Global Asbestos Congress 2004

Establishment of an Integrated Health Surveillance System of Workers for the Areas that Use Asbestos in Brazil

Hermano Castro
Coordinator Working team: Cyro Haddad Novello; Fernanda Giannasi; Vanda D'Acri; Maria Blandina Marques dos Santos; Kátia Reis de Souza.
Institutional Project: CESTEH/ENSP/FIOCRUZ (Oswaldo Cruz Foundation),Brazil

Abstract
Introduction:

Occupational and environmental exposure to asbestos is associated with diseases such as: asbestosis, lung cancer, pleural mesothelioma and other pleural diseases. National surveys referring to work conditions and health repercussions have shown an increase of cases of illness related to asbestos. It is estimated that nowadays approximately 50,000 workers ere being directly exposed to asbestos in Brazil.

According to Brazilian regulations, workers exposed to asbestos should be monitored by their companies for at least 30 years after the end of exposure to asbestos.

The construction of an environmental and epidemiological surveillance system was necessary to give visibility to the prevalence of these illnesses and to ascertain the number of people exposed to asbestos in Brazil, as well as their clinical, radiological and functional status. It is also intended to know the total amount of companies that have used asbestos in Brazil.

Objectives:
To set up an integrated system of health surveillance for workers exposed to asbestos in Brazil with the purpose of elucidating social, environmental and epidemiological aspects applicable to these workers, and seeking actions that would improve their quality of life.

Methods:
We used an on-line system tied in with the Health Ministry. The system holds personal exposure data and clinical information. A methodology for the inspection of working environments was devised which included participation by workers and the development of an educational process.

Results:
To date, five out of eleven States have started to enter in regional registers, details of asbestos-exposed workers. We have now registered the names of two thousand workers along with clinical and occupational information.

Conclusion:
The importance of understanding asbestos as a public health problem is emphasized. The prohibition of asbestos use should be followed by effective surveillance in order to minimize the residual environmental impact and to follow exposed workers' state of health.

The construction of a surveillance system will allow the Brazilian Health Ministry and the Unified Health System to attend to health and environmental problems arising from several asbestos production processes.