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Slovenian asbestos case
Prof. dr. Metoda Dodič FikfakUMC Lj, Clinical Institute of
Occupational MedicineLjubljana, SI
National directives for asbestosAims
1. Legislation
2. Collect the data about:– asbestos consumption,
– production of asbestos and asbestos-cement products,
– use of asbestos products
3. Collect the data about exposed workers
4. Collect the information about asbestos caused morbidity and mortality
National directives for asbestosAims
4. Collect available air measurements
5. Collect the information about the location of asbestos dump sides and assess the quantities of asbestos waste material
National directives for asbestosGetting information
“Snow ball” princip• Companies:
» Salonit Anhovo» Donit Tesniti» Donit Filter» Donit Laminati» Fenolit» Fragmat» Izolirka» TIT Velika Loka» TVT Maribor» TMT Velika Loka» Slovenske železnice
National directives for asbestosGetting information
Slovenian customs:• permit for import of asbestos in 1997
Ministry of Health:• Information about companies that demanded import-
export permit for asbestos products in 1998
Slovenian Cancer Registry:• Cluster analysis of mesotheliomas from 1959-1994
National directives for asbestosGetting information
Questionnaire:
• Production • Quantities of asbestos use
• Quantities of products made
• Quantities of products sold at home market and abroad
• Quantities and locations of products built in different buildings (objects)
• “Lifetime” of produced products
National directives for asbestosGetting information
Questionnaire:• Workers
• Quantity of yearly employed workers in asbestos factory• Quantity of yearly exposed workers• Names of exposed workers, birth dates, gender…• Asbestos related diseases• Exposure limits for different time periods• Health and safety education• Asbestos air measurements, methods used, locations, plans of
plants…• Asbestos waste material (quantities, location: legal-illegal..)• Do they want to educate workers
National directives for asbestosGetting information
Information about asb buildings:• Schools (451+136) and kindergartens
• Cement-asbestos roofing and water pipes
National directives for asbestosResults
Yearly consumption of asbestos from 1965 to 1997
0
5000
10000
15000
20000
25000
30000
1965 1970 1975 1980 1985 1990 1995 1999
asbe
stos
in t
ons
Slovenia
Salonit Anhovo
Quantities of Amphiboles and Chrysotile (in tons) Used in the Manufacture of Asbestos-
cement Pipes, 1963 to 1994
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
19631964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
19791980
1981
1982
1983
1984
1985
1986
1987
1988
1989
19901991
1992
19931994
year
tons
amphibole chrysotile
National directives for asbestoskm of a-c water pipes
75,7
205,5 10 6 1,2
33
132
6 14 25
420
303
245
0
50
100
150
200
250
300
350
400
450
500
CELJE
ČRNOMELJ
DRAVOGRAD
GORNJA RADG
ONA
JESENICE
ORMOŽ
POSTOJNA
PTUJ
RADLJE O
B DRAVI
SLOVENSKA B
ISTRIC
A
ŠKOFJA L
OKA
TOLM
IN
TREBNJE
RUŠE
NOVA GORIC
A
upravne enote
km
Quantities of Amphiboles and Chrysotile (in tons) Used in the Manufacture of
Asbestos-cement Sheets, 1963 to 1994
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
19631964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
19791980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
year
tons
amphibole chrysotile
National directivesfor asbestos
Number of potentially exposed workers and yearly use of asebstos
0
1000
2000
3000
4000
5000
6000
7000
8000
1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 1999
nu
mb
er
of w
ork
ers
0
5000
10000
15000
20000
25000
30000
35000
use
of a
sbe
sto
s in
ton
s
exp to asbestos
all workers
asb in tons
PLEURAL DISEASES
• pleural plaques
• diffuse thickening
• pleural effusions
AZBESTOSIS
LUNG CANCER
Date of hire, date of diagnosis andquantityofasbestos used byfibre type andby year
0
10
20
30
40
50
60
70
1923 1928 1933 1938 1943 1948 1953 1958 1963 1968 1973 1978 1983 1988 1993
n. o
f wor
k.
0
5000
10000
15000
20000
25000
t of a
sb./y
ear
date of hire date of diagnosis
amphibole
chrysotile
MESOTHELIOMA MLG.
• the most aggressive mlg. disease
• aver. survival time: 14 months
• latency period: up to 65 years• also at low exposure
Expecednumber of newcasesofmesothelioma
2 3 1224
4158 58
103
149
y = 2,3766x2 - 6,8662x + 9,0714
R2 = 0,9704
0
50
100
150
200
250
300
61-65 66-70 71-75 76-80 81-85 86-90 91-95 96-00 01-05 06-10 11-15 16-20
Year
Num
ber
of c
ases
Mesothelioma clasters in SI
Deskle
OTHER CANCERS
• Laryngeal ca• Ovarian ca• Buccal mucus ca• Esophageal ca• Kidney ca• Intestinal ca
Compensation
• 1996 - asbestos ban
• 1998 - the State Board for the Recognition of Occupational Asbestos Diseases
Compensation
• Pleural diseases
• Asbestosis
• Mesothelima
• Lung cancer
• Environmental mesothelioma
• Others: gastrointestinal, laringeal (court)
ResultsDISEASE # AGE
yearsGender
M%
CumAsbExp A
CumAsbExp B
asbestosis 448 62.528.6-93.9
71.5 31.8 141.6
pleural dis. 1188 58.331.1-93.6
71.5 15.5 85.7
mesothelioma 127 61.936.5-84.7
64.5 19.6 151.9
lung cancer 52 62.641.6-84.8
87.8 19.2 108.9
GIT cancer 10 60.555.2-65.7
80.0 25.2 117.9
ASBESTOS RELATED DISESES, COMPENSATION - 2014
DISEASE MAX. COMPENSATION, EURO
PLEURAL DISEASES 13.394,74
PLEURAL EFL. 14.573,47
CHR. PLEURAL EFL 17.393,41
ASBESTOSIS 23.507,07
MESOTHELIOMA, LUNG CANCER 46.991,55
60% RS – 40% EMPLOYER
100% RS
EMPLOYER DOES NOT EXIST + ENVIRONMENTAL MESOTHELIOMA
THE STORM 2008
THE STORM 2008
Cement Asbestos Roofs byRegion
vir: nac. smernice
“Cleaningactions”i.e CleanSloveniain one day
Vinaz
Workinggroup: IOTSM, NIPH
• The most communities did not settle appropriate asbestos dumping ground.
• Inhabitants of those communities have to pay the a or a-c pick up and disposal.
• The number of illegal dumping grounds is rapidly increasing.
Workinggroup: IOTSM, NIPH
• In the eastern part of SI, cement asbestos corrugated sheets are illegally selling to Hungary.
• Cement asbestos removal and transport are nonprotected, exposure is spreading in environment.
• Each company has to ask for permission to remove the c-a roof >300m2. The rules are bend.
Suggestions
• State/all communities have to pay a or a-cpick up and disposal.
• Withdrawal of threshold limit of 300m2 to get environmental permission
Old proposal
All retired workers who were exposed to asbestos at their jobs in the past have right for medical (periodical) check ups.
THANK YOU FOR YOUR
ATTENTION
THANK YOU FOR YOUR
ATTENTION
HVALA ZA VAŠO POZORNOSTHVALA ZA VAŠO POZORNOST