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Thai National Asbestos Workshop, 6-8 March 2007, Bangkok. Asbestos and Health WHO recommendations on elimination of asbestos-related diseases. Dr Ivan D. Ivanov Public Health and Environment World Health Organization ivanovi@who.int . Background.

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asbestos and health who recommendations on elimination of asbestos related diseases

Thai National Asbestos Workshop, 6-8 March 2007, Bangkok

Asbestos and HealthWHO recommendations on elimination of asbestos-related diseases

Dr Ivan D. Ivanov

Public Health and Environment

World Health Organization

ivanovi@who.int

background
Background
  • World Health Assembly Resolution 58.22 from 2005 on Cancer Prevention and Control
    • Countries should pay special attention to cancers for which avoidable exposure is a factor
  • Thirteenth Session of ILO/WHO Joint Committee on Occupational Health (2003)
    • Special efforts to elimination of asbestos-related diseases
  • Asbestos is the most important occupational carcinogen
    • Half of the deaths from occupational cancer are caused by asbestos
asbestos related diseases
Asbestos-related diseases
  • Lung cancer
  • Mesothelioma
  • Asbestosis
  • Pleural plaques, thickening and effusions
  • Laryngeal cancer
  • Other cancers
worldwide 125 million people are exposed to asbestos
Worldwide 125 million people are exposed to asbestos

Population exposed to asbestos by WHO region

and mortality stratum (thousands)

every year at least 90 000 people die from asbestos related diseases
Annual deaths attributable to asbestos

at least 90,000 from lung cancer, mesothelioma and asbestosis due to occupational exposure

Additionally at least several thousands deaths can be attributed to other asbestos-related cancers and to non-occupational exposure

Every year at least 90,000 people die from asbestos-related diseases
  • Asbestos is the most important occupational carcinogen causing 54% of all deaths from occupational cancer
  • The death toll will increase in the future
one third of the who member states still use asbestos
One third of the WHO Member States still use asbestos
  • 23% have banned or intend to ban chrysotile
  • 41% have not banned but show no record of trading in
  • 36% still use, import and export asbestos and asbestos-containing products
  • Largest use (90%) is in asbestos-cement industry in developing countries
  • World production and use remains stable between 2,050,000 and 2,400,000 metric tonnes.
all types of asbestos are hazardous to health
All types of asbestos are hazardous to health
  • Increased risk of lung cancer
  • Mesothelioma – both occupational and non-occupational (environmental, take-home) exposures
  • No threshold has been identified for carcinogenic risk of all asbestos types, incl. chrysotile
  • Both active and passive smoking increase the risk of lung cancer from asbestos

Mesothelioma

there are safer substitutes to asbestos
There are safer substitutes to asbestos
  • Fibre substitutes, e.g.:
    • short fibre attapulgite
    • carbon fibres
    • non-respirable cellulose fibres
    • non-biopersistent sythetic vitreous fibres
    • natural wollastonite
    • xonolite

WHO Workshop on Mechanisms of Fibre Carcinogenesis and Assessment of Chrysotile Asbestos Substitutes, 8-12 November 2005, Lyon

there are many alternatives example substitutes for asbestos cement corrugated roofing
There are many alternativesExample: Substitutes for Asbestos-Cement Corrugated Roofing
  • Fiber-cement roofing using: synthetic fibers (polyvinyl alcohol, polypropylene) and vegetable/cellulose fibers (softwood kraft pulp, bamboo, sisal, coir, rattan shavings and tobacco stalks, etc.); with optional silica fume, flyash, or rice husk ash.
  • Microconcrete (Parry) tiles
  • Galvanized metal sheets
  • Clay tiles
  • Vegetable fibers in asphalt
  • Slate
  • Coated metal tiles (Harveytile)
  • Aluminum roof tiles (Dekra Tile)
  • Extruded uPVC roofing sheets
  • Recycled polypropylene and high-density polyethylene and crushed stone (Worldroof)
  • Plastic coated aluminum
  • Plastic coated galvanized steel.

Roofing Sheets (picture BWWI)

Source: B. Castleman, 2006, personal communication

summary of the conclusions from who assessments
Summary of the conclusions from WHO assessments
  • All types of asbestos cause asbestosis, mesothelioma and lung cancer
  • No safe threshold level of exposure has been identified
  • Safer substitutes exist
  • Exposure of workers and other users of asbestos containing products is extremely difficult to control
  • Asbestos abatement is very costly and hard be carried out in a completely safe way

Working with asbestos-containing materials requires enormous measures for protection

who recommendations for elimination of asbestos related diseases
WHO recommendations for elimination of asbestos-related diseases
  • Elimination of the asbestos
    • Stop using asbestos
    • Provide information about safer substitutes
    • Develop economic and technological mechanisms to stimulate substitution
  • Asbestos abatement
    • Avoid exposure during asbestos removal
    • Develop regulatory and workplace control measures for asbestos abatement
  • Medical surveillance
    • Improve early diagnosis, treatment, rehabilitation and compensation of asbestos-related diseases
    • establish registries of people with current and past exposures
national approaches for elimination of asbestos related diseases
National profiles

Use of asbestos

Asbestos-related diseases (statistics and estimates)

Exposed populations

Awareness raising

Framing health arguments for stopping the use of asbestos

Targeting industry, entrepreneurs, workers, policy makers

Capacity building

Recognition of asbestos exposure

Detecting asbestos-related diseases

Engineering control

institutional framework

Ministries of health, labour, environment

Ministries of industry, trade, construction

National plan of action

Step by step

Priority setting

Intersectoral coordination

Involving civil and business society

Monitoring, accountability

Evaluation

National approaches for elimination of asbestos-related diseases
future steps by who
Future steps by WHO
  • Launch global campaign on elimination of asbestos-related diseases (jointly with ILO, other UN agencies, civil and business society, trade unions)
  • Endorse Global Plan of Action on Workers Health, WHA 2007
  • Implement WHO Module for Cancer Prevention
  • Pilot jointly with ILO comprehensive national approaches for elimination of asbestos-related diseases
further information
Further information

http://www.who.int/occupational_health/publications/asbestosrelateddiseases.pdf

Available also in Arabic, Chinese, French, Russian and Spanish

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