International Asbestos Conference For Fair And Equal Compensation For All Asbestos Victims And Their Families

Table of Contents

Introduction
Session 1: Current Status Of Asbestos-Related Diseases In Japan
Session 2: Asbestos Compensation In Europe
Session 3: International Asbestos Issues: Epidemiology, Legislation and Victims' Rights
Session 4: Taking Action On Japan's Epidemic Of Asbestos-Related Diseases
Session 5: Non-Occupational And Environmental Asbestos Exposures
Session 6: Question & Answer Session
Session 7: Concluding Thoughts
Appendix

Session 3: International Asbestos Issues: Epidemiology, Legislation And Victims' Rights

Beginning his talk on Asbestos-induced Diseases in Italy, with a Note on the Carcinogenicity of Chrysotile, Dr. Benedetto Terracini commented that judging by presentations given in the morning, it appears that the asbestos histories of Japan and Italy are very similar. Before Italy banned the use of asbestos in 1992, 350,000 workers were being occupationally exposed to asbestos every year; by 2001, this figure had been reduced to 76,000, of which the vast majority (92%) worked in the construction industry.

There is a wealth of data on Italian asbestos-related disease which has been collated by the National Insurance Institute (INAIL), Italian cancer registries and the Italian Registry of Mesotheliomas (ReNaM) which document:

Although the ReNaM is engaged in an active search for cases and does not rely solely on voluntary reporting from pathology departments and hospitals, there is a significant under-reporting of asbestos-related pleural cancer and lung cancer. According to INAIL data, there was an average of 714 cases of asbestos-related cancer and 559 cases of asbestosis reported each year during the period 2002-2006. Terracini believes that this figure underestimates the problem by more than 50%. This means that every year 800 cases of asbestos diseases go unrecognized and uncompensated by the INAIL.

The largest asbestos cement (AC) factory in Italy, a country which Terracini described as a "paradise" for the AC industry,9 was located in Casale Monferrato, a town of 100,000. The health repercussions caused by the presence of Eternit's AC factory in Casale Monferrato have been dire; hundreds of asbestos related deaths have been reported amongst workers, their family members and local people. Extensive epidemiological research has been done of various Casale Monferrato cohorts including 1,740 women married to Eternit workers. There are 40-50 deaths from mesothelioma in the town every year and the ratio between the number of mesotheliomas in the general population (non-Eternit workers) and Eternit workers is increasing.10 Although there is a law which provides benefits to those with occupational asbestos exposure for a minimum of 10 years, the law is ambiguous and has several requirements which are difficult to satisfy.

Towards the end of his allotted time, Dr. Terracini turned his attention to the subject of the carcinogenicity of chrysotile, citing new studies which disprove industry's assertions that chrysotile can be used safely under "controlled conditions":

He concluded his remarks by saying that the evidence for carcinogenicity of chrysotile is as convincing as the evidence for amphibole forms of asbestos.

In the Summer of 2007, a bill to ban the use of asbestos was approved by the U.S. Senate. In the presentation The U.S. Asbestos Ban and the Issue of Contaminant Asbestos, Dr. Barry Castleman explained that the bill had faced opposition from the stone and mineral industries which had concerns about low levels (under 1%) of asbestos contamination of some of their materials. In order to overcome their opposition, compromises were made, the most significant of which involved the issue of contaminant asbestos. The revised U.S. bill restricted the national prohibitions to materials with more than 1% asbestos. The figure of 1%, which has no health basis, was adopted by the Environmental Protection Agency in 1973 because of analytical limitations which existed at that time. Materials with well under 1% bulk content of asbestos can give rise to high levels of airborne asbestos when used or disturbed.

Minerals which may be contaminated by asbestos or asbestos-like fibers include:

  1. Talc
    Since the 1940s, New York talc miners have contracted asbestosis-like lung disease; excess lung cancer was first reported in N.Y. talc miners in 1967. To date there have been 13 mesotheliomas amongst 1,000 former N.Y. talc miners; research by a competitor in the 1970s, identified asbestos in Vanderbilt talc. The notorious N.Y. talc mines will finally close in 2008, but there are also other worrisome talc sources. At least one talc product has been banned in Japan, whose ban law applies to products that have more than 0.1% asbestos.
  2. Vermiculite
    Vermiculite mined in Libby, Montana was contaminated with tremolite asbestos; the tainted vermiculite was incorporated by WR Grace into attic insulation which was distributed throughout North America. Asbestos has also been found in vermiculite from Virginia.
  3. Construction Stone
    Chrysotile is found in serpentine rock in many parts of the U.S. In California, epidemiologists have correlated the occurrence of mesothelioma with living near naturally occurring asbestos containing minerals. In El Dorado County, California controversy persists over plans to develop the area because of the presence of asbestos in surface soil.
    Case Study of Biancavilla, Sicily, Italy: after the discovery of a high local rate of mesotheliomas in the 1990s, half of which were occurring in women under the age of 60, Italian investigators found that the stone quarried in Biancavilla was contaminated with fluoro-edenitic fibers.
  4. Iron Ore
    Officials in Minnesota have identified over 50 mesotheliomas amongst iron miners; Minnesota iron ore has a host rock that looks like amosite asbestos.

Should the Ban Asbestos in America Act as passed by the U.S. Senate become law, the bill mandates government agencies to undertake research into the hazards of contaminant asbestos. Upcoming hearings in the U.S. House of Representatives will focus on the hazards of products with less than 1% asbestos, and a stronger version of the bill may emerge from the House this year. Countries like South Korea which are now drafting legislation to ban asbestos, as well as countries with asbestos bans in place are advised to consider the issue of contaminant asbestos.

Although asbestos production started in Korea in the 1960s, the incidence of mesothelioma has remained low at 1-2/million with male: female ratio of 1.6:1. In the absence of sufficient data about mesothelioma in Korea, the issue of how reliable predictions can be made was addressed in the paper, Prediction of Mesothelioma Incidence from Asbestos Consumption, A Comparative Study, by Professor Domyung Paek. Several types of analysis were considered including:

Spatial variation studies which compare different:

Example: Per-capita asbestos consumption versus mesothelioma incidence in different countries as examined in the paper Ecological Association Between Asbestos-Related Diseases and Historical Consumption: an International Analysis by Takahashi et al.

Temporal variation studies which compare different:

Example: Estimation of Future Mortality from Pleural Malignant Mesothelioma in Japan Based on an Age-Cohort Model by Segura et al.

Having considered aspects of both types of studies, Paek showed how using a temporal change analysis, asbestos exposures experienced at 15-25 years of age showed the best fit of data. He also found that 30 years after exposure, the elevation of risk is revealed and that 50 years after exposure, the risk peaks. Based on these findings, Paek suggests that in Korea, there will be a spurt of mesothelioma incidence in 2010 and that incidence could peak in 2045. A table shown at the end of his presentation is informative.

Campaign to Make Mesothelioma a Compensable Disease in Hong Kong and Concern on Asbestos Usage in Hong Kong was the paper presented by Karen Lo from the Hong Kong Workers' Health Centre (WHC). Th e WHC, a non-profit organization set up in 1984, works to raise levels of occupational health. As part of its remit, the WHC is running a campaign on asbestosis and silicosis. Graphs presented by Ms. Lo showed a substantial rise in mesothelioma incidence in Hong Kong from 1983 to 2004, with male deaths outnumbering female ones. Due to the usual problems of long latency periods, difficulties in getting accurate diagnoses, lack of awareness amongst the public and medical profession, mesothelioma is not a compensable disease in Hong Kong. The WHC Campaign on Mesothelioma which began in 2006 has included:

As a result of this campaign, a proposal to amend the Pneumoconiosis Compensation Ordinance to make mesothelioma a prescribed disease was lodged in September 2007. The proposal was confirmed by the Pneumoconiosis Compensation Fund Bureau and the Labor Advisory Bureau and a draft bill will be tabled for discussion in the Legislative Council by March 2008. The WHC continues to press for other benefits such as a mesothelioma increment to allowable expenses for medical treatment, currently HK$200/day, (JPY2573 / $26/ €16), the adoption of measures to raise medical workers and employers awareness of mesothelioma to increase medical referrals and regular check-ups for at-risk workers.

Although the use of chrysotile is still legal under "controlled"11 conditions in Hong Kong, the use of amosite and crocidolite was banned in 1996. Chrysotile is being used in Hong Kong by the vehicle servicing industry in brake and clutch linings; it can still be found in old electrical and boiler insulation, hot water systems, on board ships and in sundry products such as braking pads for lifts. The number of workers currently being occupationally exposed to asbestos is unknown.

The final presentation of the day was given by Sanjiv Pandita of the Asian Network for the Rights of Occupational Accident Victims (ANROAV), who spoke about The Grassroots Asbestos Campaign in Asia. ANROAV members come from 16 different countries and include victims' groups, labor NGOs, trade unions, labor researchers and activists dedicated to the campaign to improve occupational health and safety throughout Asia. Groups from Japan - Japan Occupational Safety Health Resource Center and BANJAN - are founding ANROAV members. Recognizing the particular vulnerability of Asian markets to aggressive marketing12 by global asbestos producers, ANROAV embarked on a major asbestos campaign in 2003. With national consumption in some countries averaging more than 100,000 metric tons/year and 90% of global ship-breaking taking place in this region, occupational exposure to asbestos is common. ANROAV is particularly concerned about asbestos exposures experienced by:

With the use of graphic images taken within the asbestos sector in Asia, Pandita disproved industry's reassurances that chrysotile can be used safely. He said:

"In ship breaking industries (India, China and Bangladesh) workers often remove the asbestos packing with their bare hands and then dry it in the sun to sell. Asbestos fibers are routinely flying in the air at these ship breaking yards."

As with all occupational accidents and diseases in Asia, there is a gross under-reporting of asbestos-related diseases. Pneumoconiosis is often misdiagnosed as tuberculosis; with a few exceptions, lung cancers and mesotheliomas are hardly reported. Since there is no proper diagnosis, compensation is "out of the question." To raise awareness of the asbestos issue, ANROAV has organized and participated in numerous events including: the World Social Forum, India (2004), a two-day occupational health and safety conference with an asbestos workshop, Hong Kong (2004), the Global Asbestos Congress, Japan (2004), the Asian Asbestos Conference, Thailand (2006) and the Banning Asbestos in Asia Workshop, Bangladesh (2006). ANROAV works with grass-roots victims' organizations to identify asbestos victims and mobilize support. The ban asbestos issue is part of ANROAV's wider campaign to empower workers to demand their rights to safe workplaces.

After the sessions ended for the day, conference delegates were invited to a party in the lounge of the conference center to celebrate BANJAN's 20th anniversary. During the brief ceremony which took place, three BANJAN publications were launched including the Japanese translation of the publication: Killing the Future - Asbestos Use in Asia. Politicians, victim support personnel and international campaigners congratulated BANJAN on its success in bringing the epidemic of asbestos-related disease in Japan into the open. With live music provided by the Sho Kobayashi string quartet and a delicious buffet of Japanese food, international guests and Japanese delegates enjoyed a brief respite from the serious subjects discussed during the conference.

Endnotes

9. Up to 20,000 Italian workers received occupational exposure to asbestos in the AC industry during the 20th century.
10. From 1990-94, the ratio of non-Eternit workers: Ex- Eternit workers being diagnosed with mesothelioma in Casale Monferrato was 3.1:1; in 2001-2006, it was 8.9:1. This means that nowadays many more non-workers are being diagnosed with mesothelioma than former workers.
11. Regulations which have been enacted to control hazardous asbestos exposures in Hong Kong include: the Factories and Industrial Undertakings (Asbestos) Regulation in Hong Kong (1986), Air Pollution Control Ordinance (Cap. 311) in Hong Kong (1996) as well as directives which: set control limits for atmospheric asbestos dust concentrations, mandate procedures for risk assessment, plant hygiene, labelling, storage and disposal of asbestos waste, etc.
12. Pandita analyzed several statements made by the global propaganda campaign, spearheaded by the (Canadian) Chrysotile Institute, which are intended to reassure governments and consumers that chrysotile asbestos can be used safely under "controlled conditions."