Global Asbestos Congress 2004

Efforts of Tokyo Doken to Combat Asbestos Use and to Help Victims of Asbestos-Related Diseases and Pneumoconiosis

Kazuya Miyake
Tokyo Construction Workers' General Union (Tokyo Doken), Japan


Since Jan. 2002, the Tokyo Construction Workers' General Union (Tokyo Doken) has won certifications under the Workers' Accident Compensation Insurance Law for 32 workers and now is preparing applications for 71 cases. Among the 32 victims entitled under the law are three workers with malignant mesothelioma, six workers with lung cancer and five workers with asbestosis. The asbestos-related victims account for as many as 44% (14 workers). The prevalence of asbestos-related diseases is increasing.

Four approaches for identifying asbestos-related diseases and pneumoconiosis among members

  1. Review of the receipts submitted to the national health insurance society
  2. Rereading of chest X-ray films
  3. Screening for pneumoconiosis
  4. Initiative of Mutual Aid Association

1) Review of the receipts submitted to the national health insurance society
As for the receipts of outpatients, we set about checking the receipts submitted in April every year. The review involves picking out receipts which indicate the relevant diseases, mainly respiratory ones, including tuberculosis, lung emphysema, pneumoconiosis, interstitial pneumonia, chronic bronchitis, pleuritis, idiopathic interstitial pneumonia, asbestosis, silicosis, bronchiectasis and asthmatic bronchitis. A questionnaire is sent to each patient identified to get more detailed information about his/her occupational background.

The responses are reviewed and classified into three categories: A to C. Category A includes individuals whose diseases are likely to be occupational. Category B represents individuals who should be followed up. Category C accounts for individuals whose diseases are unlikely to be occupational. Additionally, individuals who are highly likely to have contracted occupational diseases are classified as "Special A". The receipts of hospitalized patients are reviewed every month. Among 1100 to 1200 receipts in a month, we pick out receipts indicating relevant diseases, mainly lung cancer and mesothelioma, but also others, such as lung emphysema and pneumonia.

2) Rereading of chest X-ray films
Every year approximately 22,000 workers participate in routine medical checkups, including chest X-ray examinations. Specialists are now proceeding to reread those chest X-ray films. The number processed is not very high, but they reread 3,000 films last year.

3) Screening for pneumoconiosis
Doken Union's head office and several locals (five locals last year) organize the exclusive pneumoconiosis screening and the routine medical checkups that include such screening. Approximately, 4,200 workers have received the pneumoconiosis examination.

4) Initiative of Mutual Aid Association