Workshop: Elimination of Asbestos-related Diseases in Russia

Asbestos production and use is important for the Volgograd region where several asbestos manufacturing facilities are located. These facilities have direct relationships with asbestos mining companies, the Chrysotile Association and the Research Institute of Hygiene, Toxicology and Occupational Pathology of the Russian Academy of Medical Science. Projects implemented by NGOs in the region confirmed the real lack of access to information about the asbestos threat, lack of data on the effects of asbestos on health, and low levels of protective measures in the use of asbestos-containing materials.

Since 2008 a number activities have been implemented in Volgograd, as well as in Moscow, Nizny Novgorod and Novorossisk, which have helped to provide stakeholders with new information on asbestos health effects and produced some changes in people's understanding of the true cost of asbestos production and use. These activities had the following main outcomes:

awareness of the asbestos threat has been raised among all stakeholders in the targeted regions including federal, regional and municipal authorities, environmental and health groups, local communities, business and media;
information on available environmentally safe asbestos alternatives including those produced and already used in Russia has been broadly disseminated in the target regions and beyond;
the real level of asbestos use in the target regions has been revealed and made publicly available;
the situation with regard to disposal of asbestos waste in the target regions has been highlighted and information made publicly available;
the scale of asbestos-related diseases has been revealed and information on this made publicly available;
asbestos-related issues have appeared on the agendas of relevant governmental organizations at local, regional and even federal levels.

As a follow-up to the above initiatives, in August 2012, a new project was launched in Volgograd, focused mainly on the elimination of asbestos-related diseases and on meeting the requirements of the new industrial hygiene regulations and standards 2.2.3.2887-11 adopted in 2011. The workshop described in this report was set in the framework of this new project.

Participants

In attendance at the workshop were representatives of state environmental bodies, medical professionals, the Scientific and Research Institute of Occupational Health and Occupational Pathology, regional trade unions, local authorities, WHO, IPEN, local NGOs, and ABAN.

Day One

The first day of the meeting was focused on Russian and international trends in policy development in asbestos production and use. Presentations were made by Olga Speranskaya, IPEN Co-Chair/head of the Eco-Accord Program on Chemical Safety; Dr. Rokho Kim, WHO European Centre for Environment and Health; Dr. Sugio Furuya, ABAN/Occupational Safety and Resource Center, Japan; Dr. Alexander Frolov, chief pathologist of the Research Institute of Hygiene, Toxicology and Occupational Pathology; Anatoli Vasetsky, Chair of Trade Unions at SKAI asbestos-containing products manufacturing facility; Elena Vasilieva, head of Volgograd-Ecopress NGO; Irina Panina, deputy head of Volgograd regional Federal service of Supervision of Natural Resources Use.

Rokho Kim (left) with Workshop co-organizers.

All workshop participants received a package of materials in Russian which included: WHO and ILO positions on asbestos health effects; presentations made by all speakers; ECOS magazine on asbestos; the new industrial hygiene regulations and standards 2.2.3.2887-11 "Hygiene requirements for the production and use of chrysotile and chrysotile-containing materials." The package is a valuable resource for all stakeholders as it contains information on asbestos health effects, evaluation of true costs of asbestos production and use, and data on the asbestos threat obtained from different countries world wide. It also contains information about compensation to asbestos workers provided in different countries.

The discussion was very active. Many people heard about the asbestos threat for the first time ever. They never dreamt that the problem was so serious. There were questions about asbestos thresholds, access to information, lack of information on asbestos health effects, whether there were differences between lung cancer caused by asbestos and that caused by other factors. People were wondering if mesothelioma should be considered a secondary type of cancer, only to be considered primary when patients' lungs were clear of tumors. There were many medical doctors in the room and their questions were mainly focused on asbestos health effects. We talked about WHO and IARC positions on asbestos and highlighted the need for a total ban on asbestos production and use as the only way to eliminate asbestos-related diseases.

Workshop Discussions.

There was an interesting presentation from the Regional Department of the Federal Service for Supervision of Natural Resource Usage. The speaker talked about the new legislation adopted in 2006 that allows governmental experts to conduct official performance monitoring of industrial facilities once in three years only. Intermediate monitoring could be conducted, however, if there was a request from citizens or workers confirming health threat caused by the facility. Newly formed facilities are not checked during the first three years of operation. This means that if a facility is closed in three years and/or reestablished it only becomes eligible for performance monitoring after a further three years. This approach allows industrial facilities (including asbestos products facilities) to operate practically without any performance monitoring if they are quick and smart enough to be reestablished in time. This ridiculous situation resulted in the fact that, for example, one Volgograd asbestos-containing products manufacturing facility (VATI) was eligible for performance monitoring in 2012, but since it has recently been reestablished performance monitoring will now not be conducted this or next year.

The presentation made by the chief pathologist of the Ministry of Health of the Volgograd Region was focused on the system of medical monitoring of the health of workers at asbestos products facilities in the Volgograd region. He introduced a draft of the program that the Volgograd Scientific and Research Institute on Occupational Health and Occupational Pathology intends to develop as part of federal plans to develop a program on the elimination of asbestos-related diseases. This regional program could be a serious step forward and a pioneer initiative aimed at raising asbestos health effects high on the agenda of the regional Ministry of Health. The representatives of this institute are brave enough to say that workers exposed to asbestos have to go through permanent health monitoring and check-ups to minimize the risk. The program they suggest contains several important parts which will help to reveal a real situation with respect to the number of asbestos-related diseases at workplaces and among citizens of the nearby communities.

An interesting question was raised regarding job loss if asbestos-related illness is revealed. There are no programs to help people start a new job in case their health is affected. This is one of the reasons people try to hide their real health status: to avoid ejection.

Presentations made by IPEN, WHO and ABAN representatives highlighted the need of providing compensation to workers. Russia does not have this type of compensation focused on asbestos-related diseases. It is nearly impossible to justify the need for compensation due to the long latent period of asbestos-related disease. Retired people have no chance to obtain compensation. Some positive steps forward are underway though. Due to the new industrial hygiene regulations and standards 2.2.3.2887 all asbestos industry workers stay under health dispensary registration throughout their lifetime. There are also some requirements regarding health protection of people living in the vicinity of asbestos manufacturing facilities.

Day Two

The issue of providing compensation to workers suffering from asbestos-related diseases was discussed further on Day Two of the workshop. Sugio Furuya, ABAN (Japan), made a presentation on systems of providing compensation to asbestos victims and their families in Japan. Recognition criteria for mesothelioma, lung cancer and asbestosis as occupational diseases in different countries were discussed. He highlighted the non-occupational cases in Japan when people with asbestos-related diseases are provided with compensation even if they have never worked at asbestos manufacturing facilities.

Different types of asbestos victims were discussed including:

direct occupational exposure: workers and self-employed workers;
indirect occupational exposure: workers and self-employed workers;
domestic exposure: relatives of workers; numerous reports of cases among spouses of asbestos workers (cleaning contaminated work clothes);
neighborhood exposure: residents lived near plant, mine, etc.
mines: South Africa, Australia, China, Canada, Finland, Korea …
manufacturing plants: Italy, Netherlands, Japan …
environmental exposure: the public, from building, soil, etc.
soils: Turkey, Greece, Italy, New Caledonia, Cyprus, USA…
Exposure in which origin cannot be traced.

For Russian participants this was unique information as this kind of approach to providing compensation has never been addressed in Russia. They were interested to know about compensation provided to families when a statute of limitation had expired and the victim died of occupational disease.

As was stated by the presenter, people's awareness was vital to make the whole compensation system work. If people are unaware (as in Russia) they would not apply for compensation.

Elena Vasilieva and Sugio Furuya taking part in Volgograd based Radio Echo interview.

Workshop participants were interested to know about the list of asbestos-related diseases which were subject for compensation as well as related recognition criteria. Some of the answers given to such questions are shown below.

Q. Dr. Frolov, Chief Occupational Pathologist of the Research Institute of Hygiene, Toxicology and Occupational Pathology – Where does asbestos cancer of the abdomen come from?

A. Rokho Kim, WHO – Asbestos can achieve a deep mechanical penetration of living tissue. In Kiev, 11 cases of skin diseases from asbestos were registered. In Korea, for example, people cook on an open fire on special asbestos coatings.

Q. Dr. Frolov, Chief Occupational Pathologist of the Research Institute of Hygiene, Toxicology and Occupational Pathology – Signs and symptoms of asbestosis include adhesions. Doctors know that pneumonia produces pleural changes similar to those resulting from asbestos exposure. How do we distinguish between the two?

A. Rokho Kim, WHO – The first indicator is the exposure to asbestos, but often, to establish this, it is necessary to go to court.

A. Sugio Furuya, ABAN (Japan) – each country has its own approach. Most often, insurance companies provide compensation, but if people do not agree with the amounts set by the insurance companies, they can go to court.

Q. Trade Union representative – Is the Helsinki criterion applied unconditionally or is its role an advisory one? How is asbestos waste managed in Japan?

A. Sugio Furuya, ABAN (Japan) – The Helsinki criterion occupies an advisory position. Disposal of asbestos-containing waste is a complex issue for Japan. There are several pieces of legislation in this area, but they are not satisfactory. Asbestos wastes are disposed of at specially equipped sites.

Q. Dr. Britanov, Research Institute of Hygiene, Toxicology and Occupational Pathology – Are there data (for 10 thousand people, 100 thousand) for housewives and residents of the communities located near plants? And why do you pay so much attention to wives who wash clothes? We cannot even take out clothes from the factories.

A. Sugio Furuya, ABAN (Japan) – There are limited data, only individual studies. There were not enough cases before the 1970s for housewives; but then the number of cases began to grow. We wash work clothes at home.

Alexander Frolov.

During the next session, the participants discussed the economic aspects and issues of state regulation of production and use of asbestos.

Dr. Voronovich, Kaustic chemical facility environmental specialist. According to the law on licensing, all activities dealing with waste have to be licensed. One must set limits and evaluate the conditions at workplaces where industrial wastes are treated. Among asbestos characteristics the following two should be pointed out – asbestos is chemically inert and resistant. In the Russian Federation standards are set for dust, which contains substances with fibrogenic and carcinogenic effects. But there is no specification for the fiber percentage in the dust. Establishment of asbestos content in the waste is an important problem to be addressed because this will help in choosing the appropriate method of disposal. In Russia asbestos-containing wastes are commonly used for road filling even though asbestos content may reach 70%.

It is known that asbestos (raw fiber) dust presents a category one hazard (very dangerous). At the same time asbestos-containing waste is considered to be of fourth and even fifth class of hazard (considered low risk) and thus can be disposed together with municipal waste or used for road filling, etc.

Mrs. Sapunkova, JSC Volgogradvodservice (Economic analysis of the use of asbestos and asbestos-free materials). At present, the construction industry uses large amounts of asbestos-containing materials: asbestos coating, asbestos boards, boards for suspension bridges, asbestos sheets as building material, roofing, piping, ventilation and air-conditioning components, asbestos wool, textiles made of asbestos fiber, floor coverings. There are several regulatory and legislative instruments acting in Russia: ILO Convention 162 N Geneva, June 4, 1986 "On the safety in the use of asbestos"; Industrial hygiene norms and regulations 2.2.3.757-99 "Working with asbestos and asbestos-containing materials" and a new Industrial hygiene regulation 2.2 .3.2887-11 "Hygiene requirements for the production and use of chrysotile and chrysotile-containing materials." According to the new Industrial hygiene regulations when working with asbestos-containing materials one must use special protective clothing and special methods of work (wetting, a special vacuum cleaner, and specified methods of enclosing the repair and demolition of buildings, etc.). To meet the requirements of the new legislation some increase in cost of asbestos-containing materials is inevitable. Finally, asbestos materials will lose their economic attractiveness due to higher prices as a result of expenses incurred on protective measures.

Rokho Kim, WHO (The experience of countries in the development of alternatives to asbestos-containing products). As a result of the ban on production and use of asbestos-containing materials, industrial production, has not fallen, but rather evolved. Enterprises began to produce alternative materials, enabling companies to continue to operate successfully. There is an economic incentive for people to use local materials. Though, Australia has its own deposits of crocidolite, after asbestos was banned the country started producing alternative materials. Asbestos-cement pipe can be replaced with plastic or steel. In the U.S., asbestos-cement pipes are cheaper, but are more expensive to use – breakages mean they have to be changed more often. In Europe the use of asbestos brake pads was soon abandoned, once the danger of asbestos exposure to mechanics was recognized. Water storage tanks can be plastic, metal, cellulose. Projects financed by WHO or the World Bank are not allowed to use asbestos as a construction material.

Rokho Kim.

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