Asbestos and Health WHO recommendations on elimination of asbestos-related diseases

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1 Asbestos and Health WHO recommendations on elimination of asbestos-related diseases

2 Background World Health Assembly Resolution 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 estimated mortality from occupational cancer

3 Asbestos-related diseases Lung cancer Mesothelioma Asbestosis Pleural plaques, thickening and effusions Laryngeal cancer Other cancers Mesothelioma

4 Worldwide 125 million people are exposed to asbestos WPRO B SEARO D EURO C EURO A AFRO E AMRO B SEARO B EMRO D AFRO D AMRO A EURO B WPRO A EMRO B AMRO D 7,057 6,312 6,233 6,222 6,155 5,678 5,084 4,683 4,462 2,842 1, ,651 39, ,000 20,000 30,000 40,000 Population exposed to asbestos by WHO region and mortality stratum (thousands)

5 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 asbestosrelated cancers and to nonoccupational exposure Asbestos is the most important occupational carcinogen causing 54% of all estimated deaths from occupational cancer

6 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

7 Summary of the conclusions from WHO assessments 1. All types of asbestos cause asbestosis, mesothelioma and lung cancer 2. No safe threshold level of exposure has been identified 3. Safer substitutes exist 4. Exposure of workers and other users of asbestos containing products is extremely difficult to control 5. 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

8 WHO recommendations for elimination of asbestos-related diseases Elimination of the exposure Recognize that stopping the use of asbestos is the most effective preventive measure 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

9 National programmes for elimination of asbestos-related diseases - international basis ILO instruments: Convention 139 on occupational cancer Convention 162 on asbestos Convention 170 on chemicals Resolution on asbestos (2006) Multilateral environmental agreements Rotterdam convention on prior informed consent Basel convention on hazardous waste WHO recommendations Resolution WHA58.22 Cancer prevention and control Resolution WHA60.26 Workers' Health: Global Plan of action Elimination of asbestos-related diseases Cancer Control: WHO Guide for Effective Programmes, Module Cancer Prevention

10 National programmes for elimination of asbestos-related diseases - WHO/ILO model Introduction and purpose Health aspects Magnitude of the problem Economic and social aspects Political and legal background National legislation International commitments Strategy for elimination of asbestos-related diseases Preventive strategies Strategic actions national, provincial and enterprise levels Knowledge management information about substitutes registry of exposed workers capacities and resources

11 National programmes for elimination of asbestos-related diseases cont'd Implementation Preparatory phase building up political commitment First phase reduce exposure to chrysotile Second phase stop use of chrysotile Monitoring and evaluation outcome process Administration National asbestos profile first profile periodic update

12 Further information WHO Elimination of asbestos-related diseases ILO & WHO, 2007 Outline for the development of national programmes for elimination of asbestos-related diseases WHO 2007, Cancer Control: WHO Guide for Effective Programmes, Module Cancer Prevention

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