Prevalence of Asbestos-Related Disease Among Workers in Sri Lanka

BACKGROUND

Asbestos products are manufactured and used in Sri Lanka in the construction and automobile industries.

OBJECTIVE

To determine radiologically if exposure to asbestos caused lung disease among workers handling asbestos products, and to generate data in Sri Lanka where no such data exist due to poor reporting and a poor surveillance system.

METHODS

Following ethics approval and written consent plain chest X-rays and exposure data were obtained in 230 workers in asbestos manufacturing, building construction, building demolition, tsunami debris cleanup, and other trades. The assumption was that all exposed workers were exposed to chrysotile. Participants were from provinces with asbestos factories, and where tsunami cleanup had occurred.

FINDINGS AND CONCLUSIONS

Radiological findings of the 230 participants showed lung fibrosis in 7% (16 cases), and other non-asbestos-related lung conditions. Of the 16 fibrosis cases, none were in manufacturing workers, one in a construction worker, six in tsunami workers, six in demolition workers, and three cases in others. Globally, Sri Lanka has one of the highest consumptions of chrysotile asbestos per capita. This first known study documenting asbestos disease in Sri Lanka is clearly a limited, self-selected group of workers studied with obvious limitations. The prevalence of asbestos-related lung disease among tsunami and demolition worker indicates that a risk exists for asbestos material already in use in Sri Lanka. Hence a significant concern is the safety of asbestos demolition workers and cleanup workers exposed to asbestos debris from major natural disasters such as hurricanes, tornados, typhoons, and tsunamis.

Prevention of Asbestos Exposure in Latin America within a Global Public Health Perspective

BACKGROUND

Asbestos consumption in Latin America (LA) amounts to 10% of yearly global production. Little is known about the impact of asbestos exposure in the region.

OBJECTIVE

To discuss scientific and socio-economic issues and conflicts of interest and to summarize epidemiological data of asbestos health effects in LA.

DISCUSSION

Recent data on chrysotile strengthened the evidence of its carcinogenicity and showed an excessive risk of lung cancer at cumulative exposure levels as low as 1.5 fibre-years/ml. Technology for substitution is available for all asbestos-containing products and ceasing asbestos production and manufacturing will not result in unemployment and loss of income, except for the mining industry. The flawed arguments used by the industry to maintain its market, both to the public and in courtrooms, strongly relies on the lack of local evidence of the ill effects and on the invisibility of asbestos-related diseases in LA, due to the limited number of studies and the exposed workers' difficulty accessing health services. The few epidemiological studies available show clear evidence of clusters of mesothelioma in municipalities with a history of asbestos consumption and a forecasted rise in its incidence in Argentina and Brazil for the next decade. In Brazil, non-governmental organizations of asbestos workers were pivotal to counterbalance misinformation and inequities, ending recently in a Supreme Court decision backing an asbestos ban. In parallel, continuous efforts should be made to stimulate the growth of competent and ethical researchers to convey adequate information to the scientific community and to the general public.