Occupational Burden of Asbestos-Related Diseases in Korea, 1998–2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer

BACKGROUND: Asbestos exposure causes asbestos-related diseases (ARDs) including asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer. Although Korea used substantial amounts of asbestos in the past, no study has focused on its occupational burden of disease (OBD). Therefore, this study aimed to determine the OBDs of ARDs in Korea. METHODS: The CARcinogen Exposure (CAREX) database was used to determine the proportion of exposed population. Relative risks for lung cancer, laryngeal cancer, and ovarian cancer were used to determine the population-attributable fraction. Data for deaths caused by ARDs during 1998–2013 were obtained from the World Health Organization mortality database. The potential years of life lost (PYLL) and annual average PYLL (APYLL) indicated OBDs. RESULTS: In Korea, the number of ARD-attributable deaths and PYLL due to all ARDs during 1998–2013 were 4,492 and 71,763.7, respectively. The number of attributable deaths and PYLL due to asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer were 37 and 554.2, 808 and 15,877.0, 3,256 and 47,375.9, 120 and 1,605.5, and 271 and 6,331.1, respectively; additionally, the APYLL were 15.0, 19.7, 14.6, 13.4, and 23.4, respectively, and the average age at death was 70.4, 62.6, 69.1, 69.9, and 61.8, respectively. Our study showed that although the use of asbestos has ceased in Korea, the incidence of ARDs tends to increase. CONCLUSION: Therefore, efforts to reduce future OBDs of ARDs, including early detection and proper management of ARDs, are needed in Korea.

Developing Asbestos Job Exposure Matrix Using Occupation and Industry Specific Exposure Data (1984–2008) in Republic of Korea

BACKGROUND: The goal of this study is to develop a general population job-exposure matrix (GPJEM) on asbestos to estimate occupational asbestos exposure levels in the Republic of Korea. METHODS: Three Korean domestic quantitative exposure datasets collected from 1984 to 2008 were used to build the GPJEM. Exposure groups in collected data were reclassified based on the current Korean Standard Industrial Classification (9th edition) and the Korean Standard Classification of Occupations code (6th edition) that is in accordance to international standards. All of the exposure levels were expressed by weighted arithmetic mean (WAM) and minimum and maximum concentrations. RESULTS: Based on the established GPJEM, the 112 exposure groups could be reclassified into 86 industries and 74 occupations. In the 1980s, the highest exposure levels were estimated in “knitting and weaving machine operators” with a WAM concentration of 7.48 fibers/mL (f/mL); in the 1990s, “plastic products production machine operators” with 5.12 f/mL, and in the 2000s “detergents production machine operators” handling talc containing asbestos with 2.45 f/mL. Of the 112 exposure groups, 44 groups had higher WAM concentrations than the Korean occupational exposure limit of 0.1 f/mL. CONCLUSION: The newly constructed GPJEM which is generated from actual domestic quantitative exposure data could be useful in evaluating historical exposure levels to asbestos and could contribute to improved prediction of asbestos-related diseases among Koreans.

Asbestos exposure at workplace / Шинэ санаа Шинэ нээлт

Asbestos is a human carcinogen, and prohibited to use in 55 countries. Thermal power plants, construction industries, locomotive repair shops and analytical laboratories in Mongolia use asbestos as thermal insulation material. This study investigated exposure to airborne asbestos in workplaces. Total of 85 air sampleswere collected from thermal power plants (n=4), locomotive repairshop (n=1), construction renovation workplace (n=1), construction material shop (n=1) and analytical laboratory (n=1).The air samples were collected and analyzed by NIOSH 7400 and 7402 standard analytical methods. The average of airborne asbestos concentration (0.72f/cm3) in the workplaces was 7.2 times higher than the occupational exposure limit (0.1f/cm3). Exposure to airborne asbestos was exceeded in insulation workplaces of the thermal power plants and locomotive repairshop.Airborne asbestos was detected from construction renovation worksite, construction material shop and analytical laboratory, but did not exceeded the occupational exposure level.

Asbestos and Asbestos-related Diseases in Vietnam: In reference to the International Labor Organization/World Health Organization National Asbestos Profile

This paper describes progress on formulating a national asbestos profile for the country of Vietnam. The Center of Asbestos Resource, Vietnam, formulated a National Profile on Asbestos-related Occupational Health, with due reference to the International Labor Organization/World Health Organization National Asbestos Profile. The Center of Asbestos Resource was established by the Vietnamese Health Environment Management Agency and the National Institute of Labor Protection, with the support of the Australian Agency for International Development, as a coordinating point for asbestos-related issues in Vietnam. Under the National Profile on Asbestos-related Occupational Health framework, the Center of Asbestos Resource succeeded in compiling relevant information for 15 of the 18 designated items outlined in the International Labor Organization/World Health Organization National Asbestos Profile, some overlaps of the information items notwithstanding. Today, Vietnam continues to import and use an average of more than 60,000 metric tons of raw asbestos per year. Information on asbestos-related diseases is limited, but the country has begun to diagnose mesothelioma cases, with the technical cooperation of Japan. As it stands, the National Profile on Asbestos-related Occupational Health needs further work and updating. However, we envisage that the National Profile on Asbestos-related Occupational Health will ultimately facilitate the smooth transition to an asbestos-free Vietnam.

Awareness of Asbestos and Action Plans for Its Exposure can Help Lives Exposed to Asbestos

Despite the fact that asbestos is a known carcinogen to humans, it is still used in industrialized countries, especially Asian countries. The global incidence of asbestos-related diseases (ARDs) due to the past use of asbestos, continues to increase, although many countries have adopted a total ban on asbestos use. The implementation of effective strategies to eliminate ARDs is therefore an important challenge in Asia, where asbestos is still mined and consumed. Collaborative efforts and strategies at the local and international levels are vital, in the pursuit toward the elimination of ARDs in this region.

Association of Biomarker Levels with Severity of Asbestos-Related Diseases

OBJECTIVES: Asbestos-related diseases (ARDs) have increased globally over the decades, causing an economic burden and increased health care costs. It is difficult to predict the risk of development of ARDs and of respiratory disability among workers with a history of asbestos exposure. Blood based biomarkers have been reported as promising tools for the early detection of malignant mesothelioma. This study investigated whether serum soluble mesothelin-related peptide (SMRP) would reflect severity of disablement in compensable ARDs. METHODS: SMRP levels were measured in a cohort of 514 asbestos-exposed subjects. Severity of ARDs was assessed by a Medical Authority comprising four specially qualified respiratory physicians. Severity of ARDs and SMRP levels were compared. RESULTS: Mean (standard deviation) serum SMRP level in the population with compensable ARDs (n = 150) was 0.95 (0.65) nmol/L, and was positively associated with disability assessment (p = 0.01). Mean SMRP level in healthy asbestos-exposed subjects was significantly lower than those with pleural plaques (p < 0.0001) and in subjects with ARDs who received compensation (p < 0.01). CONCLUSION: This study indicates that serum SMRP levels correlate with severity of compensable ARDs. Serum SMRP could potentially be applied to monitor progress of ARDs. Further prospective work is needed to confirm the relationship between SMRP and disability assessment in this population.

Asbestos and environmental diseases

Asbestos causes several asbestos related diseases (ARDs). Not only occupational asbestos exposure but also environmental asbestos exposure can cause ARDs. In Korea compensation for workers with ARDs has been provided by workers' compensation. Because the asbestos damage relief act (ADRA) was enacted in 2011, ARDs by environmental exposure can now be compensated. Korea is the sixth country in the world to compensate environmental asbestos victims. In the ADRA, the list of compensable diseases eligible for relief consists of lung cancer, malignant mesothelioma, and asbestosis. Because the back ground and criteria of each ARD for relief is different, physicians need to be familiar with all of them in order to deal with ARD patients. In this paper, the properties of asbestos, history of ARDs, and contents of the ADRA are discussed. Although the relationships between occupational asbestos exposure and ARDs have been well established, those for environmental exposure have not. More specifically, the relationship between lung cancer and environmental asbestos exposure is still not clear because of strong confounders. The first wave of asbestos problems arose from occupational exposure directly involving asbestos production, the second wave arose from usage of asbestos products, and the third wave would be related to asbestos ubiquitous in the environment. In Korea the second wave is just beginning to swell. Physicians must to prepare for these waves to crest in the near future.

Preventive Measures to Eliminate Asbestos-Related Diseases in Singapore

The incidence of asbestos-related diseases (ARD) has increased in the last four decades. In view of the historical use of asbestos in Singapore since the country started banning it in phases in 1989 and the long latency of the disease, the incidence of ARD can be expected to increase further. As occupational exposure to asbestos still occurs, preventive measures to eliminate ARD continue to be required to protect the health of both workers and the public from asbestos exposure. The majority of occupational exposures to asbestos at present occur during the removal of old buildings. Preventive measures have been utilized by different government ministries and agencies in eliminating ARD in Singapore over the past 40 years. These measures have included the enforcement of legislation, substitution with safer materials, and engineering controls during asbestos removal as well as improvements in personal hygiene and the use of personal protective equipment. The existing Workman's Compensation System for ARD should be further refined, given that is currently stipulates that claims for asbestosis and malignant mesothelioma be made within 36 and 12 months after ceasing employment.

Towards Elimination of Asbestos-Related Diseases: A Theoretical Basis for International Cooperation

We develop a theoretical framework for international cooperation that can be used for the elimination of asbestos-related diseases (ARDs). The framework is based on the similarities in the temporal patterns of asbestos use and occurrence of ARDs in diverse countries. The status of each nation can be characterized by observing asbestos use and ARD frequency therein using a time window. Countries that supply technology for prevention of ARDs can be classified as donors and countries that receive these technologies as recipients. We suggest identification of three levels of core preventative technologies. Development of a common platform to gather and manage core preventative technologies will combine the strengths of donor countries and the needs of recipient countries.

Asbestos-related Diseases among Asbestos Textile Factory Workers and Residents Around the Factory

The asbestos textile industry is characterized by the highest asbestos ambient air concentration of those workers who have suffered from high incidence of lung cancer, malignant mesothelioma, and other asbestos related diseases (ARDs). Also, asbestos dust occurred in a factory can be disseminated into the environmental air around the factory, which can cause ARDs among residents of the factory. High lung cancer and malignant mesothelioma mortality rates among asbestos textile workers were established, and increase of ARDs among residents around the factory has been reported. A large number of environmentally exposed residents as well as severity of health problems among asbestos textile workers would cause huge social problems. The high exposure group needs to be monitored for early detection and management. In addition, a nationwide mandatory malignant mesothelioma registration system to identify exposure sources and high risk groups might help to predict and manage ARDs.