International Asbestos Conference for Fair and Equal Compensation for all Asbestos Victims and their Families
On November 23-24, 2007, a conference was held at the Annex Hall of the Pacifico Conference Center in Yokohama, Japan. Organized by the Ban Asbestos Network Japan (BANJAN), the purpose of this well-attended event was to compare national schemes in Europe and Asia and identify measures which were effective in providing equitable compensation for asbestos sufferers and their families.
Most conference delegates were not surprised by revelations that wherever government schemes are imposed to resolve the issue of asbestos compensation, the needs of corporations and governments take precedence over the needs of victims.
The timing of this event was significant as it was chosen to coincide with the 20th anniversary of BANJAN. This landmark anniversary gave a positive tone to the proceedings showing just how much can be accomplished by determined individuals working together. In many of the presentations, speakers underlined the need for cross-border cooperation to prevent the exploitation of vulnerable groups. Having heard several presenters describe the fatal consequences of Japan's asbestos heritage, it seemed inexplicable that most governments in Asia still sanctioned the use of asbestos. The outreach programs, including the ongoing collaboration of Japanese and Korean campaigning groups, were grounds to hope that before too long other Asian governments would follow the example of Japan and Korea and ban asbestos. The provision of simultaneous translations from Japanese to English and vice versa facilitated the exchange of information and enabled discussions to take place.
A photographic exhibition entitled Please Give Us Tomorrow Records of Asbestos Pollution and Patients and their Families showed the reality of the personal asbestos tragedy being played out in so many households in Japan. The photographer Akira Imai's work is both touching and memorable; standing in room E205 surrounded by the faces of so many asbestos-injured people, one could not be in any doubt that behind each statistic is a devastated human being and a grieving family. All the photographs in this report are reproduced with the kind permission of Akira Imai.
The consequences of Japan's asbestos use have impacted on the public consciousness on two occasions: in 1987, with the news of the dumping of asbestos-containing waste from a U.S. aircraft carrier in Yokosuka City and in 2005 with the revelation of an epidemic of asbestos cancer (mesothelioma) linked to an asbestos factory belonging to the Kubota Corporation. The plant in Amagasaki City manufactured asbestos-containing pipes and building materials for almost 40 years. In the paper Asbestos-Related Diseases Developed among Residents in the Vicinity of a Former Asbestos Pipe Factory in Amagasaki City, Japan, Dr. Shinji Kumagai showed photographs and diagrams illustrating the proximity of residential areas to the factory which annually used, on average, 4670 tons of crocidolite (blue asbestos) from 1957-1975, and 4600 tons of chrysotile (white asbestos) from 1975-1995.
In 2004, a citizen's group began door-to-door investigations near the factory and found three residents with mesothelioma; the following year, negotiations with the Kubota Corporation began. At a press conference on June 29, 2005, it was announced that 79 employees from the plant had died of lung cancer, mesothelioma or asbestosis between 1978 and 2004 and that Kubota was paying 2 million yen ($20,000/ €12,788) as consolation money (Kubota never used the term compensation). After the newspaper coverage of this event appeared in the national media, enquiries from the public inundated not only the victims' group but also Kubota and Amagasaki City Government. In December 2005, the President of Kubota confirmed that negotiations were ongoing with asbestos victims and their families; in April 2006, it was announced that an agreement had been reached.
Scientists undertook investigations into the correlation of asbestos-related disease and asbestos pollution from the plant. They concluded:
In Professor Takehiko Murayama's presentation, Japanese Perspective and Liability, bar charts and graphs revealed an upward trend in Japanese mesothelioma mortality. In 2006, the latest year for which data are available, there were more than 1,000 mesothelioma deaths in Japan. Compared to other countries, such as the UK, ratios of male: female mesothelioma mortality exhibited an unusual pattern with, in recent years, 2 male: 1 female. Although the reason for the relatively high incidence amongst women remains unproven, a high element of environmental exposure is suspected. Color coded maps of Japan showed the distribution of asbestos-using shipyards and factories that correlated almost exactly with asbestos disease hotspots. The prevalence of middle-large shipyards in the West of Japan and asbestos factories in Tokyo, Amagasaki City, and Osaka were reflected in the regional distribution of asbestos-related disease.
The use of asbestos in Japan began before World War II and was stipulated by the Government which controlled imports, promoted asbestos consumption in industrialization efforts and provided assistance, such as subsidies, to encourage use. In the 1950s-1960s, increasing activity of the private sector and more technical cooperation between Japanese and foreign companies saw national consumption increase. A rise in foreign investment by Japanese companies stimulated asbestos consumption in neighboring countries. Concurrently, international conferences were being held which documented the health repercussions of exposure to asbestos. Events such as the 13th International Conference on Occupational Health (New York, 1960), the Biological Effects of Asbestos (New York, 1964), 9th International Cancer Congress (Tokyo, 1966), International Conference on Occupational Health (Tokyo, 1969) left government and industry stakeholders with few illusions about potential dangers; yet virtually no efforts were made in Japan to protect those at risk of occupational or environmental exposure.
The reaction of Japanese companies to the widely publicized news of asbestos epidemics at their factories has, on the whole, been motivated by their desire to avoid lawsuits. They pay compensation at a relatively low rate to avoid an examination of the hazardous conditions which existed in their factories, all the while promoting themselves as socially and ethically responsible corporations. Civil society has the right to know what negligent corporations knew about the asbestos hazard and when they knew it. Companies must disclose corporate asbestos practices not only at their manufacturing facilities in Japan but also at their foreign factories.
The next speaker, Professor Ken Takahashi, discussed an International Comparative Approach to the Global Asbestos Epidemic. Building on previous research,2 national mortality rate trends of asbestos diseases from 1996-2005 were related with trends of per capita asbestos use from 1970-1985.
A global survey was done of countries with relevant data, age-adjusted annual and period mortality rates for 1996-2005 were calculated and historical asbestos consumption was characterized by per capita use and status of national bans. Professor Takahashi presented tables which summarized the findings amongst which were:
Concluding his talk, Takahashi pointed out that national interventions to substantially reduce asbestos use, including bans had been effective in scores of countries.
Journalist Hidetoshi Ohshima has covered the unfolding of the Japanese asbestos scandal since the Kubota Shock3 in 2005. In his talk on Compensation and Relief for Asbestos Victims in Japan: Observations Based on Interviews he focused on the many gaps which persist in the disbursement of compensation for asbestos-related diseases in Japan. There are, he said, gaps in: data collection, perception, payment of workers' compensation insurance benefits, with whole industrial sectors totally ignored, and compensation paid by negligent employers and polluting factories. The Japanese Government has a collective responsibility with asbestos-polluting corporations as the Diet consistently backed industry at the expense of workers:
In interviews he has conducted with Japanese asbestos victims and their families, Ohshima observed the bewilderment and despair at the neglect they have suffered from government agencies and polluting companies. Exhibiting photographs and newspaper articles which documented the growth of the Japanese asbestos victims' movement, he described some of the changes that have occurred:
Nevertheless there are many asbestos-injured who remain uncompensated, including those with occupational and neighborhood exposure and people suffering from asbestos-caused lung cancer; whole industrial sectors are still overlooked such as seamen; limitation issues have barred many affected families from obtaining compensation. In the aftermath of the Kubota Shock, the Ministry of Health, Labor and Welfare disclosed data revealing the number of asbestos victims compensated at named factories; this gave local people the opportunity to seek redress from these polluters. With recent moves to conceal this information, one has to question the depth of the Government's commitment to helping those so cruelly affected by the country's asbestos legacy.
In 1931, Britain was the first government to regulate the use of asbestos. Despite many other firsts in the evolution of knowledge about asbestos, British victims have faced a long and difficult struggle to achieve justice for their asbestos injuries. In her presentation, Current UK Asbestos Developments: Compensation, Medical Treatment and Political Support, Laurie Kazan-Allen, Coordinator of the International Ban Asbestos Secretariat, described the growing awareness of the asbestos hazard, the injustices experienced by asbestos victims, government and judicial means of delivering compensation and effective strategies for securing improvements.
Government action to deal with the national asbestos epidemic has been slow. As recently as 2003, UK medical specialists were bemoaning a national failure to diagnose and treat mesothelioma victims. A significant gap exists between the number of mesothelioma deaths and the number of claimants receiving disablement benefits; the size of government payouts to mesothelioma claimants is substantially less than court-awarded compensation. From 2002-2006, more than 10,000 people died from asbestos-related lung cancer; fewer than 500 received government benefits. There are very few cases involving asbestos-related lung cancer which succeed in the courts.
Since the 1990s, victim support groups have been set up in many regional asbestos hotspots. In July 2005, nine asbestos victims' groups from the North of England and Wales formed a campaigning body called The Asbestos Victims Support Groups Forum (the Forum). The Forum has mounted a coordinated campaign calling for improvements on a range of different issues including streamlining procedures for obtaining compensation and better medical treatment for the injured. Working with the Asbestos Sub-Committee of the House of Commons, the Forum has effected change by bringing issues such as the double diagnosis of mesothelioma patients and the inequity of the House of Lords' decision in the Barker case to the attention of MPs and Ministers.
The long latency period of asbestos-related diseases leads to many time-consuming complexities in the process of obtaining compensation. Previously, it was common for mesothelioma plaintiffs to die before their cases were heard. Since 2002, a specialist court4 has transformed the process of bringing a personal injury claim for fatal asbestos diseases. The London-based judicial service at the Royal Courts of Justice (RCJ) is currently dealing with 600 cases a year from all over England and Wales. Early admission of liability and the use of joint expert witnesses have reduced litigation costs and expedited the settlement of cases. Tightly timetabled procedures, the use of telephone and email for case management conferences and applications have increased the certainty of results and cut costs for both sides. Ninety-seven per cent of mesothelioma claims are settled before they reach trial; only 1% of these cases require assessment hearings.
The author of the presentation French Approach to Achieve Justice for all Asbestos Victims, Dr. Annie Thebaud-Mony, was unable to travel to Japan for the conference; her colleague Dr. Paul Joban presented her paper. France, at one time one of Europe's biggest users of asbestos, has been left with a tragic and costly asbestos legacy. There are 3,000 asbestos-related deaths annually and scientists predict that, in total, 100,000 French lives will have been lost to asbestos-related disease by the time the French epidemic is ended. In 2003, government compensation for asbestos-related injuries, including early retirement of victims5 and asbestos-exposed workers and payments for occupational asbestos disease,6 amounted to €1.2 bn (JPY190 bn/ $1.9 bn). Total payments for the next twenty years are predicted to be in the region of €26.8 €37.2 bn (JPY4240-5890 bn/ $42-$59 bn).
A national asbestos compensation fund (FIVA), set up by the government in 2000 ostensibly to compensate all French residents with proven asbestos-related diseases, has been more instrumental in protecting negligent corporations and government agencies than in providing justice for asbestos victims. FIVA has succeeded in minimizing compensation awards and diverting public attention away from the polluters:
Since FIVA has been established, few court cases of inexcusable fault have been brought. This enables guilty employers to escape civil and penal liability for their negligent behavior, gives little incentive to improve conditions and creates inequality between victims, with those compensated by FIVA receiving much less then those who litigate. FIVA has done nothing to assist many categories of asbestos victims, including thousands of contaminated migrant workers who return to their home countries, sub-contracted workers whose asbestos exposure is denied, the majority of environmental exposure victims and workers exposed to asbestos at sites operated by French multinationals overseas.
Eric Jonkheere's presentation, Actions and Achievements of Belgium Asbestos Victims and their Families, introduced a personal note into the proceedings. Eric's father Pierre worked for one of Europe's biggest asbestos groups Eternit. Recently, Eternit celebrated its 100th anniversary amidst much fanfare and in the presence of royalty. The company's position in the Belgian political and economic structure has been used to its advantage on many occasions: to prevent the imposition of health and safety regulations in its factories, and, more recently, to insure that asbestos cement production continued until the very last moment allowed under the European Union ban asbestos directive. As for compensating the thousands of Belgians whose lives had been damaged by Eternit asbestos, Belgian jurists and politicians ensured that the legal climate was heavily skewed in the company's favor.
Pierre Jonckheere worked as an engineer at Eternit's factory in Kapelle op den Bos from 1956 until his forced early retirement in 1985. As it was mandated that all the company's middle management lived within 10 km of the factory, the Jonckheere home was only 400 meters away. Pierre died of mesothelioma in 1987, when he was 59 years old; his wife, Francoise, who never worked at the plant, died of mesothelioma in 2000 and one of his sons died of mesothelioma when he was 42 years old, leaving 3 young children. Of the four remaining sons: one was diagnosed with mesothelioma in January 2007 and two have asymptomatic pleural plaques. In his talk, Eric conveyed the collision of feelings experienced by asbestos families: surprise, dismay, frustration, anger, anxiety and sadness.
In Belgium, a struggle to obtain accurate diagnoses and difficulty in accessing state-of-the-art medical treatment for asbestos-related diseases are sadly all too common. Eric's mother was determined that her family would begin the fight back against an establishment which cared little for individuals whose lives had been sacrificed to asbestos. Honoring their promises to their Mother, the Jonckheeres have worked closely with other victims to establish the Belgian Asbestos Victims Group: ABEVA. Despite press conferences, public demonstrations, newspaper articles and two high-profile asbestos conferences at the European Parliament, few improvements were achieved. That is, until the Prime Minister became personally affected by a loved one succumbing to an asbestos-related disease. At that point, serious negotiations began about establishing a national fund to compensate Belgian asbestos victims. In April 2007, this Fund was set up with the sum of €10 million (JPY1567 m /$15.65 m) donated by the State. Unfortunately, the Fund does not encompass all the demands made by ABEVA, but it is a beginning.
Eric pledged the Jonckheeres ongoing commitment to making asbestos a national priority in Belgium and their solidarity with the cause of Japan's asbestos victims. His speech was very warmly received by the Japanese audience and an interview with Eric was printed in a regional Japanese newspaper the following day.
Unlike its neighbor to the south, in the Netherlands asbestos victims have been able to bring personal injury lawsuits for over a decade. As in many countries, however, the ability to seek judicial redress was often compromised by the long latency periods of asbestos diseases, multiple defendants, matters of limitation and lack of funding. After a sustained and highly publicized campaign by asbestos victims and their supporters, the Government agreed to set up a neutralto speed up litigation by mediating between asbestos victims and employers/insurers. The work of this institute was discussed in the presentation, The Dutch Approach to Compensation for Asbestos Exposure: from Litigation to Mediation, by Yvonne Waterman.
The Institute for Asbestos Victims (Institut voor Asbestslachtoffers or IAS), which began processing cases in 2000, was introduced as an exemplaryof harmonious conflict resolution; it has been a disappointment on many fronts. The IAS is quite successful at reaching one category of asbestos victims; 370 out of the 400 (92%) people diagnosed with mesothelioma every year opt to use its services. However, a surprisingly high percentage of these victims according to informal sources, as much as 60% is found to be ineligible for IAS compensation. In addition, asbestos victims with asbestosis or asbestos-related lung cancer as well as the asbestos-injured with product (DIY), self-employedenvironmental exposure are ineligible to bring IAS claims.
The standardization of IAS-awarded damages means that a 36-year old electrician with young children would receive $78,000 (€54,133), the same amount as an 80-year old with no dependants. In the civil courts, where the loss of life is a major component in setting compensation levels, the sum awarded would have been higher to the younger man.
Initially, the lower IAS awards were viewed as a fair trade-off for an expedited receipt of benefits; nowadays few claimants receive their compensation as per the IAS guidelines. Even more damaging is the unexpected effect that the relatively low level of IAS damages has had on the judicial system; on the rare instances when lawsuits are initiated by asbestos victims nowadays, judges are:
increasingly referring to the Institute's standardized compensation, so now both regular court compensation and the Institute mediated compensation amount to the same, about €54,000. This makes the Dutch standard for compensation of occupational mesothelioma, one of the lowest in all of Europe.
The Dutch system is unique in that it mandates an up-front lump sum payment (TAS benefit) to mesothelioma victims of €16,500 ($24,000) as soon as the medical condition has been confirmed. While at first glance this would appear to be a considerate gesture,receipt of the TAS benefit can have some very negative consequences. In most cases, accepting the TAS benefit means that the claimant is no longer entitled to cheap legal assistance from the State and must fund his or her legal fees. As these are likely to far exceed the €16,500, it becomes undesirable to embark on a dubious venture where the prospective litigant could face paying his own legal bills, those of the defendant and the court costs. Also, when the potential financial outcome is much the same as that set by the IAS (€54,000), going to court becomes an irrational exercise. It is therefore little surprise that nowadays asbestos litigation in the Netherlands has almost disappeared. Concluding her talk, Waterman said that the IAS has:
effectively taken away the opportunity for occupational mesothelioma victims to seek legal redress in a public court, in all openness, in the eyes of society All the public anger about the injustice of the fate that asbestos victims suffer has evaporated. There is no media involved in their cases any more, they are now neither seen nor heard. The victims of the hidden epidemic have been silenced once more
In her opinion, the IAS serves negligent employers and insurers very well indeed, but victims rather less so.
Beginning his talk on Asbestos-induced Diseases in Italy, with a Note on the Carcinogenicity of Chrysotile, Dr. Benedetto Terracini commented that judging by presentations given in the morning, it appears that the asbestos histories of Japan and Italy are very similar. Before Italy banned the use of asbestos in 1992, 350,000 workers were being occupationally exposed to asbestos every year; by 2001, this figure had been reduced to 76,000, of which the vast majority (92%) worked in the construction industry.
There is a wealth of data on Italian asbestos-related disease which has been collated by the National Insurance Institute (INAIL), Italian cancer registries and the Italian Registry of Mesotheliomas (ReNaM) which document:
Although the ReNaM is engaged in an active search for cases and does not rely solely on voluntary reporting from pathology departments and hospitals, there is a significant under-reporting of asbestos-related pleural cancer and lung cancer. According to INAIL data, there was an average of 714 cases of asbestos-related cancer and 559 cases of asbestosis reported each year during the period 2002-2006. Terracini believes that this figure underestimates the problem by more than 50%. This means that every year 800 cases of asbestos diseases go unrecognized and uncompensated by the INAIL.
The largest asbestos cement (AC) factory in Italy, a country which Terracini described as a paradise for the AC industry,7 was located in Casale Monferrato, a town of 100,000. The health repercussions caused by the presence of Eternit's AC factory in Casale Monferrato have been dire; hundreds of asbestos-related deaths have been reported amongst workers, their family members and local people. Extensive epidemiological research has been done of various Casale Monferrato cohorts including 1,740 women married to Eternit workers. There are 40-50 deaths from mesothelioma in the town every year and the ratio between the number of mesotheliomas in the general population (non-Eternit workers) and Eternit workers is increasing.8 Although there is a law which provides benefits to those with occupational asbestos exposure for a minimum of 10 years, the law is ambiguous and has several requirements which are difficult to satisfy.
Towards the end of his allotted time, Dr. Terracini turned his attention to the subject of the carcinogenicity of chrysotile, citing new studies which disprove industry's assertions that chrysotile can be used safely under controlled conditions:
He concluded his remarks by saying that the evidence for carcinogenicity of chrysotile is as convincing as the evidence for amphibole forms of asbestos.
In the Summer of 2007, a bill to ban the use of asbestos was approved by the U.S. Senate. In the presentation The U.S. Asbestos Ban and the Issue of Contaminant Asbestos, Dr. Barry Castleman explained that the bill had faced opposition from the stone and mineral industries which had concerns about low levels (under 1%) of asbestos contamination of some of their materials. In order to overcome their opposition, compromises were made, the most significant of which involved the issue of contaminant asbestos. The revised U.S. bill restricted the national prohibitions to materials with more than 1% asbestos. The figure of 1%, which has no health basis, was adopted by the Environmental Protection Agency in 1973 because of analytical limitations which existed at that time. Materials with well under 1% bulk content of asbestos can give rise to high levels of airborne asbestos when used or disturbed.
Minerals which may be contaminated by asbestos or asbestos-like fibers include:
Since the 1940s, New York talc miners have contracted asbestosis-like lung disease; excess lung cancer was first reported in N.Y. talc miners in 1967. To date there have been 13 mesotheliomas amongst 1,000 former N.Y. talc miners; research by a competitor in the 1970s, identified asbestos in Vanderbilt talc. The notorious N.Y. talc mines will finally close in 2008, but there are also other worrisome talc sources. At least one talc product has been banned in Japan, whose ban law applies to products that have more than 0.1% asbestos.
Vermiculite mined in Libby, Montana was contaminated with tremolite asbestos; the tainted vermiculite was incorporated by WR Grace into attic insulation which was distributed throughout North America. Asbestos has also been found in vermiculite from Virginia.
Chrysotile is found in serpentine rock in many parts of the U.S. In California, epidemiologists have correlated the occurrence of mesothelioma with living near naturally occurring asbestos-containing minerals. In El Dorado County, California controversy persists over plans to develop the area because of the presence of asbestos in surface soil.
Case Study of Biancavilla, Sicily, Italy: after the discovery of a high local rate of mesotheliomas in the 1990s, half of which were occurring in women under the age of 60, Italian investigators found that the stone quarried in Biancavilla was contaminated with fluoro-edenitic fibers.
Officials in Minnesota have identified over 50 mesotheliomas amongst iron miners; Minnesota iron ore has a host rock that looks like amosite asbestos.
Should the Ban Asbestos in America Act as passed by the U.S. Senate become law, the bill mandates government agencies to undertake research into the hazards of contaminant asbestos. Upcoming hearings in the U.S. House of Representatives will focus on the hazards of products with less than 1% asbestos, and a stronger version of the bill may emerge from the House this year. Countries like South Korea which are now drafting legislation to ban asbestos, as well as countries with asbestos bans in place are advised to consider the issue of contaminant asbestos.
Although asbestos production started in Korea in the 1960s, the incidence of mesothelioma has remained low at 1-2/million with male: female ratio of 1.6:1. In the absence of sufficient data about mesothelioma in Korea, the issue of how reliable predictions can be made was addressed in the paper, Prediction of Mesothelioma Incidence from Asbestos Consumption, A Comparative Study, by Professor Domyung Paek. Several types of analysis were considered including:
Spatial variation studies which compare different:
Example: Per-capita asbestos consumption versus mesothelioma incidence in different countries as examined in the paper Ecological Association Between Asbestos-Related Diseases and Historical Consumption: an International Analysis by Takahashi et al.
Temporal variation studies which compare different:
Example: Estimation of Future Mortality from Pleural Malignant Mesothelioma in Japan Based on an Age-Cohort Model by Segura et al.
Having considered aspects of both types of studies, Paek showed how using a temporal change analysis, asbestos exposures experienced at 15-25 years of age showed the best fit of data. He also found that 30 years after exposure, the elevation of risk is revealed and that 50 years after exposure, the risk peaks. Based on these findings, Paek suggests that in Korea, there will be a spurt of mesothelioma incidence in 2010 and that incidence could peak in 2045. A table shown at the end of his presentation is informative.
Campaign to Make Mesothelioma a Compensable Disease in Hong Kong and Concern on Asbestos Usage in Hong Kong was the paper presented by Karen Lo from the Hong Kong Workers' Health Centre (WHC). The WHC, a non-profit organization set up in 1984, works to raise levels of occupational health. As part of its remit, the WHC is running a campaign on asbestosis and silicosis. Graphs presented by Ms. Lo showed a substantial rise in mesothelioma incidence in Hong Kong from 1983 to 2004, with male deaths outnumbering female ones. Due to the usual problems of long latency periods, difficulties in getting accurate diagnoses, lack of awareness amongst the public and medical profession, mesothelioma is not a compensable disease in Hong Kong. The WHC Campaign on Mesothelioma which began in 2006 has included:
As a result of this campaign, a proposal to amend the Pneumoconiosis Compensation Ordinance to make mesothelioma a prescribed disease was lodged in September 2007. The proposal was confirmed by the Pneumoconiosis Compensation Fund Bureau and the Labor Advisory Bureau and a draft bill will be tabled for discussion in the Legislative Council by March 2008. The WHC continues to press for other benefits such as a mesothelioma increment to allowable expenses for medical treatment, currently HK$200/day, (JPY2573 / $26/ €16), the adoption of measures to raise medical workers and employers awareness of mesothelioma to increase medical referrals and regular check-ups for at-risk workers.
Although the use of chrysotile is still legal under controlled9 conditions in Hong Kong, the use of amosite and crocidolite was banned in 1996. Chrysotile is being used in Hong Kong by the vehicle servicing industry in brake and clutch linings; it can still be found in old electrical and boiler insulation, hot water systems, on board ships and in sundry products such as braking pads for lifts. The number of workers currently being occupationally exposed to asbestos is unknown.
The final presentation of the day was given by Sanjiv Pandita of the Asian Network for the Rights of Occupational Accident Victims (ANROAV), who spoke about The Grassroots Asbestos Campaign in Asia. ANROAV members come from 16 different countries and include victims' groups, labor NGOs, trade unions, labor researchers and activists dedicated to the campaign to improve occupational health and safety throughout Asia. Groups from Japan Japan Occupational Safety Health Resource Center and BANJAN are founding ANROAV members. Recognizing the particular vulnerability of Asian markets to aggressive marketing10 by global asbestos producers, ANROAV embarked on a major asbestos campaign in 2003. With national consumption in some countries averaging more than 100,000 metric tons/year and 90% of global ship-breaking taking place in this region, occupational exposure to asbestos is common. ANROAV is particularly concerned about asbestos exposures experienced by:
With the use of graphic images taken within the asbestos sector in Asia, Pandita disproved industry's reassurances that chrysotile can be used safely. He said:
In ship breaking industries (India, China and Bangladesh) workers often remove the asbestos packing with their bare hands and then dry it in the sun to sell. Asbestos fibers are routinely flying in the air at these ship breaking yards.
As with all occupational accidents and diseases in Asia, there is a gross under-reporting of asbestos-related diseases. Pneumoconiosis is often misdiagnosed as tuberculosis; with a few exceptions, lung cancers and mesotheliomas are hardly reported. Since there is no proper diagnosis, compensation is out of the question. To raise awareness of the asbestos issue, ANROAV has organized and participated in numerous events including: the World Social Forum, India (2004), a two-day occupational health and safety conference with an asbestos workshop, Hong Kong (2004), the Global Asbestos Congress, Japan (2004), the Asian Asbestos Conference, Thailand (2006) and the Banning Asbestos in Asia Workshop, Bangladesh (2006). ANROAV works with grass-roots victims' organizations to identify asbestos victims and mobilize support. The ban asbestos issue is part of ANROAV's wider campaign to empower workers to demand their rights to safe workplaces.
After the sessions ended for the day, conference delegates were invited to a party in the lounge of the conference center to celebrate BANJAN's 20th anniversary.
During the brief ceremony which took place, three BANJAN publications were launched including the Japanese translation of the publication: Killing the Future Asbestos Use in Asia. Politicians, victim support personnel and international campaigners congratulated BANJAN on its success in bringing the epidemic of asbestos-related disease in Japan into the open. With live music provided by the Sho Kobayashi string quartet and a delicious buffet of Japanese food, international guests and Japanese delegates enjoyed a brief respite from the serious subjects discussed during the conference.
The first speaker on November 24th morning was Akinobu Itoh, the General Secretary of Zenkowan11 and the Secretary General of BANJAN (1988-1993); he addressed the subject: Initiatives Taken by All Japan Dockworkers' Union and Early Activities of Ban Asbestos Network Japan (BANJAN). A series of photographs showing the hazardous conditions created by loading and unloading asbestos shipments at Japanese docks made the level of hazardous exposure experienced by dock workers in Japan very clear.12 In 1974 during voluntary health check-ups, the union discovered that some of its members had contracted asbestos-related diseases. When they filed applications for compensation under the Pneumoconiosis Law, they were informed that: Port cargo handling is not deemed to be dust yielding work under the Pneumoconiosis Law. It took 10 years of concerted protests, lobbying and programs such as the Dust Particles Asbestos Initiative by the trade union to get this decision reversed (April, 1985). As of July 2005, 13 union members had confirmed cases of asbestos-related disease; there were 6 cases of asbestosis, 6 of lung cancer and 1 of mesothelioma; in the last 2.5 years, 6 more cases of asbestos-related disease have been confirmed with 4 mesotheliomas and 2 cases of lung cancer being diagnosed.
Achieving the extension of the Pneumoconiosis Law to cover dockyard workers with asbestos-related illnesses was just one of the union's accomplishments. It has also:
With the impending dissolution of the General Council of Trade Unions of Japan (1987), groups representing labor and civil society decided to establish BANJAN. As asbestos was regarded as purely an occupational issue, awareness of the national implications of increasing consumption was low; the government's position on asbestos was that it could be used safely under controlled conditions. BANJAN followed a phased approach to assessing and quantifying the issues. In Spring 1987, asbestos exploded onto the national consciousness over the presence of sprayed asbestos products in schools. Unfortunately, once the media coverage stopped, the public lost interest. BANJAN continued its work and negotiations with various government ministries and agencies were commenced. A bill to ban asbestos was presented to the national Diet in 1992 but was scrapped by a committee in the lower house. BANJAN continues to demand improvements to programs and measures for asbestos-injured individuals and remains committed to its core principles of:
phased actions for realizing a non-asbestos society, policy enforcement based on the precautionary principle, information disclosure, consensus building among the nation and implementation of an integrated controlling structure.
Tackling Asbestos in Yokosuka, was the title of the presentation by Munehiro Yasumoto of the Kanagawa Occupational Safety and Health Center. Yasumto described the coalescing of local and national groups to address the high local incidence of what was originally thought of as pneumoconiosis and was later redefined to include asbestos-related illnesses under the remit of the Yokosuka project.
Supporters of this initiative included occupational health organizations, patient groups, medical bodies and labor unions. The leadership of local people such as that provided by the late Mr. Tajiri was pivotal in assuring that the project responded to the needs of the community. Actions taken included: setting up the Yokosuka Pneumoconiosis Society, founding a Yokosuka branch of the Japan Pneumoconiosis Association, lobbying for a Pneumoconiosis and Asbestos Fund (which was set up in 1997), raising awareness of occupational illnesses through initiatives such as the pneumoconiosis and asbestos health problems hotline, and supporting legal actions to obtain compensation for the injured such as victims with asbestosis or mesothelioma who had worked at the U.S. naval base in Yokosuka.
Hajime Miyamoto of the National Federation of Construction Workers' Union (Zenkensoren), spoke about The Measures Concerning Asbestos Exposure and the Compensation for Construction Workers in the next presentation. In 2006, there were 5.5 million construction workers in Japan; Zenkensoren, established in 1960, represents 710,000 of them. In 1987 the union set up an Asbestos Committee to raise members' awareness of the occupational asbestos hazard. Questionnaires were circulated and health examinations were undertaken; literature and educational videos have been produced focusing on asbestos hazards in the construction and demolition sectors. Working with BANJAN, the Union has lobbied the Government and national medical associations for better medical treatment and better support for victims.
As in other parts of the world, construction workers in Japan are at high risk of contracting asbestos-related diseases. Figures shown by this speaker documented the impact asbestos exposures have had on them.
Compensation Cases Among Construction Workers
From 2005-2006, the number of cases nearly trebled from 301 to 847. The geographical distribution of cases is also significant; in 2005, compensation cases were approved in twelve prefectures, in 2006, twenty prefectures were involved. Although the union's efforts have been crucial in identifying and bringing compensation cases, unresolved problems remain, such as the shortage of medical facilities, failure to diagnosis asbestos-related illnesses and difficulties in establishing the site of hazardous exposures in individual cases.
Zenkensoren supported the movement to collect a million signatures for a petition requesting the Diet enact a new asbestos law which ensures fair compensation and equal relief to all victims. This action gathered 1,870,000 signatures!
Kazuko Furukawa, of the Japan Association of Mesothelioma and Asbestos-Related Diseases Victims and their Families (the Association), reminded conference delegates of the very personal nature of the asbestos tragedy; Mrs. Furukawa is a mesothelioma widow. Her presentation, Live Today for the Future, documented the efforts of ordinary men and women whose lives have been impacted by asbestos in Japan. The Association was founded in February 2004 to spread awareness of asbestos-related diseases and provide a forum for information exchange amongst the injured and their family members to combat the depression, loneliness and isolation an asbestos diagnosis brings. Setting up this national body was made possible by years of work by local groups which had organized meetings, press conferences and lobbying efforts in asbestos hotspots for a number of years.
In August 2004, the Association began negotiations with the Ministry of Health, Labor and Welfare. A few months later it played a pivotal role in the organization of the Global Asbestos Congress (GAC); the GAC 2004 provided a wonderful opportunity for Japanese people to have face-to-face meetings with overseas experts, victims' representatives, victims and bereaved family members. The Association worked with injured individuals and local groups in the run-up to the Kubota Shock (July 2005) and in the months which followed played an important role in the press coverage of the unfolding asbestos scandal in Japan. In 2007, the Association sponsored a petition for the provision of basic rights for asbestos victims and for the creation of an asbestos-free society which attracted massive support. To draw attention to this document, the Association held public meetings and a rally in Tokyo.
The next speaker, Sugio Furuya, known to all the conference delegates as the main organizer of this event, has been leading the Ban Asbestos movement in Japan for many years. It was his job to try and sum up 20 years of BANJAN's efforts in 30 minutes: not an easy task! In his presentation, Asbestos Issues in Japan: Past and Present, Furuya placed the Japanese asbestos experience within the international context, showing graphs of national and regional consumption data and mesothelioma incidence.
Among the industrialized nations listed, Japan was the last to recognize and compensate cases of asbestosis, lung cancer and mesothelioma; the first Workers' Compensation awards for these diseases were in 1954, 1973 and 1978 respectively. Selected photographs from the BANJAN scrapbook illustrated the growth of the ban asbestos campaign featuring landmark events such as the Global Asbestos Congresses (2000 & 2004), Asian Asbestos Conference (2006), Japan-Korea Asbestos Symposium (2007), victims' meetings throughout Japan and newspaper coverage of key developments such as the Kubota Shock and One Million Signature Campaign. BANJAN's success is based on the strength of its grass-roots support and members of the BANJAN board include representatives from all parts of civil society including railway, construction, water and shipyard workers' trade unions, teachers, consumers, asbestos victims, scientists, technicians and health and safety campaigners.
BANJAN's basic demands are:
The purpose of the conference in Yokahama is, said Furuya, to investigate compensation systems in other countries and identify which work best for asbestos victims. To this end, comparative data from Japan, the UK, the Netherlands, France and Belgium were presented. The speaker criticized the low levels of compensation being paid in Japan to victims of non-occupational asbestos exposure and the excessive burden of proof placed on sufferers and their families.
Dr. Norio Kurumatni, of the Nara University School of Medicine, was the first speaker in the afternoon session. His subject was What We Learned and What We Need to do Next: Kubota's Case in Japan. Reviewing the evolution of international knowledge on the effects of non-occupational asbestos exposures, Kurumatni was in little doubt that the present disaster in Kubota could have been prevented had the warnings been heeded. Many of the present cases of asbestos-related diseases would not have occurred if the factory had stopped using crocidolite in the mid-1960s. Had action been taken in 1986 when the first Kubota asbestos-cement worker died from mesothelioma, many lives would have been saved.
There are many lessons which can be learned from the Kubota debacle. It is absolutely essential that information is shared among local authorities and central government. New legislation should be enacted that makes such inter-agency communication mandatory; it should stipulate that corporate health professionals notify the authorities of the use of any toxic substances which could impact on the local community. Regarding the asbestos fallout from Kubota, government backing should be provided for:
The Relationship Between Environmental Asbestos Exposure and Malignant Mesothelioma in Busan,13 Korea was the title of the paper presented by Dr. Domyung Kang from the Pusan National University School of Medicine. In Korea there were 14 asbestos fabric factories, of which 9 were located in Busan City and 4 were nearby; the oldest (J-Chemistry), which was also the largest, began asbestos production in 1969 and closed in 1992. It was located in a residential area of the Yeonje district of Busan and used crocidolite asbestos. An elementary school was built in 1984 within 50 meters of the J-Chemistry factory; 10 other schools were located within 2 km of its premises. Three other asbestos fabric factories were situated in the Sasang district and four were in the Saha district. Nearly half a million people lived in proximity to these polluting units.
After TV broadcasts in 1990 about the operations of the asbestos fabric industry in Busan and increasing anecdotal reports of the elevated level of asbestos-related disease in the city, a study was undertaken to quantify the impact of the asbestos sector on human health. Ten years (1997-2006) of data on the incidence of malignant mesothelioma, information from a national mesothelioma surveillance program and records from 4 Busan hospitals were analyzed. A total of 25 cases of malignant mesothelioma were diagnosed in Korea of which 13 were due to environmental exposures; 11 occurred in people who lived near the J-Chemistry factory. An analysis of the environmental exposures showed that 20% of those affected lived within 1 km of a polluting source, 56% within 2 km and 80% within 3 km. Among those with mesothelioma contracted from environmental exposures, there were more females then males; with occupationally-caused mesotheliomas, the situation was reversed. The speaker outlined plans which include: verifying conflicting data sources, following up on the status of high-risk groups, investigating the incidence of other asbestos-related diseases, establishing an Asbestos Center and developing compensation methods and criteria for Korean victims of environmental asbestos exposure.
Due to a last minute complication, the presentation by Dr. Annie Thebaud-Mony, the Director of Research at Inserm, was given by her colleague Dr. Paul Jobin. In The Social Visibility of Asbestos-Related Diseases Compared to other Industrial Diseases, the speaker discussed available means of raising public awareness of occupational ill health and thereby bringing a problem previously relegated to the industrial sector into the public arena. A detailed analysis of occupational cancers in Japan, France, Germany, Finland, Sweden, Denmark, Italy and Spain showed that asbestos-related cancers accounted for the vast majority of compensated cases ranging from 67% (Italy) to 97% (Japan, 2005). For the most part, the claiming process for these cancers ensures they remain invisible. Looking at asbestos-related disease within the context of occupational diseases such as Karoshi (death from overwork) and musculoskeletal disorders, the speaker concluded that although a certain level of social visibility had been reached in some countries for asbestos-related cancers and Karoshi, the occurrence of other industrial diseases remains hidden. These victims are no less worthy and society must mobilize to ensure they obtain the justice they deserve. Jobin concluded the presentation by stating that without a social battle there is no social visibility of industrial diseases.
Outline of The Asbestos-Related Health Damage Relief Law (the Law) was the title of the paper given by Kenji Kamigawara of the Environmental Restoration and Conservation Agency (ERCA), Japan. Under the Law approved by the Japanese Diet in February 2006, the ERCA certifies the eligibility of claims for mesothelioma and asbestos-related lung cancer compensation brought by victims and/or the families of deceased victims. Explaining the procedures followed for approving claims, the speaker highlighted the significant financial contribution required by the central government, local governments and Japanese companies to pay for this scheme. From the data he showed detailing applications and certifications for relief benefits as of September 30, 2007, it is clear that a significant proportion (38%) of the claims are not approved:
Some claims are withdrawn during the vetting process because of lack of medical evidence or payments from other systems such as workers' accident insurance.
The final plenary speaker was Yeyong Choi from Friends of the Earth, Korea. His presentation, A Dangerous Trade, documented research conducted in Japan, Korea and Indonesia which clearly revealed the dumping of hazardous technology on developing countries. From 1943-1970, companies such as Tatsuta, a subsidiary of the Nichias Corporation, manufactured asbestos textiles in Japan using crocidolite asbestos. In 1971, Tatsuta's asbestos textile production relocated to Korea; Tatsuta and JEIL Chemistry, a Korean company, set up a joint venture called JEIL Asbest, with Tatsuta holding 45% of the new company's stock. The JEIL asbestos factory, which operated until 1990 in Busan, also used crocidolite asbestos. One year after production ceased in Korea, it re-started in Indonesia. Equipment, processes and procedures were transferred from Busan to Cibinong, Bogor, Indonesia; to asbestos textile factories such as that operated by PT Jeil Parjar.14
As in Japan and Korea, Indonesian asbestos factories are heavy polluters putting both workers and local people at risk from hazardous levels of exposure to asbestos. An analysis of PT Jeil Parjar products undertaken in 2007 showed they are composed of 48%-98% chrysotile asbestos. The workplace conditions in Cibinong's asbestos textile factories are on a par with those found in Busan, that is to say, workers do not have protective equipment and methods of suppressing fiber liberation are absent. Photos of broken sacks of Ural Asbestos fiber littering the factory premises were appalling, as were images the speaker showed of asbestos-covered factory equipment. No information is available at this time on the conditions in asbestos production units which were relocated from Korea to Malaysia and China.
Using graphs and data to document the incidence of asbestos-related disease in industrialized countries, the speaker asked: What about Asia? While an asbestos epidemic is emerging in Japan, only a few cases of asbestos-related disease have been diagnosed in Korea. A black and white photo of a young woman working in a Busan asbestos textile factory was contrasted with that of a color photo of a woman lying in a hospital bed; it was the same person. She died of mesothelioma in 2006. What about the other workers in Korea and those in Indonesia, Choi asked. What about the children at the schools in Japan, Korea and Indonesia which were/are in close proximity to the industrial polluters?
In Korea, at the same time as the import of raw asbestos fiber has been decreasing, the import of asbestos-containing products has been on the rise. Asbestos contamination is everywhere in Korea as illustrated by the photos of contaminated subway stations, schools, public buildings and rubbish dumps. Concluding his presentation, Choi said work is urgently needed to quantify the ongoing asbestos hazard not only in Korea but also in Indonesia. Highlighting the cooperation of BANJAN, he called for the establishment of a similar organization in Korea and throughout the region: Ban Asbestos Asia.
The final sessions of the conference were allocated for discussion. The informative presentations stimulated a wide range of questions and debate on a variety of subjects including:
Three themes were explored:
Theme 1 Levels of Compensation
Theme 2 Success of National Compensation Delivery Systems
Theme 3 Challenges for the Future
At the end of the discussion, a draft resolution, 2007 Yokohama Declaration for Fair and Equal Compensation for all Asbestos Victims and Their Families, was presented; after discussion the text was unanimously adopted by the delegates (Appendix). It stated that:
When the Kubota Shock propelled Japan's asbestos epidemic into the public arena, there was little awareness of the painstaking efforts which had been ongoing since 1988 to identify victims and establish the facts regarding the source of their exposure. The prescience of BANJAN's founders and the pioneering work of this group deserve worldwide recognition. As was shown by the very effective conference which this report details, far from resting on its laurels, BANJAN continues its vigorous campaign to document every aspect of the asbestos scandal.
Although some multinational corporations believe that issues of corporate accountability can be ignored, they are wrong. Companies will be held to account for the harm they have done. That this is happening in Japan now is thanks to the mobilization of civil society. BANJAN, working with its social partners in Japan, has succeeded in placing asbestos on the national agenda. Even so, many sufferers remain marginalized and some are unable to obtain medical treatment or compensation from government schemes or negligent companies. Problems stemming from asbestos contamination of the national infrastructure and the safe disposal of asbestos waste remain unresolved and few parents can be confident that their children are attending an asbestos-free school. In Japan, progress has been made but much remains to be done.
In collaboration with Asian NGOs and others, BANJAN has worked to reveal the Asian Asbestos Trail and expose the nefarious practices of those who continue to profit from The Deadly Trade. There is every reason to fear for the health of people living in countries where asbestos consumption is increasing. Congratulating BANJAN's on its 20th anniversary, it is true to say that now, more than ever, BANJAN's expertise and determination are needed to create an asbestos-free future at home and abroad.
for fair and equal compensation for all asbestos victims and their families
Although most industrialized countries ceased using asbestos many years ago, Japan has only just done so. The human cost of this delay is clearly illustrated by the country's emerging asbestos epidemic.
During the Summer of 2005, it was disclosed that many workers had died of asbestos-related diseases at the former Kanzaki plant of the Kubota Corp (Amagasaki City, Hyogo Prefecture) and that residents who had lived near the plant had also contracted mesothelioma, asbestos cancer. As of now, the number of asbestos-related diseases among workers from the Kanzaki plant is more than 150; in excess of 130 neighborhood mesothelioma cases have also been identified. The fallout from the Kubota Corporation's asbestos exposures in Amagasaki City was just the beginning; more neighborhood asbestos sufferers in other parts of the country are being reported. Victims, families and affected residents, who were never warned about the asbestos hazard, are uniting and working with trade unions, citizens' groups, organizations and individuals to achieve justice for the injured.
There is no excuse for the deadly asbestos exposures which have had such tragic consequences in Japan; the hazards of asbestos were well known before these exposures took place. The on-going Japanese epidemic of ill-health and death was totally avoidable. Similar catastrophes must be prevented elsewhere. Ban Asbestos Network Japan (BANJAN), which is dedicated to campaigning against asbestos, held the 2007 International Asbestos Conference from 23-24 November, 2007 in Yokohama as part of its 20th anniversary events.
We, 380 participants of the conference from 11 countries and regions, agree that:
We declare that we will do our best to obtain the rights listed above for all the asbestos-injured and to work together to achieve an asbestos-free society.
November 24, 2007
1 On the south side of the plant, asbestos fiber concentrations exceeded 3f/ml. Areas found to have fiber concentrations greater than 0.01f/ml were: south-south west 4 kilometres/(km), north-north east 1.5 km, north-west 1 km, south-east 1.6 km.
2 In an earlier paper, Takahashi found that an increment of 1 kg per capita corresponded to a 2.4-fold increase in mesothelioma and a 2.7-fold increase in asbestosis.
3 In July 2005, announcements by several major Japanese corporations of asbestos-related deaths amongst former workers became front page news throughout the Japanese media. The attention these announcements attracted was enormous; the Kubota Shock, as this sequence of events came to be called, had a great impact on the national government and the public.
4 The Queen's Bench Division's fast track asbestos disease list at the Royal Courts of Justice.
5 By 2005, 40,000 workers had qualified for this.
6 In France, prescribed asbestos-related diseases are: mesothelioma, asbestosis, pleural plaques, diffuse pleural thickening and lung cancer with pleural plaques or asbestosis or with exposure of 10+ years in specified high-risk trades. According to National Health Insurance data, the vast majority of lung cancer victims are not compensated.
7 Up to 20,000 Italian workers received occupational exposure to asbestos in the AC industry during the 20th century.
8 From 1990-94, the ratio of non-Eternit workers: Ex-Eternit workers being diagnosed with mesothelioma in Casale Monferrato was 3.1:1; in 2001-2006, it was 8.9:1. This means that nowadays many more non-workers are being diagnosed with mesothelioma than former workers.
9 Regulations which have been enacted to control hazardous asbestos exposures in Hong Kong include: the Factories and Industrial Undertakings (Asbestos) Regulation in Hong Kong (1986), Air Pollution Control Ordinance (Cap. 311) in Hong Kong (1996) as well as directives which: set control limits for atmospheric asbestos dust concentrations, mandate procedures for risk assessment, plant hygiene, labelling, storage and disposal of asbestos waste, etc.
10 Pandita analyzed several statements made by the global propaganda campaign, spearheaded by the (Canadian) Chrysotile Institute, which are intended to reassure governments and consumers that chrysotile asbestos can be used safely under controlled conditions.
11 Zenkowan: All Japan Dockworkers' Union
12 In the Port of Kobe in 1977 asbestos exposure levels inside containers were measured at up to 73.2 f/ml; at the time, the recommended level was 5 f/ml.
13 Busan and Pusan are used interchangeably to refer to Korea's 2nd largest city. This metropolitan area has a population of 3.5+ million and is the location of the country's largest port.
14 On their company literature, JEIL Chemistry, a Korean company, lists PT JEIL, the Indonesian asbestos-producing company, as a joint venture