A Lost Opportunity
In January 2007, Japanese researchers announced a five year plan to track individuals at-risk of developing asbestos-related diseases. Nearly forty years previously, a pioneering scheme with a similar objective was set up in the UK only to disappear without trace or explanation some time in the 1980s. The survey of UK asbestos workers, set up in 1969 by Dr. Lloyd Davies, was designed with a great deal of thought by a tripartite advisory panel representing industry, trade unions and academia and was intended to continue for decades. This initiative was innovative and comprehensive and included: detailed occupational, medical and smoking histories; standardized symptomatic respiratory inquiries; chest auscultation; lung function tests; chest radiography; immunological studies; parallel environmental hygiene studies; mortality and malignancy studies.
The developmental ILO/UICC scheme for the epidemiological use of chest radiographs in cases of pneumoconiosis was used by the study and a research programme was initiated to validate and improve the protocol, using multi-reader panels and monitoring observer changes over time. Methods for computer scanning of films were investigated, automated data handling was exploited, and research was sponsored into a statistical method for producing a single score for a film that had several independent readings that varied. The whole system was up and running by 1969/70 under Dr. Lloyd Davies and continued under his immediate successor Dr. Suzette Gauvain. Alas, when Professor Irving Selikoff, from the Mount Sinai School of Medicine (New York), asked the Director of the Health & Safety Executive in 1990 about this scheme, he was informed that it had been terminated; no explanation was given and no official policy document was cited.
Considering the lengthy consultation that gave birth to the scheme, its unilateral secret termination raised many questions, which have, to this day, remained unanswered. Had the study proceeded as planned, however, the inadequacy of “reasonably practicable” engineering control measures would have been revealed, as would the inability to identify stages of asbestos diseases at which intervention was beneficial. These unwelcome findings would have supported an earlier call for a national asbestos ban and in the process would have saved many British lives. One can only hope that 21st century Japanese politicans are more far-sighted then their 20th century British counterparts.
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February 6, 2007
