents in view of the new advances in research.