Asbestos Exposure and the Continuing Burden of Asbestos Related Disease. Paul A. Demers Partners in Prevention April, 2014

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1 Asbestos Exposure and the Continuing Burden of Asbestos Related Disease Paul A. Demers Partners in Prevention April, 2014

2 Town of Asbestos, Quebec Source:

3

4 Annual asbestos production:

5 Selected asbestos mines, historic vermiculite processing facilities and potential naturally occurring asbestos deposits CAREX Canada. Asbestos Environmental estimate. ental_estimate/#provincial_tables_and_maps+maps

6 Libby Vermiculite Shipments to Ontario Locations Tons shipped Years Ajax 96, St. Thomas 66, Caledonia 4, Oakville 3, Guelph 2, Waterdown 1, Scarborough Mississauga, Smithville, St. Laurent, Toronto Provincial Total 176,

7

8 Asbestos containing Products Building Product Friablity Dates of Use Mechanical insulation high mid 1970's Spray insulation high Texture coat moderate - high mid 1970's Floor tile low late 1970's Drywall taping compound low - moderate late 1970's Cement pipe low present Brake linings low present Duct wrap moderate - high mid 1970's Textiles/gaskets low - moderate mid 1970's Roofing material low late 1970's Ceiling tiles low - moderate 's Cement board low present HSE, University of British Columbia:

9 Industry Canada Data on Asbestos Imports based on Value (Cdn dollars) 14,000,000 12,000,000 10,000,000 8,000,000 6,000,000 Friction materials Sheets, panels, pipes Clothing, footwear Paper, millboard & felt Compressed jointing Other asbestos prod. Crocidolite products Pure asbestos 4,000,000 2,000,

10 Facilities* Reporting Use, Storage or Disposal of asbestos based on TRA: 2012 * 8 of 998 Facilties Reporting in 2012

11 CAREX Canada Estimates of Exposure to Asbestos in Ontario Industry Sector Ontario Construction 47,500 Residential building construction 15,300 Building equipment contractors 12,000 Building finishing contractors 11,300 Foundation, structure & building exterior contractors 4,500 Other construction 4,400 Automotive repair and maintenance 1,500 Remediation and other waste management services 600 Other 500 Total 52,200 See

12 Recognition of Asbestos-related Disease Health Effect Suspected Probable Established Asbestosis ~1900 ~1915 ~1930 Lung Cancer ~1930 ~1945 ~1955 Mesothelioma ~1940 ~1955 ~1965 Other Cancers ~1955 ~1970? From: U.S. IOM Asbestos, Selected Cancers, Original sources: Becklake (1976), Liddell (1997), Ross & Nolan (2003)

13 Incident Cases of Mesothelioma* Ontario, Male Female Source: Ontario Cancer Registry, 2014 (Cancer Care Ontario) Prepared by: Cancer Care Ontario (Population Health and Prevention), Report date: April 2015 *Mesothelioma: ICD O 3 morphology 905.

14 Mesothelioma incidence among males in the U.S., Steep increase in cases between mid 1970s 1990s, reflecting peak asbestos usage in 1960s Fast Stats: An interactive tool for access to SEER cancer statistics. Surveillance Research Program, National Cancer Institute. (Accessed on )

15 Trends in Mesothelioma Incidence Ontario Quebec Canada Linear (Ontario) Linear (Quebec) Log. (Canada)

16

17 Excess lung cancer based on the Mesothelioma Ratio Method According to data from the Ontario Cancer Registry there were 212 mesotheliomas in Ontario in 2010 Based on data from 49 cohort studies Mean ratio: 2.52 (95% CI= ) 530 lung cancers per year (6.7% of all lung cancer) North American: 4.37 (95% CI= ) 930 lung cancers per year (11.6% of all lung cancer) Chrysotile only: 3.62 (95% CI= ) 770 lung cancers per year (9.6% of all lung cancer)

18 Population Attributable Risk of Lung Cancer from Case Control Studies According to Stats Can there were 7990 lung cancers diagnosed in Ontario in 2010 Based on modeling of data from all 25 case control studies 9% = 720 (95% CI= ) new lung cancer cases per year Based only on North American studies 5% = 400 (95% CI= ) new lung cancer cases per year

19 Number of Fatal Cases of Asbestosis in Canada: Male Female Statistics Canada. Table New cases of primary cancer (based on the February 2014 CCR tabulation file), by cancer type, age group and sex, Canada, provinces and territories, annual, CANSIM (database). (accessed: )

20 Asbestosis Incidence in Canada Public Health Agency of Canada. Life and breath: Respiratory disease in Canada aspc.gc.ca/publicat/2007/lbrdc vsmrc/index eng.php

21 New cases, n=312 Source: Gan WQ, Demers PA, McLeod CB, Koehoorn M. Population based asbestosis surveillance in British Columbia. Occup Environ Med 2009;66(11):

22 Other Asbestos-related Cancers Cancer Site IOM, 2006* IARC, 2009** Larynx Sufficient Sufficient Pharynx Suggestive Limited Stomach Suggestive Limited Colorectal Suggestive Limited Esophagus Inadequate Inadequate Ovary Not reviewed Sufficient *U.S. Institute of Medicine. Asbestos: Selected Cancers, ** International Agency for Research on Cancer, Monograph 100c Working Group, 2009.

23 Mesothelioma Trends in Compensated Fatal Cancers in Ontario Del Bianco A, Demers PA. The Examination of Workplace Fatalities Within Ontario and Canada. Toronto: Occupational Cancer Research Centre, Data from AWCBC. National Work Injury Statistics Program, extracted March 12, Lung Cancers, asbestos Other cancers Lung Cancers, not asbestos

24 Conclusions Years after reductions in exposure and improvements in regulation, many workers are still being exposed. Canada continues to experience a large burden of disease related to asbestos. Further efforts to eliminate exposure and better compensation policies are needed.

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