Asbestos Exposure and the Continuing Burden of Asbestos Related Disease Paul A. Demers Partners in Prevention April, 2014
Town of Asbestos, Quebec Source: http://en.wikipedia.org/wiki/asbestos,_quebec
Annual asbestos production: 1886 2006 http://www.carexcanada.ca/en/asbestos/environmental_estimate/#provincial_tables_and_maps
Selected asbestos mines, historic vermiculite processing facilities and potential naturally occurring asbestos deposits CAREX Canada. Asbestos Environmental estimate. http://www.carexcanada.ca/en/asbestos/environm ental_estimate/#provincial_tables_and_maps+maps
Libby Vermiculite Shipments to Ontario Locations Tons shipped Years Ajax 96,664 1973 1991 St. Thomas 66,449 1967 1991 Caledonia 4,954 1971 1988 Oakville 3,157 1967 1978 Guelph 2,336 1971 1978 Waterdown 1,494 1978 1982 Scarborough 894 1974 Mississauga, Smithville, 949 1967 1977 St. Laurent, Toronto Provincial Total 176,898 1967 1991 http://www.carexcanada.ca/en/asbestos/environmental_estimate/#provincial_tables_and_maps+vermiculite_processing
Asbestos containing Products Building Product Friablity Dates of Use Mechanical insulation high 1926 - mid 1970's Spray insulation high 1935-1974 Texture coat moderate - high 1950 - mid 1970's Floor tile low 1950 - late 1970's Drywall taping compound low - moderate 1945 - late 1970's Cement pipe low 1935 - present Brake linings low 1940 - present Duct wrap moderate - high 1920 - mid 1970's Textiles/gaskets low - moderate 1920 - mid 1970's Roofing material low 1920 - late 1970's Ceiling tiles low - moderate 1950-1970's Cement board low 1930 - present HSE, University of British Columbia: http://www.hse.ubc.ca/safety/asbestosmanagement/typicalusesofasbestos.html
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 2,000,000 0 2007 2008 2009 2010 2011 2012 2013 2014
Facilities* Reporting Use, Storage or Disposal of asbestos based on TRA: 2012 * 8 of 998 Facilties Reporting in 2012
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 http://www.carexcanada.ca/en/asbestos/occupational_estimate/
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, 2006. Original sources: Becklake (1976), Liddell (1997), Ross & Nolan (2003)
Incident Cases of Mesothelioma* Ontario, 1981 2012 250 200 Male Female 150 100 50 0 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.
Mesothelioma incidence among males in the U.S., 1975 2010 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. http://seer.cancer.gov/faststats. (Accessed on 9 27 2013)
Trends in Mesothelioma Incidence 3.5 3 2.5 2 1.5 1 0.5 Ontario Quebec Canada Linear (Ontario) Linear (Quebec) Log. (Canada) 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012
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=2.06 3.11) 530 lung cancers per year (6.7% of all lung cancer) North American: 4.37 (95% CI=2.83 6.73) 930 lung cancers per year (11.6% of all lung cancer) Chrysotile only: 3.62 (95% CI=1.47 8.96) 770 lung cancers per year (9.6% of all lung cancer)
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=559 1039) new lung cancer cases per year Based only on North American studies 5% = 400 (95% CI=240 639) new lung cancer cases per year
90 80 70 60 50 Number of Fatal Cases of Asbestosis in Canada: 2000 2011 40 30 Male Female 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Statistics Canada. Table 103 0550 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: 2014 07 29)
Asbestosis Incidence in Canada Public Health Agency of Canada. Life and breath: Respiratory disease in Canada. 2007. http://www.phac aspc.gc.ca/publicat/2007/lbrdc vsmrc/index eng.php
New cases, 1992-2007 111 n=312 Source: Gan WQ, Demers PA, McLeod CB, Koehoorn M. Population based asbestosis surveillance in British Columbia. Occup Environ Med 2009;66(11):766 71. 21
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, 2006. ** International Agency for Research on Cancer, Monograph 100c Working Group, 2009.
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, 2013. Data from AWCBC. National Work Injury Statistics Program, extracted March 12, 2012. Lung Cancers, asbestos Other cancers Lung Cancers, not asbestos
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.