Slovenian asbestos case

Prof. dr. Metoda Dodič FikfakUMC Lj, Clinical Institute of

Occupational MedicineLjubljana, SI

National directives for asbestosAims

1. Legislation

2. Collect the data about:– asbestos consumption,

– production of asbestos and asbestos-cement products,

– use of asbestos products

3. Collect the data about exposed workers

4. Collect the information about asbestos caused morbidity and mortality

National directives for asbestosAims

4. Collect available air measurements

5. Collect the information about the location of asbestos dump sides and assess the quantities of asbestos waste material

National directives for asbestosGetting information

“Snow ball” princip• Companies:

» Salonit Anhovo» Donit Tesniti» Donit Filter» Donit Laminati» Fenolit» Fragmat» Izolirka» TIT Velika Loka» TVT Maribor» TMT Velika Loka» Slovenske železnice

National directives for asbestosGetting information

Slovenian customs:• permit for import of asbestos in 1997

Ministry of Health:• Information about companies that demanded import-

export permit for asbestos products in 1998

Slovenian Cancer Registry:• Cluster analysis of mesotheliomas from 1959-1994

National directives for asbestosGetting information

Questionnaire:

• Production • Quantities of asbestos use

• Quantities of products made

• Quantities of products sold at home market and abroad

• Quantities and locations of products built in different buildings (objects)

• “Lifetime” of produced products

National directives for asbestosGetting information

Questionnaire:• Workers

• Quantity of yearly employed workers in asbestos factory• Quantity of yearly exposed workers• Names of exposed workers, birth dates, gender…• Asbestos related diseases• Exposure limits for different time periods• Health and safety education• Asbestos air measurements, methods used, locations, plans of

plants…• Asbestos waste material (quantities, location: legal-illegal..)• Do they want to educate workers

National directives for asbestosGetting information

Information about asb buildings:• Schools (451+136) and kindergartens

• Cement-asbestos roofing and water pipes

National directives for asbestosResults

Yearly consumption of asbestos from 1965 to 1997

0

5000

10000

15000

20000

25000

30000

1965 1970 1975 1980 1985 1990 1995 1999

asbe

stos

in t

ons

Slovenia

Salonit Anhovo

Quantities of Amphiboles and Chrysotile (in tons) Used in the Manufacture of Asbestos-

cement Pipes, 1963 to 1994

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

19631964

1965

1966

1967

1968

1969

1970

1971

1972

1973

1974

1975

1976

1977

1978

19791980

1981

1982

1983

1984

1985

1986

1987

1988

1989

19901991

1992

19931994

year

tons

amphibole chrysotile

National directives for asbestoskm of a-c water pipes

75,7

205,5 10 6 1,2

33

132

6 14 25

420

303

245

0

50

100

150

200

250

300

350

400

450

500

CELJE

ČRNOMELJ

DRAVOGRAD

GORNJA RADG

ONA

JESENICE

ORMOŽ

POSTOJNA

PTUJ

RADLJE O

B DRAVI

SLOVENSKA B

ISTRIC

A

ŠKOFJA L

OKA

TOLM

IN

TREBNJE

RUŠE

NOVA GORIC

A

upravne enote

km

Quantities of Amphiboles and Chrysotile (in tons) Used in the Manufacture of

Asbestos-cement Sheets, 1963 to 1994

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

19631964

1965

1966

1967

1968

1969

1970

1971

1972

1973

1974

1975

1976

1977

1978

19791980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

year

tons

amphibole chrysotile

National directivesfor asbestos

Number of potentially exposed workers and yearly use of asebstos

0

1000

2000

3000

4000

5000

6000

7000

8000

1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 1999

nu

mb

er

of w

ork

ers

0

5000

10000

15000

20000

25000

30000

35000

use

of a

sbe

sto

s in

ton

s

exp to asbestos

all workers

asb in tons

PLEURAL DISEASES

• pleural plaques

• diffuse thickening

• pleural effusions

AZBESTOSIS

LUNG CANCER

Date of hire, date of diagnosis andquantityofasbestos used byfibre type andby year

0

10

20

30

40

50

60

70

1923 1928 1933 1938 1943 1948 1953 1958 1963 1968 1973 1978 1983 1988 1993

n. o

f wor

k.

0

5000

10000

15000

20000

25000

t of a

sb./y

ear

date of hire date of diagnosis

amphibole

chrysotile

MESOTHELIOMA MLG.

• the most aggressive mlg. disease

• aver. survival time: 14 months

• latency period: up to 65 years• also at low exposure

Expecednumber of newcasesofmesothelioma

2 3 1224

4158 58

103

149

y = 2,3766x2 - 6,8662x + 9,0714

R2 = 0,9704

0

50

100

150

200

250

300

61-65 66-70 71-75 76-80 81-85 86-90 91-95 96-00 01-05 06-10 11-15 16-20

Year

Num

ber

of c

ases

Mesothelioma clasters in SI

Deskle

OTHER CANCERS

• Laryngeal ca• Ovarian ca• Buccal mucus ca• Esophageal ca• Kidney ca• Intestinal ca

Compensation

• 1996 - asbestos ban

• 1998 - the State Board for the Recognition of Occupational Asbestos Diseases

Compensation

• Pleural diseases

• Asbestosis

• Mesothelima

• Lung cancer

• Environmental mesothelioma

• Others: gastrointestinal, laringeal (court)

ResultsDISEASE # AGE

yearsGender

M%

CumAsbExp A

CumAsbExp B

asbestosis 448 62.528.6-93.9

71.5 31.8 141.6

pleural dis. 1188 58.331.1-93.6

71.5 15.5 85.7

mesothelioma 127 61.936.5-84.7

64.5 19.6 151.9

lung cancer 52 62.641.6-84.8

87.8 19.2 108.9

GIT cancer 10 60.555.2-65.7

80.0 25.2 117.9

ASBESTOS RELATED DISESES, COMPENSATION - 2014

DISEASE MAX. COMPENSATION, EURO

PLEURAL DISEASES 13.394,74

PLEURAL EFL. 14.573,47

CHR. PLEURAL EFL 17.393,41

ASBESTOSIS 23.507,07

MESOTHELIOMA, LUNG CANCER 46.991,55

60% RS – 40% EMPLOYER

100% RS

EMPLOYER DOES NOT EXIST + ENVIRONMENTAL MESOTHELIOMA

THE STORM 2008

THE STORM 2008

Cement Asbestos Roofs byRegion

vir: nac. smernice

“Cleaningactions”i.e CleanSloveniain one day

Vinaz

Workinggroup: IOTSM, NIPH

• The most communities did not settle appropriate asbestos dumping ground.

• Inhabitants of those communities have to pay the a or a-c pick up and disposal.

• The number of illegal dumping grounds is rapidly increasing.

Workinggroup: IOTSM, NIPH

• In the eastern part of SI, cement asbestos corrugated sheets are illegally selling to Hungary.

• Cement asbestos removal and transport are nonprotected, exposure is spreading in environment.

• Each company has to ask for permission to remove the c-a roof >300m2. The rules are bend.

Suggestions

• State/all communities have to pay a or a-cpick up and disposal.

• Withdrawal of threshold limit of 300m2 to get environmental permission

Old proposal

All retired workers who were exposed to asbestos at their jobs in the past have right for medical (periodical) check ups.

THANK YOU FOR YOUR

ATTENTION

THANK YOU FOR YOUR

ATTENTION

HVALA ZA VAŠO POZORNOSTHVALA ZA VAŠO POZORNOST