Asbestos related health risks Pascal DUMORTIER *,** & Paul DE VUYST** *a-ulab ** Chest Department Hopital ERASME
Asbestos related health risks Asbestos : some facts Asbestos related diseases Detection of asbestos exposures Types of abestos exposures Activities of a-ulab 2
Asbestos : naturally occuring fibrous minerals 3
Asbestos minerals Industrial Use Serpentine ASBESTOS Fibrous Amphiboles Common Chrysotile (White Asbestos) Amosite (Brown Asbestos) Crocidolite (Blue Asbestos) Marginal Anthophyllite None Tremolite Actinolite 90-95 % 5-10 % 4
Uses of asbestos +/- 3000 applications Building and construction materials asbestos cement sprayed-on asbestos (fire protection, thermal, acoustical and condensation insulation) pipe covering roofing floor and ceiling tiles acoustical panels Textiles Asbestos paper and milboard Mastics, paints, adhesives, coatings,... Friction products.. 11 décembre 2012 5
Asbestos related diseases Asbestosis Benign pleural diseases Mesothelioma Lung cancer Compensation in Belgium 6
Asbestosis LUNG FIBROSIS close to IPF Asbestos bodies in sections Needs a «reliable» history of exposure and an appropriate time interval between exposure and detection* Associated with high cumulative exposure > 25 fibres/ml.years seems necessary for occurrence and radiological and clinical detection** Mineralogical analysis : usually high fiber or AB counts in BALF or lung tissue *ATS criteria for asbestosis (1986) **Ontario Royal Commission on matters of health and safety arising from the use of asbestos in Ontario,1984 7
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Benign Pleural Disorders Pleural plaques (parietal pleura) Rather specific : 80-90% (especially if bilateral/calcified) Marker of exposure rather than disease (no measurable effect on lung function : Van Cleemput, 2001- Copley 2001) Usually no compensation Diffuse pleural thickening (visceral pleura) Less specific Can induce restrictive defects Can induce parenchymal lesions (rounded atelectasis) Benign asbestos pleural effusion other etiology must be excluded 9
Mesothelioma Primary malignant tumor of the pleura (also peritoneum and pericardium) Starts usually from the parietal pleura Not related to smoking Specifically associated with asbestos exposure (> 80% of cases) Can be induced by low or very low dose and/or intermittent exposures Latency periods are very long (mean 35 years after onset of exposure) 10
Lung cancer due to asbestos Smoking is the main cause of lung cancer Relative risk increases with cumulative exposure to asbestos Multiplicative effect between asbestos and cigarette smoking ~ 5% of lung cancer cases are due to asbestos No specific biomarker In many countries, diagnosis and registration rate of lung cancer cases attributed to asbestos are very low
Compensation of asbestos related diseases in Belgium FMP - FBZ Occupational exposure Only for wage-earners Fonds amiante Asbestosfonds Effective creation on April 1st, 2007 Everybody can apply to AFA Only one condition : asbestos exposure in Belgium
Tools for retrospective assessment of individual exposures to asbestos Airborne measurments (PCOM, EM) rarely available for an individual case Questionnaire Evaluation of exposure for each job probability, intensity, frequency and duration Index of cumulated exposure (epidemiology, compensation) Mineralogical analysis of biological samples
Types of asbestos exposures Occupational salaried or self-standing workers Para-occupational and domestic Households of asbestos workers (wives, children) Hobby Environmental Neighbourhood of asbestos mines or factories Indoor passive exposure in buildings Outdoor urban general environment Naturally occurring asbestos (Turkey, Corsica ) 14
Evolution of occupational exposure Shift in occupations : from handling raw asbestos (shipyards, insulation, primary asbestos industry) to end-users, especially in the construction Most currently exposed workers are in contact with asbestos material still in place : heating workers, electricians, plumbers, demolition workers, asbestos removers... These workers are often self-standing workers or even undeclared workers 15
Asbestos related health risks Asbestos : some facts Asbestos related diseases Detection of asbestos exposures Types of abestos exposures Activities of a-ulab 16
Analysis of materials (PLM) 11 décembre 2012 17
Determination of airborne fiber concentration (PCM) 11 décembre 2012 18
Formations proposées par a-ulab Obligation légale Formation aux traitements simples pour le retrait d amiante non friable par les entrepreneurs généraux Formations et recyclages annuels pour les désamianteurs Formations et informations spécifiques Conseillers en prévention Ouvriers de maintenance, plombiers, électriciens,.. Coordinateurs sécurité-santé Agents immobiliers 11 décembre 2012 19
CONTACT Contacts : Pascal Dumortier Philippe Remy Bernard Hermans Adresse : Avenue Auguste Picard, 48 6041 Gosselies Téléphone : 071 34 81 11 E-mail : Site Web : info@a-ulab.com www.a-ulab.com 11 décembre 2012 20