Asbestos Conference in Poland
The first international asbestos conference to be held in Poland took place on May 11, 2004 in Lodz, an industrial town 75 miles from Warsaw. The meeting: Asbestos Issues in Poland was organized by the Nofer Institute of Occupational Medicine, Lodz and the Department of Occupational and Environmental Epidemiology as part of a series of events to mark the 50th anniversary of the Nofer Institute. Just days before the conference took place, Poland and nine other countries took up membership in the European Union (EU).1 The political, economic, environmental and cultural challenges which EU integration poses will be formidable. Although little has been done to quantify the asbestos problem in many of the new member states, in Poland, formerly the 16th biggest user globally, efforts are being made to examine and rectify the repercussions of the country's asbestos past.2 By providing a public forum for the discussion of global as well as national asbestos issues, delegates were able to consider alternative programs and identify successful strategies.
Global Asbestos IssuesThe first six speakers addressed international topics. After the opening ceremony, Laurie Kazan-Allen, Coordinator of the International Ban Asbestos Secretariat, assessed the global asbestos situation. Contrasting the decreasing use of asbestos in developed countries with increasing consumption in developing countries, she said: The lack of adequate health and safety legislation and enforcement in newly industrializing nations will ensure that the asbestos plague which has decimated workers and the public in the UK, France, Italy and the US will spread. Aggressive marketing by asbestos producers is succeeding in expanding markets for asbestos in countries such as India, Indonesia and Thailand. Even in countries which are signatories to the International Labor Organization (ILO) Asbestos Convention, workers are routinely experiencing hazardous exposures. Brazilian Labor Inspector Fernanda Giannasi reports:
The controls specified by ILO Convention 162 are frequently absent, especially in smaller companies. Even when these firms are aware of the risks, they continue to treat asbestos as just another raw material; no safety measures or protective equipment are used. Employers prefer to pay fines which are cheaper than adequate controls. The highest fine ever imposed for infringement of safety and health regulations is US$3,000. It is very cheap to kill and injure Brazilian workers. Another serious problem in Brazil is asbestos waste; as it is expensive to dispose of this waste appropriately, many companies dump it in secluded spots such as abandoned warehouses and derelict buildings.
The global nature of the asbestos epidemic requires the implementation of a global ban on asbestos. Working with international organizations such as the ILO, the World Health Organization, the United Nations and the World Bank is essential.
In his talk on The Global Incidence Asbestos-Related Disease, Dr. Antti Tossavainen, of the Finnish Institute of Occupational Health, showed the correlation between asbestos consumption and the incidence of mesothelioma in industrialized nations. Tossavainen said:
The results (of the research) indicate that the national use of 2.8 kg per capita will induce about 18 mesothelioma cases/million people, i.e. 170 tons of produced and consumed asbestos will cause one death from pleural or peritoneal mesothelioma.
Although less than 0.1 kg/capita/year of asbestos is now used in Western Europe and North America, 3.4 kg/capita/year is consumed in Russia. Nowadays, 70% of the asbestos produced worldwide is used in Eastern Europe and Asia; the vast majority is used for low cost asbestos cement building materials. While the disease rate could peak in Western countries around 2010-2020, Dr. Tossavainen says no reliable incidence data are available for the developing countries in Asia, Africa and South America.
The importance of an agreement reached by international experts on diagnosis and attribution of asbestos diseases was discussed;3 the Consensus Report: Asbestos, asbestosis and cancer states: 4
In general, reliable work histories provide the most practical and useful measure of occupational asbestos exposure. Using structured questionnaires and checklists, trained interviewers can identify persons who have a work history compatible with significant asbestos exposure. Dust measurements can be used in the estimation of past fiber levels at typical workplaces and in the use of asbestos-containing materials. A cumulative fiber dose, as expressed in fiber-years per cubic centimeter, is an important parameter of asbestos exposure.
Dr. Annie Thebaud-Mony, Director of Research, National Institute of Health and Medical Research, University of Paris, France, examined one hundred years of asbestos use in France and the epidemic of ill-health which resulted. Remarking on the dismal record of various French governments, members of the medical establishment and trade unions, she explained the importance of the National Association Supporting Asbestos Victims (ANDEVA), a social movement which suceeded in over-turning years of inaction:
The social movement supporting the asbestos victims broke the wall of silence which surrounded such a national and international drama. This movement obtained two important victories: recognition of the prejudices undergone by the victims and their families; the prohibition of asbestos not only in France but in all European Union countries.
The creation in 2000 of FIVA, a central indemnification fund for asbestos victims, is an attempt to relieve negligent employers of their guilt for the hazardous exposures their workers experienced:5
Responsible but not guilty such is the protection by which the asbestos industry executives and the employers' community prevailed against the penal complaints for manslaughter, poisoning, causing danger to other people
In the presentation Asbestos Issues in the UK, John Flanagan, of the Merseyside and District Asbestos Victims' Group, described the work of victim support groups in Liverpool and Manchester:
The strength and defining character of the Merseyside Asbestos Victims' Support Group and the Greater Manchester Asbestos Victims' Support is the commitment, experience and voluntary work of asbestos victims themselves, in both management committees and day-to-day work. However, volunteers with failing health, cannot by themselves, provide the continuity the groups need. To support asbestos victims, both groups have endeavoured to fund paid support workers, providing essential skills and continuity for the groups' work.
Our groups provide advice and support to asbestos victims and their families and campaign for justice for all asbestos victims. We provide information and advice on benefits and civil and state compensation. We assist asbestos victims at Medical Appeal Tribunals, attend inquests and provide information on access to expert legal advice.
Cooperating with other UK asbestos groups, all of which are poorly funded, and trade unions, MPs, solicitors and public health campaigners, the groups have suceeded in mounting high-profile campaigns such as the protests against: the repercussions of the Chester Street Insurance Company collapse, the limbo created by the administration of T& N Ltd. and the injustice of court decisions in the Fairchild case. Flanagan concluded his comments by highlighting the social importance of these groups:
Campaigns, including protests, are not just important in raising public awareness and forcing the pace of change. They give asbestos victims and deprived families an opportunity to voice their anger at the appalling loss of life and health caused by asbestos in the workplace and the community. As more and more people present with asbestos diseases from past exposure to asbestos and a desperate and criminal asbestos industry floods markets in the developing world with their poisonous product, it was never more important to raise our voices in protest.
The concerted attempt made by US asbestos companies and their insurers to suppress adverse research findings on the links between asbestos exposure and disease were described by Dr. Barry Castleman, author of Asbestos: Medical and Legal Aspects. Currently, there are 10,000 asbestos-related deaths every year in the US; these deaths could have been prevented if warnings by factory inspectors, scientists and doctors had been heeded rather than buried by asbestos company executives.
Illustrating the lengths to which enterprises would go to find new uses for asbestos, Dr. Castleman displayed a series of advertisements for:
asbestos socks: protect your feet by wearing patent asbestos socks;
material made of asbestos combined with 80 per cent cotton (which) produces a fabric similar to linen (1947);
women's coats exported from Italy containing 8% asbestos;
a new dishtowel which contains 20 per cent asbestos comes out of the United States Rubber laboratories. The asbestos towel is made in six colors red, green, yellow, rose, blue and burgundy;
asbestos Jewelry: a craft for schoolchildren.
The first asbestos-containing products banned in the US were imported Italian coats containing asbestos; although these were banned in 1972, the use of white (chrysotile) asbestos has not yet been banned by federal statute. A Congressional bill to ban asbestos, presented by Senator Murray in 2002, has not suceeded. The threat of litigation has, however, contributed to a climate in which asbestos is no longer used on a large scale but the effects of past usage are there for everyone to see. They include increasing numbers of victims and compensation cases. The business establishment, aggressively searching for ways of avoiding their liabilities, is backing legislative efforts to eliminate sympathetic juries, such as the proposals currently being supported by Senator Hatch.
Dr. Gregory Deleuil, the Medical Adviser of the Asbestos Diseases Society of Australia, illustrated his talk on asbestos issues in Australia with a breath-taking collection of photographs depicting the reality of life in an Australian asbestos mining town. Although the Wittenoom (Crocidolite: Blue Asbestos) Mine was operational for only 23 years, it has produced an epidemic of asbestos disease in Western Australia amongst former workers, their families and town residents. Many young adults, who had lived in Wittenoom as children, have died from asbestos-related diseases in their 20s and 30s. Greg's photos of race day in Wittenoom showed horses running on a blue track made from asbestos tailings. A photograph of children competing in sack races on the same track told its own story while the image of men competing to fill 50 gallon storage drums with asbestos tailings elicited gasps of disbelief from the audience. Dr. Deleuil informed us that the 1st and 2nd prize winners and the judge of the asbestos shovelling contest have all died from asbestos-related disease.
In recognition of the appalling human tragedy experienced by Australians, the Government set up The Asbestos Working Party in 2002 to identify research strategies aimed at reducing the incidence of asbestos-related cancer particularly mesothelioma, or curing these diseases.6 The budget for this program totals A$110 million over the next ten years. It is expected that this money will come from those with significant asbestos liabilities such as insurers, the national government and employers.
Cause and Effect: Asbestos Use and Repercussions in PolandDr. Neonila Szeszenia-Dabrowska, the main organizer of the conference, began the presentations on asbestos issues in Poland with her talk: Asbestos-Related Diseases in Poland Epidemiological Overview. Between 1945 and 1997,7 2 million tons of asbestos fiber were imported into Poland, of which 90% was chrysotile from the former Soviet Union and 10% was crocidolite, mainly from South Africa.8 Eighty per cent of the asbestos was used in the production of asbestos-cement (ac) construction materials. By the mid 1980s, it is estimated that annual asbestos use per individual (ind) in Poland was 1.7kg; compared to other countries, consumption was low:
Asbestos use Mid 1980s
German Democratic Republic | 3.3kg/ind |
Czechoslovakia | 2.8 kb/ind |
Japan | 2.6 kg/ind |
Austria | 2.0 kg/ind |
Belgium and Luxembourg | 1.9 kg/ind |
Data presented by Dr. Neonila Szeszenia-Dabrowska detailed the Polish incidence of mesothelioma amongst former asbestos workers. Those at high-risk of contracting mesothelioma, an asbestos cancer, include:
Workers from asbestos processing factories (produced asbestos packing, cords, ropes, threading and brake linings)
men in this cohort were nine times more likely to contract mesothelioma than in the general population;
women in this cohort were twenty times more likely to contract mesothelioma than in the general population.
Workers from ac plants
men in this cohort were twenty-three times more likely to contract mesothelioma than in the general population;
women in this cohort were fifty times more likely to contract mesothelioma than in the general population.
There were 1,174 deaths from pleural mesothelioma in Poland between 1980-1996, of which only 37 (3.1%) were recognized as being caused by occupational exposure. Compared to other countries, the speaker said, the incidence of pleural mesothelioma in Poland is low. Possible explanations for this are:
large-scale production of ac products did not begin until the 1960s;
the practice of rotating workers resulted in a relatively low cumulative lifetime exposure to asbestos;
male life expectancy in Poland is shorter than in some other European countries;
lack of medical knowledge which results in a failure to diagnose mesothelioma.
Dr. Jerzy Dyczek, from the Technical University of Mining and Metallurgy, spoke on: The Assessment of the Burden of Materials Containing Asbestos Used for Construction in Poland and the Level of their Degradation. The first asbestos factories in Poland were opened by Eternit, an Austrian company, in Krakow and Lublin at the beginning of the 20th century; the manufacture of ac products, primarily roofing materials, at these plants continued until 1972 and 1975, respectively. In Poland, asbestos was used in ac products such as: flat pressed boards, corrugated non-pressed boards, ridge tiles, flat pressed lining boards, normal pressure sewage pipes, high-pressure pipes, sewage piping sections and sections for air conditioning systems. Other asbestos-containing products were: asbestos boards, cords, ropes, cloth, sealing compounds, cements, mortars, packing. The asbestos content of these products varied; while flat pressed boards contained between 9.5-11% asbestos and normal pressure pipes 14-16% asbestos, asbestos ropes and cords were 80-96% asbestos fiber.
It has been calculated that the Polish infrastructure contains: 14 million tons of ac roofing material, 600,000 tons of ac high pressure pipes, 50,000 tons of ac panels in cooling towers, 60,000 tons ac plates and pipes in ventilation systems. As the service life of many of these products has been reached, the risk of fiber liberation is increasing. This was illustrated by a photograph of the surface of an ac board removed from a cooling tower after 26 years; exposed asbestos fibers were observed. The same situation was seen in a photograph of a roof section from an ironworks building. Although Polish regulations for asbestos management and removal are compatible with EU Directives, stricter enforcement is needed to ensure that hazardous practices do not increase environmental asbestos contamination.
Government Programs to Tackle Poland's Asbestos LegacyThe subject Government Project: Elimination of Asbestos and Asbestos-Containing Products Used in Poland was addressed by Stanislawa Szalucha from the Ministry of Economy, Labour and Social Policies. There are a multitude of laws governing various aspects relating to asbestos in Poland including thirty which regulate the removal of asbestos from buildings and the disposal of asbestos waste. Government estimates indicate that the amount of asbestos waste which will be generated in 2003-2012 will require 34 landfills, (25 are operational); by 2032, a total of 84 asbestos landfills of varied acreage will be needed. In May 2002, the Council of Ministers adopted a comprehensive program to address Poland's asbestos legacy. The objectives of this program are: asbestos decontamination of Polish buildings, infrastructure and environment, elimination of asbestos health hazards and implementation of all EU asbestos directives. The work of this interdisciplinary program is being overseen by a Program Council composed of 60 members divided into 8 problem committees and a Chief Coordinator, working under the auspices of the Ministry of Economy, Employment and Social Policies.
The title of the presentation by Bozenna Stankiewicz-Choroszucha, from the Ministry of Health, was The National Project of Medical Examination of Former Asbestos Workers - The Amiantus Project. Article 7a of the 1997 law banning asbestos in Poland stipulates that former workers from 28 asbestos processing plants throughout the country are eligible for free: medical examinations, drugs for asbestos diseases and annual spa treatments. As the examinations are conducted at 12 regional occupational medicine centers a standardized method was implemented. As part of the Amiantus Project, a Central Register of Workers Occupationally Exposed to Asbestos was developed; the accumulated data is being used to assess the national incidence of asbestosis, lung cancer and pleural mesothelioma. The following information was gathered from 4,850 former asbestos workers examined between 2000-2003:
54.5% of those examined were former ac workers;
radiological findings of pleural changes were found in 1,886 (30.6%) and opacities in 1,778 (36.7%) workers;
698 (14.4%) had asbestosis;
16 had lung cancer;
11 had pleural mesothelioma;
the longer the employment in asbestos processing, the higher the risk of asbestosis and chest abnormalities.
Dr. Ewa Wagrowska-Koski, from the Institute of Occupational Medicine, Lodz discussed The Legal Basis for the Recognition of Asbestos-Related Diseases in Poland. Regulations of the Council of Ministers (July 20, 2002), the Ministry of Health (August 1, 2002), the Ministry of Labour and Social Policy (December 18, 2002) and supplementary asbestos legislation and protocols stipulate procedures for diagnosing, certifying, documenting and compensating occupational diseases in Poland. The list of prescribed asbestos diseases includes: asbestosis, diffuse pleural thickening, diffuse pleural or pericardium plaques, lung cancer and mesothelioma. The diagnostic process requires notification by a primary care physician of a suspect case to a State Labor or Health Inspector. The doctor also refers the patient to an outpatients clinic or department of occupational diseases in a specialist centre at which an authorized physician is empowered to certify the occupational cause of the disease; an appeal can be lodged within fourteen days should a patient be dissatisfied with the outcome of this process. Once a State Health or Labor Inspector confirms the occupational cause of an illness, compensation can be claimed.9 Workers with certified asbestos-related occupational disease can receive:
sickness benefit for those with temporary disability;
rehabilitation benefit for those with long-term incapacity who are likely to regain the ability to work after treatment;
one-off compensation payment for family members of an asbestos fatality;
work disability pension for those incapable of work;10
vocational training pension for those able to work but in need of retraining.
The Management of Asbestos Waste in Poland was the subject of the presentation by Ewa Mieczkowska, an expert from the Ministry of Environment. A raft of legislation, including the Environmental Protection Act (2001), the Waste Act (2001), the Ministry of Economy Ordinance (1998), the Ministry of Labour and Social Policy Ordinance (1998), the Ministry of Economy, Labour and Social Policy Ordinance (2003), Road Transport of Dangerous Goods Act (2002) and Bulletin on Provisions and Procedures for Safe Handling of Asbestos-cement Goods (2003) specify procedures for:
safe removal of asbestos-containing products;
securing asbestos-containing goods and waste;
transport of asbestos-containing waste including training of drivers who operate vehicles transporting asbestos debris;
training courses for asbestos removal workers and workers handling asbestos waste;
cleaning of installations and equipment where asbestos was used;
submitting data to local, regional and national government on type, quantity and location of substances which constitute a threat to the environment;
regulating asbestos landfill sites: In a landfill with separate quarters asbestos-containing waste should be stored separately from other waste and the quarter should bear warning signs and should be marked on the landfill map. Such waste should be stored in landfill sites located far from residential buildings and separated from them with a green strip A layer of waste packages thus stored should be covered with plastic or with 5 cm ground layer in order to prevent damage of the packaging.
Case Study: Szczucin Community
The international notoriety achieved by one Polish community was explained by Dr. Neonila Szeszenia-Dabrowska in her presentation: Asbestos as an Environmental Hazard the Example of the Szczucin Community. The asbestos industry in Szczucin was an integral part of the community:
Asbestos has been a way of life here since the asbestos cement factory opened. Mothers knitted sweaters for children from asbestos cloth. The cloth was used for rugs and slipcovers. Many residents routinely kept piles of asbestos handy for little projects around the house. The piles would often be left uncovered sending dangerous fibers aloft with every gust of wind.
The Szczucin ac plant used 305,000 tons of chrysotile (white asbestos) and 65,000 tons of crocidolite (blue asbestos); between 1959 and 1996, the plant's emissions totalled 3.2 tons of crocidolite and 14.3 tons of chrysotile. Locally, asbestos waste was widely used in roads, farmyards, paving, houses, farm buildings and tool sheds; mounds of asbestos waste were situated in residential areas and fine-grain asbestos waste was spread on farmland. The total volume of asbestos waste and contaminated soil in the area has been estimated by the Institute of Environmental Protection as 0.8 - 1.0 million m3:
roads 330,000 m3 (65.5 km)
farmyards 8.6 hectares
driveways 28.6 hectares
Not surprisingly the incidence of mesothelioma amongst former workers and local residents is high. In the period 1987-2003, there were 55 cases of pleural mesothelioma in Szczucin: 28 cases among factory workers and 27 among local inhabitants. Between 2000-2003, there were 28 cases of pleural mesothelioma; the incidence of mesothelioma in this community is 125 times that of the general population in Poland. The local death rate from lung and gastric cancers is also high, as is that from non-cancerous respiratory diseases. Over the period 1975-1996, the age at death from lung cancer of Szczucin female inhabitants decreased by ten years. Dr. Neonila Szeszenia-Dabrowska concluded her talk by reiterating the extremely complex problems faced by this community.
International Asbestos Initiatives
Nigel Bryson, Director of Health and the Environment of the General and Municipal Boilermakers' Union (GMB) from 1992-2002, spoke about the GMB's long-term campaign to raise awareness of asbestos problems in the UK. The union's concern with this issue reflects the high price paid by GMB members who worked with asbestos:
The GMB membership of 720,000 includes asbestos removal workers, gas service engineers, construction workers, former asbestos product workers and shipyard employees, all of whom are considered to be at high-risk of developing asbestos-related diseases due to current and/or previous exposures Between 1980-85, there were 2,317 mesothelioma deaths in the UK. In the period 1996-2000 6,475 mesothelioma deaths were registered, a threefold increase. Unfortunately, many GMB members were among the dead.
Through leaflets, at seminars, on the GMB website and in training courses, GMB members were educated on where asbestos products are to be found and how to deal with the hazardous situations they create. The GMB's 1995 initiative: Asbestos: It's Still a Killer was a practical and sustained campaign; literature produced included a pamphlet showing examples of asbestos-containing roofing, construction and insulation materials in situ. Countering industry's on-going propaganda, Mr. Bryson wrote the publication: White Asbestos: It's Still a Killer, which has been widely circulated. The GMB worked closely with UK government agencies to develop stricter health and safety legislation; this resulted in the adoption of the Control of Asbestos at Work Regulations 2002 which introduced a new duty to manage asbestos. Recognizing the importance of European developments, the GMB has cooperated with bodies such as:
the Social, Health and Family Affairs Committee of the Council of Europe. (The Committee's report on asbestos recommended a comprehensive ban; this policy was adopted in April, 1998 by the Council of Europe);
a European Commission group tasked with developing asbestos removal training standards for European Union (EU) operatives and supervisors;
a Working Group on Asbestos, under the auspices of the EU Senior Labour Inspectors' Committee, which observed and commented on asbestos controls in France, Spain, Sweden and the UK in 2000.
In the presentation Danish Trade Union's Asbestos Program, Occupational Health and Safety Officer Lars Vedsmand, who has been working on asbestos issues since 1978, explained that even though Denmark had banned asbestos nearly twenty years ago, much remained to be done. People are still dying and will continue to die from asbestos diseases. As well as the usual high-risk trades, workers engaged in the refurbishment of buildings are also experiencing hazardous exposures to asbestos hidden within the country's buildings. Within Denmark, the union promotes awareness of asbestos hazards through its training courses. In Denmark, anyone whose work involves the risk of contact with asbestos is required to take a 4 day training course which covers information on the history and health risks of exposure to asbestos and practical guidelines on the recognition of asbestos-containing building materials and asbestos management techniques. With time, new workers come into the labor market, many of whom have no knowledge of asbestos; asbestos training must remain an on-going process. To prevent the transfer of asbestos technology from the developed to the developing world, the union works with international groups such as the International Federation of Building and Woodworkers, which coordinates the efforts of 283 trade unions with 11 million members in 124 countries, and the International Confederation of Free Trade Unions to lobby for a global ban on asbestos.
Jim Fite, from the White Lung Association (US), spoke about The Technical Aspects of Asbestos Abatement. The US is in the midst of an asbestos epidemic; recently asbestos was elevated to the number one position as an industrial killer via inhalation:
Over 100,000 workers present their diseased lungs for compensation each year in the United States. It is crucial that asbestos abatement becomes a recognized science so that millions of valuable schools, public buildings, houses, apartments, churches, mosques and synagogues, political halls, libraries and museums, police and court buildings can be properly cleaned. They are known to be contaminated. How to clean them? This is the question which requires asbestos abatement to become a science.
Faulty removal of asbestos has the potential to vastly increase exposure levels to asbestos removal workers and building users. Stressing the need for thorough worker training, clean working practices, use of wet methods and safe waste disposal, Mr. Fite listed the five standard abatement methodologies:
Repair |
Purpose: to make the asbestos containing material (acm) non-friable. Process: use of glue, plaster or other products to seal a broken floor tile, a cracked transite board, etc. |
Encapsulation |
Purpose: to bond asbestos onto a surface or into a material thereby preventing fiber liberation. Process: application of a liquid sealer over acm. |
Enclosure |
Purpose: to prevent liberation of fibers. Process: use of an airtight and watertight barrier to prevent human exposure to asbestos dust. Examples: used where asbestos cannot be removed such as in abandoned mines, factories, crawl spaces, boilers. |
Operations/ Maintenance |
Purpose: recognition of damaged acms and hazardous conditions, minimization of risks for small jobs. Process: training. |
Removal |
Purpose: final solution to asbestos contamination. Process: location of and evaluation of asbestos, state-of-the-art removal and decontamination techniques (negative pressure, HEPA filtered equipment, etc.), constant monitoring, clearance with phase contrast microscopy or transmission electron microscopy. |
Concluding Thoughts
There was a consensus that one day was not long enough to thoroughly explore the multitude of issues raised at the conference. While distribution of conference notes provided delegates with a useful summation of many of the presentations made, the crowded agenda could not accommodate much discussion. This was overcome, however, by delegates who continued to explore asbestos issues during breaks and in the evening. The exchange of email addresses was an assurance that communication would continue long after the conference was a distant memory.
Judging by the quality of presentations and the attendance of delegates, the first international asbestos conference in Poland was a success. By providing a public forum for international experts and their Polish counterparts to share asbestos experiences, effective strategies were identified and new initiatives were explored; media interest was high and news items broadcast on radio and television increased public awareness of this event. One of the many positive results of the conference was the decision by four Polish experts to attend the Global Asbestos Congress being held in Tokyo in November, 2004. Another achievement was the agreement to cooperate on plans for a conference in 2005 which would concentrate on asbestos issues in new EU member states and accession countries. There is much work to be done.
July 23, 2004
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1 The new EU members are: Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Slovenia , the Slovak Republic and Poland.
2 Indulski J, Szeszenia-Dabrowska N. Asbestos in Poland. Proceedings of the Asbestos Symposium for the Countries of Central and Eastern Europe. Finnish Institute of Occupational Health, 1998.
3 Asbestos, Asbestosis and Cancer Proceedings of an International Expert Meeting, Finnish Institute of Occupational Health, 1997.
4 Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution, Scand J Work Environ Health 1997;23:311-6.
5 FIVA is 75% financed by the national fund for occupational injuries and illnesses to which all employers contribute and 25% by the State. Between July 2002 and May 2003, FIVA processed 5,433 applications for compensation, of which 95% were from victims of occupational exposure. The average amount of compensation awarded by FIVA was higher than the basic compensation awarded by the occupational disease compensation system but lower than that obtained in the most successful court cases for negligent asbestos exposure.
6 Document published by the Australian National Health and Medical Research Council, Asbestos Working Party.
7 The manufacture of asbestos-containing products was banned in Poland in 1997.
8 From the early 1960s until the mid 1980s, crocidolite was used for the production of asbestos-cement pipes.
9 According to Iwona Pawlacyk writing in the TUTB Newsletter (April, 2004): Analyses done by the Central Occupational Safety and Health Institute and the experience of EU member states suggest that the total cost of occupational accidents and diseases may have topped 16 billion zlotys ($4.43 billion) in 2002.
10 Since March 1, 2004, the lowest monthly disability pensions for occupational asbestos-related disease amount to:
675.10 zl ($186.30) for total work disability
519.29 zl ($143.30) for partial work disability