Asian Asbestos Conference (AAC 2006)

AAC 2006 was a resounding success, attracting more than 300 delegates, including 94 international delegates from Asia, Africa, Europe, Australia and North America. The wide range of presentations and discussions progressed the debate on the use of asbestos in Asia that had begun in earnest in November 2004 at the Global Asbestos Congress (GAC 2004) in Tokyo, Japan. Thai colleagues attending that event declared their intention to hold a future meeting to consider the repercussions of increasing asbestos consumption in Thailand within the regional context. As the first independent asbestos conference to take place in Thailand, AAC 2006 was a landmark event. Sugio Furuya, one of the organizers of GAC 2004, felt that the timing was serendipitous coming so soon after the World Health Organization (WHO) and the International Labor Organization (ILO) declared their support for a global asbestos ban. The presence at the conference of a large contingent of Japanese asbestos victims, experts, public health campaigners and journalists ensured that the tragic lessons learned from that country's asbestos past were not ignored.

The Department of Disease Control of the Thai Ministry of Public Health, the Department of Labor Protection and Welfare and the Social Security Office of the Ministry of Labor were the main organizers of this event; co-sponsoring organizations were the International Ban Asbestos Secretariat (IBAS), the ILO and the WHO. The smooth running of plenary and workshops session was the result of months of detailed planning and the presence of many dedicated members of the conference staff. Attendance by high-level Thai politicians and civil servants enabled Thai delegates to engage in one-to-one discussions on issues such as the lack of surveillance of working conditions in asbestos facilities located in rural areas. Dr. Ivan D. Ivanov, an Occupational Health specialist from the WHO, called the meeting an “important milestone” in regional and global efforts to curb the epidemic of asbestos-related diseases.

Session 1: Opening Session

During the opening session of the conference, national dignitaries including Dr. Vachara Phanchet, Vice-Minister of Public Health, Dr. Narongsakdi Aungkasuvapala, Deputy Permanent Secretary of the Ministry of Public Heath and Mr. Padungsak Thephasdin, Department of Labor Protection and Welfare, Ministry of Labor warmly welcomed international speakers and delegates to Thailand and thanked Thai colleagues for their attendance. Expressing their concerns about the impact of asbestos use in Thailand, they urged conference attendees to make full use of the opportunities offered by AAC 2006 to identify the most effective means to protect Thai workers and the public from hazardous exposures.

Thanking the Ministry of Public Health for the opportunity to attend the meeting, Mrs. Sasiwan Ananatagool from the Social Security Office, Ministry of Labor, regretted that a lack of funding had resulted in the country's current dearth of occupational health and medical specialists. In recent years, however, provision has been made in the national budget for the training of medical personnel in occupational health. Under the Workmen's Compensation Act, an occupational disease center is being set up in cooperation with the Ministry of Public Health. The information gathered from presentations made at AAC 2006 will inform the national occupational health program and will enable Thailand to “provide suitable treatment and benefits for sufferers of occupational disease.”

Dr. Jorma Rantanen, President of the International Commission on Occupational Health (ICOH), declared ICOH's unequivocal support for a global asbestos ban; this position is rooted in the experiences of ICOH members who have observed the dire consequences of hazardous asbestos exposures on their patients in industrialized countries. The effects of the high levels of asbestos consumption in Asia now will only become apparent in 30-40 years because of the long latency period of asbestos-related diseases. Unfortunately, Dr. Rantanen said: “Globalization seems not to help in the control and prevention of asbestos hazards as it has helped in some other issues in the world of work.” There is, therefore, an obligation to warn people in Asia of what is to come if they do not ban the use of asbestos. Dr. Rantanen urged that concerted action be taken by international agencies, national governments, trade unions and NGOs to raise awareness of the asbestos hazard and to highlight the long-term economic benefits of transferring to non-asbestos technologies.

Representing the ILO, Dr. Tsuyoshi Kawakami stressed the organization's commitment to the Resolution Concerning Asbestos, adopted at the ILO's General Conference in June 2006, which:

“Considering that all forms of asbestos, including chrysotile, are classified as human carcinogens by the International Agency for Research on Cancer, a classification restated by the International Program on Chemical Safety (a joint program of the International Labour Organization, the World Health Organization and the United Nations Environment Programme),

Alarmed that an estimated 100,000 workers die every year from diseases caused by exposure to asbestos, …

1. Resolves that:

(a) the elimination of the future use of asbestos and the identification and proper management of asbestos currently in place are the most effective means to protect workers from asbestos exposures and to prevent future asbestos-related disease and deaths…”

The ILO will, Dr. Kawakami said, encourage Member States to ratify conventions relating to asbestos and whilst promoting the need for national asbestos bans will highlight techniques for the identification and management of asbestos-containing products contained within the built environment to safeguard occupational health and safety. Dr. Kawakami outlined key action points to protect people from the asbestos hazard:

adopting clear legislative frameworks detailing best practices;
providing information on practical measures and engineering techniques to minimize hazardous exposures;
monitoring asbestos health hazards and providing surveillance for at-risk workers;
facilitating medical training for the diagnosis of asbestos-related disease and improved treatment for asbestos patients;
working with national governments to inform the public and industry about a range of issues including the availability of safer alternatives and non-asbestos technologies;
exposing the double standards of multinational companies using asbestos in developing countries whilst not doing so in their home countries.

The next speaker, Dr. Ivanov was emphatic in his discussion of the WHO's stance on asbestos explaining that:

“Our estimates show that more than half of all people in the world who are exposed to asbestos live in Asia… At the WHO, we are very concerned about the lack of substantial progress in some parts of the world in reducing the exposure to workers, their families and the general population to asbestos. While most developed countries have banned the use of asbestos, it is still being widely used in many nations primarily those with emerging and transitional economies.”

Dr. Ivanov believed that the magnitude of AAC 2006 and the variety of international speakers it attracted demonstrated that the predictable consequences of asbestos consumption in Asia are a matter of global concern. Condemning the use of asbestos-containing materials for disaster relief and tsunami reconstruction, he was optimistic that the conference would play a major role in modifying the public attitude in Thailand towards asbestos. As indicated in the WHO's new policy paper on asbestos, the organization is keen to work with international actors such as trade unions and NGOs to empower the public, workers, the health sector and others to act on the challenges presented by the need to replace out-dated asbestos technologies, safely manage asbestos already in the infrastructure and assist the asbestos-injured. WHO action at the World Health Assembly in 2007 will be informed by the discussion which takes place and the resolution adopted by AAC 2006.

The Building and Woodworkers International (BWI) has long campaigned for a global ban according to its Director of Health, Safety & the Environment Ms. Fiona Murie who was at the conference with a delegation of BWI trade unionists from Malaysia, Indonesia, Philippines, Singapore and Vietnam. She said:

“A global ban on asbestos remains a top priority for us today. One hundred thousand workers die every year from asbestos-related diseases – 1 person every 5 minutes. Even this is a serious underestimate of the true situation. Most of today's asbestos fatalities are amongst workers in the building trade. Ninety per cent of chrysotile asbestos used currently is in asbestos-cement building products which are made and/or handled by our members at building sites.”

The use of asbestos in industrialized countries in the 1960s and 1970s has given rise to a global epidemic of disease and death. To protect future generations from the asbestos hazard, the BWI is:

lobbying for a global ban;
working to expose the “voodoo science” espoused by asbestos stakeholders;
countering the aggressive marketing strategy of the asbestos industry, led by Canadian asbestos lobbyists, with accurate information and increased training;
working at national levels on practical ways of dealing with asbestos hazards which persist even after bans have been implemented; ensuring that measures are implemented to protect at-risk workers such as carpenters, electricians, heating and ventilation workers and demolition crews;
researching asbestos alternatives – the 40 countries which have already banned asbestos continue to function so must have found suitable materials to replace asbestos; former asbestos-cement plants are still operational in France, Belgium and elsewhere.
campaigning for justice for asbestos victims and increased levels of medical treatment, support and compensation.

Mr. Issei Tajima, a Member of the House of Representatives of Japan and the Secretary General of the Asbestos Task Force of the Democratic Party of Japan, urged his Thai hosts and members of other Asian countries not to make the same mistakes as Japan had made. Despite the fact that the ILO had pointed out the carcinogenicity of crocidolite as early as 1970, the Japanese Diet did not ban its use until 1995; although government negligence led to high levels of asbestos-related damage, the Japanese Government continues to deny its responsibilities saying that it acted in accordance with the level of scientific knowledge available at the time:

“I have strong feelings that for other countries to delay their response in the same way as Japan, a whole host of potentially avoidable problems such as an increase in damage including pollution and panic will occur in other regions of the world. We must find a global solution to the problem of asbestos starting with a response in Asia as a whole.”

Little progress has been made in ridding Japan of asbestos pollution, but some steps have been taken to investigate the extent of the problem and pay relief money to the injured. The level of relief paid to victims of environmental exposure, however, is much less than compensation paid to those whose exposure was work-related. The Japanese asbestos compensation system is in drastic need of a complete overhaul as it remains inefficient and full of holes. To protect public health and safety and prevent further pollution, immediate action on the asbestos hazard is required.

Session 2: Impact of Asbestos – Global Overview

This session was chaired by Dr. Wilawan Juengprasert, from the Ministry of Public Health with Ms. Pensri Anantagulnathi, from the Bureau of Occupational and Environmental Diseases, providing the secretariat. The first presentation in this session, Asbestos in the 21st Century, was made by Laurie Kazan-Allen, the Coordinator of the International Ban Asbestos Secretariat (IBAS) and one of the organizers of the conference. Ms. Kazan-Allen illustrated the recent shift in asbestos consumption patterns with data which showed that Asian countries currently consume over 50% of global asbestos production, with the biggest users being: China (491,954 t)¹, India (192,033 t), Thailand (132,983 t) and Indonesia (75,840 t). “If we accept the fact that human biology is universal, and how can it be otherwise,” Ms. Kazan-Allen stated “increasing asbestos consumption in Asia will, in years to come, assuredly result in an epidemic of ill-health and death.”

The year 2006 was dubbed the Year of Action on Asbestos by the global ban asbestos campaign. During this time, the asbestos debate started in earnest in Bangladesh, Bulgaria, Egypt, Greece, India, Indonesia, Thailand and the Philippines and engaged with new social partners, groups and individuals in Australia, Belgium, Brazil, Canada, Denmark, France, Italy, Japan, Korea, Poland, Italy, South Africa, the UK and the U.S. Groups representing global labor mobilized trade union affiliates around the world on International Workers' Memorial Day (April 28, 2006) and together they made the same demand: a global ban on asbestos. In recent months, the WHO and the ILO have joined the rapidly expanding list of international organizations, including the European Union, the United Nations, the World Trade Organization, the Collegium Ramazzini, and the World Bank, that have recognized the tragic impact asbestos has had on human health. Concluding her presentation, Ms. Kazan-Allen said:

“People in Asia are entitled to live and work in a healthy environment. We do not need to see another pile of bodies to prove that asbestos is a killer. The experiences of asbestos victims and afflicted communities in Europe, North America and Australia tell us all we need to know. Working together we can end this needless slaughter; Asia's asbestos-free future starts here!”

The next speaker, Environmental Consultant Dr. Barry Castleman, addressed the subject: The Export of Asbestos Hazards to Developing Countries. Up until the late 20th century, multinational asbestos groups, often owned by European or American companies, ran the global asbestos industry. As the asbestos hazard was exposed, however, and national regulations were implemented, asbestos-consuming operations were relocated to countries which imposed fewer health and safety safeguards. One example was the U.S. company Amatex which closed a relatively modern asbestos yarn mill in Pennsylvania in 1971, the year after the Occupational Safety and Health Administration (OSHA) and the Environmental Protection Agency (EPA) were set up. Within two years, Amatex had set up a new asbestos manufacturing facility in Agua Prieta, Mexico. Eventually, mounting public pressure and negative publicity over the existence of double standards combined to force the multinationals out of the asbestos business. Citing examples of recent asbestos industry propaganda from India, Zimbabwe and Thailand, i.e. “white asbestos is safe,” Dr. Castleman said:

“The asbestos industry in the 21st century has become an industry of national companies with even less respect for the truth than the former asbestos multinationals… The present owners of the asbestos industry are investors who stepped in when the multinational corporations stepped out. Wherever a lot of asbestos is used, there is an industry that works hard to minimize the two prohibitive costs of running an asbestos enterprise – prevention and compensation. Critically important to this industry strategy is the development of the closest possible relations with powerful champions in politics, government and academia.”

The glue which holds the global asbestos lobby together is provided by the Government of Canada which has, time and again, acted in the interests of asbestos stakeholders and at the expense of workers and the public. Working hand in glove with the (Canadian) Chrysotile Institute, the Government has played a pivotal role in protecting the image of chrysotile, organizing industry conferences in the guise of “scientific events” and attempting to manipulate international bodies such as the International Program on Chemical Safety and the World Trade Organization.

During the opening remarks of the next presentation, Canadian Asbestos: A Global Concern, Pat Martin, a Member of the Canadian Parliament, said:

“I am very proud that Canada is a progressive modern democracy with a well-deserved reputation for its commitment to human rights and social justice. But having said that, I hang my head in shame that Canada continues to be one of the world's leading producers and exporters of asbestos, the greatest industrial killer that the world has ever known. The government of Canada is directly involved in the promoting and marketing of this deadly material around the world. While the rest of the world is banning asbestos in all its forms, Canada is busy exporting over 220,000 tons per year (2004) mostly to developing nations where, in many cases, health and safety regulations are very lax, if they exist at all thereby exposing millions to avoidable hazards.”

MP Martin worked in an asbestos mine in the Yukon Territory as a young man and reported that at that time the industry lied to the workforce about the health risks of asbestos; “they are still lying,” he said. There is no safe level of exposure to any type of asbestos fiber; even light and infrequent exposure can trigger asbestos-related diseases. The asbestos industry is the tobacco industry's evil twin; both enjoyed huge profits throughout the 20th century by promoting and marketing a product they knew could be lethal. Both industries relied on campaigns of misinformation, manipulated research, lobbied governments and targeted emerging nations as domestic markets shrank.

“In my opinion,” MP Martin said “the asbestos industry is a corporate serial killer and the Canadian Government is using my tax dollars to promote it.” The Canadian Government sends teams of lawyers around the world to prevent countries from banning asbestos; it initiated a legal action at the World Trade Organization against the French ban on asbestos and threatened the UK and other governments with similar actions. Canadian consulates and embassies are being used to host asbestos marketing junkets around the world such as the recent activities in Jakarta, Indonesia. Canadian government personnel influenced industry in Thailand and North Korea not to put warning labels on asbestos products sold domestically.

The only remaining asbestos mines in Canada are located in Quebec, a province which has threatened to secede from the Canadian federation. The last referendum on secession retained the Canadian federation by the merest of margins; 49.6% voted for secession and 50.4% against. Consequentially, Quebec's asbestos lobby, which holds considerable sway over voters, has enjoyed the political and financial support of the federal government even though the industry is now a shadow of its former self. Through much of the 20th century, Canada was the world's leading producer and exporter of asbestos; by 2002, Canada was only the 3rd largest producer in the world (240,000 t), by 2004, production had fallen by almost 20% (193,000 t) and since then exports have dropped due to the Japanese asbestos ban.²

Concluding his talk, MP Martin called on the Canadian Government to ban asbestos, shut down the mines, provide early retirement or transition measures for affected workers, undertake comprehensive testing and removal programs to eradicate asbestos from public and private places and, as an act of contrition, invest heavily in medical research for improving the diagnosis and treatment of asbestos-related diseases so that Canada can begin to export solutions and not human misery.

Having briefly mentioned the WHO's asbestos consultation exercise during the welcoming session, Dr. Ivanov, from the WHO's Occupational Health Program, explained the process in greater detail during his presentation: Asbestos and Health: From Knowledge to Action. The shift in the WHO's asbestos policy is based on risk assessment, evaluation and research by the International Program on Chemical Safety and the International Agency for Research on Cancer which concluded that:

all types of asbestos cause asbestosis, mesothelioma and lung cancer;
there is no safe threshold level of exposure;
safer substitutes exist;
exposure of workers and other users of asbestos-containing products is extremely difficult to control;
asbestos abatement is very costly and difficult to carry out in a completely safe way.

The WHO is scaling up its action on asbestos under its policy of primary prevention of environmental risks to public health and advocates effective interventions by Member States for the elimination of asbestos-related diseases. “Asbestos is,” Dr. Ivanov said “the most important occupational carcinogen causing 54% of all deaths from occupational cancer.” According to the WHO, 89,000 people die every year from asbestos-related diseases; this is, said Dr. Ivanov, a conservative estimate:

“We estimate that currently 124 million people in the world are exposed to asbestos and thus are at risk of developing asbestos-related diseases – the majority of people at risk, 66 million, live in Asian countries particularly in the regions of the Western Pacific…These diseases have high fatality rates and do not respond well to medical treatment.”

As of June 2006, 23% of WHO Member States have banned or intend to ban chrysotile; 41% have not banned it but show no records of trading in asbestos and 36% still import, use and export asbestos and asbestos-containing materials. The largest users of chrysotile are developing countries which mostly use chrysotile in asbestos-cement products. The continued use of asbestos-cement is of particular concern because: the at-risk workforce is large, it is difficult to control hazardous exposures and next to impossible to ensure that the preventative measures needed to minimize hazardous exposures are implemented. The most effective way to eliminate asbestos-related diseases in Member States is to cease using asbestos and asbestos products. The WHO has identified and evaluated safer substitutes for asbestos.

The WHO will work with Member States and major international actors on the elimination of asbestos-related diseases and will advise countries to:

stop the use of asbestos;
take measures to avoid exposure to asbestos during asbestos removal and abatement work;
provide information about solutions for replacing asbestos with safer substitutes and develop economic and technological mechanisms to stimulate the transition to safer non-asbestos technologies;
improve the early diagnosis, treatment, social and medical rehabilitation and compensation for sufferers of asbestos-related diseases;
establish registries of people with past and/or current exposure to asbestos.

The final presentation in Session 2 was given by Professor Dr. Jorma Rantanen on Incidence Use of Asbestos and Technical Prevention. Before they were closed in the late 1960s, two asbestos mines in Finland produced 5,000 t of asbestos, exposing 2% of the country's workforce to asbestos. The 200,000 t of asbestos consumed before Finland banned its uses put the health of 10% of the national workforce at risk. To cleanse the country from asbestos pollution would create a total of 5 million tonnes of asbestos-contaminated waste which would expose 20% of the population to the asbestos hazard.

Asbestos use, which benefits only a handful of producing countries, causes far-reaching damage during each industrial phase: manufacture, demolition and disposal.³ Only by externalizing significant costs, such as the compensation and medical treatment of the asbestos-injured, can asbestos products compete with safer alternative materials.⁴ When the problems which remain in Europe from our asbestos past are examined, it is inexplicable that decision makers in developing countries continue to allow the use of asbestos materials. At Thailand's current rate of consumption, 121,000 t of asbestos a year (2 kg/person/year), experts predict nearly 3,000 cases of asbestos-related disease every year.⁵

Calling for practical action Prof. Rantanen said:

“We have enough declarations, enough regulations and enough conventions, now we should go for action. Some countries have ratified the ILO Asbestos Convention, but don't implement it. Canada and Russia have ratified it but they still continue (asbestos) production…. Some (national asbestos) bans have not been implemented.”

The best way to reduce the burden of asbestos-related disease is to ban asbestos; asbestos is yesterday's material and should be replaced with more modern and safer substitutes. Plans for dealing with asbestos-containing products still in society should focus on: dust controls, prudent working practices for demolition and waste disposal and the need for personal protection. National Asbestos Programs, supported by the ILO and WHO, are needed to delineate the most effective means of limiting hazardous exposures and compensating victims in individual countries.

Session 3: Health Effects of Asbestos Use in Asia

This session was chaired by Dr. Wilawan Juengprasert, from the Ministry of Public Health with Dr. Surasak Buranatrivate providing the secretariat. The first speaker Professor Kouki Inai, from Hiroshima University in Japan, addressed the subject Diagnosis of Asbestos-Related Diseases. The Japanese Government recognizes the following diseases as asbestos-related: asbestosis, benign asbestos pleural effusion, diffuse pleural thickening, mesothelioma and lung cancer. In the past, the incidence of asbestos-related disease was under-reported in Japan; nowadays, the number of reported cases of mesothelioma and lung cancer has risen. In 2004, there were 953 mesothelioma deaths; experts predict that annual mesothelioma deaths will peak at 1,700.

Prof. Inai believes that “the pathological diagnosis of mesothelioma in Japan is very important in solving social problems as the number (of those affected) has doubled in the last ten years.” Because mesothelioma is a difficult disease to diagnose and because a new government scheme will make compensation available to a greater number of mesothelioma sufferers, new immunohistochemical techniques are needed to improve diagnosis of this fatal cancer. Detailing Japanese work on immunohistochemical staining using specific antibodies such as Calretinin, WT1, AE1/AE3, CAM5.2, Cytokeratin 5/6, Vimentin, EMA, Thrombomodulin and Mesothelin, Prof. Inai welcomed improved techniques for the diagnosis of some types of mesothelioma but lamented the lack of progress on asbestos-related lung cancer.

Dr. Kamjad Ramakul from the Bureau of Occupational and Environmental Diseases, one of the organizing bodies of the conference, spoke about the Health Impact of Asbestos Use in Thailand. Asbestos has been imported by Thailand for more than 30 years for use by several industries including cement manufacturing and the production of brakes. Three government agencies supervise asbestos issues in Thailand:

Ministry of Industry – Department of Industrial Work regulates the control of asbestos imports, use and storage.
Ministry of Labour, charged with the protection of occupational health, implements asbestos regulations under the Labor Protection Law.
Ministry of Public Health – Bureau of Occupational and Environmental Diseases, Department of Disease Control provides occupational health and safety guidelines and services.

Thailand is currently the world's 4th largest importer of asbestos.⁶ In 2004, 1,784 workers were employed at 16 asbestos-using factories in Thailand, most of which were located in central Thailand. Environmental monitoring by government agencies carried out since 2000 shows elevated levels of airborne asbestos at many of these factories (7 plants with 1,297 workers); conditions in brake and clutch factories were the most hazardous. Most asbestos (90%) in Thailand is used in the manufacture of asbestos-cement pipes and roofing materials; 8% is used in the production of brakes and clutches and 2% is used for vinyl floor tiles, gaskets and heat insulating material.

Given the high level of asbestos use, it is surprising that not one case of asbestos-related disease has been reported to the national surveillance scheme or the Workmen's Compensation Fund. Perhaps this might be explained, Dr. Ramakul suggested, by the long latency period of these diseases; another explanation might be the lack of medical personnel trained to make accurate diagnoses: “Since asbestos consumption is increasing and concentrations of asbestos in working conditions are high, especially in brake and clutch factories, we can expect the number (of asbestos cases) to be high in the near future.”

The Government is taking steps to tackle the asbestos hazard by: lowering the threshold limit value from 5 fibers/cc to 2 fibers/cc, setting up criteria to limit hazardous asbestos exposures, providing health surveillance and dust monitoring in small and medium-sized companies and improving the criteria for the diagnosis and compensation of asbestos-related diseases. Calling for a National Asbestos Control Program, Dr. Ramakul said, however, that more could and should be done to protect Thais from the deadly effects of hazardous asbestos exposures:

“Although asbestosis or other asbestos-related disease cases have never been detected or reported in the country, the prevention and control of these diseases is still very important. Since the trend of using the materials is increasing and the concentrations of asbestos in working environments are high, numbers of cases will be expected to be high in the near future.”

The Asbestos Legacy: A Lesson From Japan was the title of the presentation by the next speaker, Dr. Kenji Morinaga from the National Institute of Industrial Health, Japan. On June 29, 2005 the Kubota Corporation disclosed that 63 of the workers at its former Kanzaki asbestos-cement pipe plant and three local residents had contracted asbestos cancer. On July 1, the Taiheiyo Cement Corporation followed suit announcing that six of its workers had died from the same asbestos cancer: mesothelioma. Five days later, the Nichiasu Corporation, formerly called the Japan Asbestos Corporation, admitted that 86 former workers had died of asbestos-related diseases. The media 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.

Long after other industrialized countries had imposed regulations on using or importing asbestos, Japan continued to utilize crocidolite, amosite and chrysotile. Although no large-scale epidemiological survey has been conducted, anecdotal evidence has been accumulating which demonstrates the effect that Japanese asbestos consumption has had, not only on workers but also on residents living in close proximity to asbestos-using factories.⁷ Cases of pleural mesothelioma in local people have been found as follows:

111 victims in Amagasaki City near the Kubota Kanzaki factory;
1 female victim from Tosu City, the location of the Japan Eternit Tosu factory;
3 victims in Ikaruga Town, the site of the Tatsuta plant;
2 victims in Ohji Town, the location of the Nichiasu Ohji factory;
2 victims in Nashua City, the home of the Nichiasu Hashima plant;
1 female victim in Amagasaki City due to exposure generated by the Kansai Slate factory;
1 male victim in Kawachi Nagano City from exposure generated by the Toyo company.

Although the Kubota Shock was the impetus which finally forced the Japanese Government to address the national asbestos scandal, the first asbestos panic had, in fact, taken place nearly 20 years earlier:

in April 1986, a retrospective study of asbestos textile workers showed a six-fold increased risk of lung cancer;
in February 1987, the first case of mesothelioma due to neighborhood exposure was reported in Japan;
in April 1987, the disturbance of sprayed asbestos in a university building was reported;
in July 1986, baby powder used in Japan was found to be contaminated with asbestos;
at the end of 1987, 3 workers in the Kanzaki asbestos plant were diagnosed with pleural mesothelioma;
during the mid-1980s, concern about asbestos contained in school buildings escalated amongst parents and schoolteachers.

Unfortunately, the Japanese Government did not react to any of these developments and the asbestos business continued unabated for another two decades. Only after the Kubota Shock did the Government ratify the ILO Asbestos Convention. Having been forced post-July to acknowledge the asbestos scandal by overwhelming media furore and public concern, the Government convened five meetings over the next six months to discuss its response; it was resolved that:

a Law Concerning the Relief of Health Hazards Caused by Asbestos, to provide compensation for individuals and families affected by mesothelioma and lung cancer, would be passed; it came into force on March 27, 2006;
legislation would be revised to curtail hazardous exposures: changes were made to the Air Pollution Control Law, the Building Standards Law, the Waste Management and Public Cleaning Law.

Despite the Government's show of concern, it did not consult medical specialists, plan an epidemiological survey or establish a national mesothelioma register. Victims' organizations have criticized the relief scheme as providing inadequate levels of compensation.

The presentation by Dr. Noor Jehan, a geologist from the University of Peshawar, entitled Hazardous Exposure to Local, Imported Asbestos and Asbestos-Containing Products in Pakistan was brought to life by photographs illustrating the contamination which is a daily feature of life in Pakistan. “Are people in Pakistan exposed to asbestos,” Dr. Jehan asked. Having conducted a range of tests including geological, air and product sampling from various deposits, mines, mills, factories and residential areas, the answer was a categorical “yes.” Analytical techniques including atomic absorption, X-Ray diffraction, stereoscopic, polarized light and scanning electron microscopy, ascertained that all samples contained:

“different types of respirable chrysotile, tremolite and anthophyllite. The exposure level is hundreds and thousands times greater than the permissible exposure limit in the indoor and outdoor environment as specified by the WHO and OSHA.”⁸

This widespread contamination by both imported and locally sourced asbestos endangers the health of housewives, schoolchildren, hospital patients, schoolteachers as well as mine and industrial workers.

Photographs by Dr. Jehan showed:

workers in a mine where after just 15 minutes, a filter Dr. Jehan was using was so clogged with fiber that it ceased functioning;
processing facilities owned by a multinational corporation which had no controls to minimize hazardous exposures;⁹
people living in close proximity to small-scale asbestos-using production units;
workers in a small-scale asbestos unit where a filter became so choked with asbestos that it ceased functioning after 2 minutes;
a small mud-floored unit in the tribal area in which wheat crushing and asbestos processing was carried out in the same small space;
very old asbestos boards and asbestos furniture such as asbestos bedside tables and operating tables present in hospitals; corrugated sheeting in Hayat Shaheed Teaching Hospital and Lady Rading Hospital in Peshawar contained chrysotile;
asbestos tables in schools; Dr. Jehan says that such furniture is present in most of the country's 1700 schools;
typical houses in Pakistan containing uncoated asbestos doors, windows and sidings; a minor scratch can liberate hazardous fibers;
small heating plates which are sold in Peshawar's main market containing up to 80% asbestos.

As well as the asbestos mined in Pakistan, asbestos is also imported not only as loose fiber from Canada but also in end-of-life ships. Extensive asbestos contamination in Pakistan has produced more than 5,000 deaths from mesothelioma; the data show that those most at-risk of mesothelioma are housewives. Even if asbestos were banned tomorrow, the problem of disposal would remain. There are no waste collection or disposal procedures and no dumps designated to receive asbestos waste in Pakistan.

Dr. Domyung Paek from Seoul National University, described The Rise and Fall of the Asbestos Industry and Its Repercussions in Korea. Correlating the changing fortunes of Korea's asbestos industry with key events, Dr. Paek highlighted lessons for developing countries which can be drawn from Korea's experience. The historical stages of the asbestos industry were inextricably linked to changes in administrative policy, politics and the economy.

Expansion (1960-1982)

The industry's expansion was fuelled by overseas investment, principally from Japan and Germany, with foreign companies transferring hazardous technologies abroad in light of increasing restrictions at home. Concurrently, Korean policies to stimulate the construction and manufacturing sectors boosted asbestos demand; the lack of any health and safety regulations meant companies were spared the expense of installing control measures or providing personal protective equipment for workers. As the asbestos industrial sector matured, the production of asbestos textiles increased; these products required a higher quality of fiber and import patterns reflected this shift in consumption.

Plateau (1983-1995)

Although consumption was adversely affected by the introduction of the (Korean) Industrial Safety and Health Act (1981), asbestos had not yet become a social issue.

Decline (1996-Present)

As active regulation of hazardous working conditions began, Korean producers of asbestos textiles and brake linings relocated to China and other countries in Southeast Asia. The diagnosis of the first case of mesothelioma in Korea (1994) brought the compensation issue to the fore and the removal of asbestos from old buildings and demolition sites became a social issue.

As of now, there have only been 35 mesothelioma and asbestos-related lung cancer compensation claims most of which came from end-users such as construction and maintenance workers and welders. Although Korea is 15-20 years behind Japan in its national epidemic of asbestos-related disease, there is no doubt that a trend is developing which will continue for decades to come.

Dr Paek concluded by saying that it is not necessary for every developing country to repeat the asbestos scenario from Korea. “We should,” he said “apply our knowledge and experience to shorten these kinds of changes. We have to say no, not only to asbestos but to all its products!”

The Asbestos Debate in Indonesia was the subject discussed by Dr. Zulmiar Yanri from the National Occupational Safety and Health Center of Indonesia's Ministry of Manpower and Transmigration. In the global rankings, Indonesia is the 8th largest importer, processor, consumer and exporter of asbestos and asbestos materials.¹⁰ In July 2005, the Ministry of Manpower organized a roundtable attended by government personnel and representatives from industry, trade unions and professional organizations to discuss national asbestos policy in light of increasing national asbestos consumption and lack of coordination between government agencies and Ministries.¹¹ Recommendations made to investigate the types of asbestos used and the asbestos materials produced in order to harmonize regulations and standards led to aggressive countermeasures by chrysotile stakeholders.

In February 2006, the Fiber Cement Manufacturers Association (FCMA), supported by the International Chrysotile Association and the Canadian Embassy, held a so-called “International Scientific Symposium” in Jakarta which was little more than a propaganda exercise to promote the “safe use” use of chrysotile. On the cover of the symposium program the logos of the International Chrysotile Association, the Government of Canada and the Chrysotile Association were prominently displayed. Dr. Yanri declined an invitation to speak at this meeting in protest at the one-sided nature of the debate; her proposal to invite pathologist Dr. Douglas Henderson, a leading asbestos expert and adviser to the World Trade Organization on the case Canada brought against the French asbestos ban, was rejected by the event organizers. “The Canadian Government,” Dr. Yanri reported “says asbestos is too risky for use in Canada, ironically they support chrysotile sales in Indonesia. Authorized and independent international bodies should stop Canada's double standards on asbestos and protect developing countries from unfair trade practices.” Dr. Yanri urged:

ILO to assist Member States to develop action programs for the management, control and elimination of asbestos from the working environment;
WHO to work with health practitioners to improve their ability to diagnose asbestos-related conditions;
global unions to encourage and support affiliated trade unions to pursue their rights;
NGOs to support developing countries with information, research and development programs.

In his presentation Sugio Furuya, from the Japan Occupational Safety and Health Resource Center (JOSHRC) and Ban Asbestos Network Japan (BANJAN), analyzed the Japanese Asbestos Scandal which came to national prominence in the aftermath of the Kubota asbestos shock. The government's first response was to set up an inter-ministerial team at section chief level (July 1, 2006); the bureaucratic response was soon upgraded to department director level (July 21) and subsequently minister level (July 28) in light of public outrage at the government's collusion with the asbestos industry.

Japan is the latest industrialized country to ban asbestos, doing so decades after other developed economies. Epidemiological data from Europe, North America and Australia show the correlation between the level of national asbestos consumption and the incidence of mesothelioma mortality. Based on Japan's high levels of consumption – up to 10 million tonnes of asbestos were imported – and the lack of regulations to protect workers and the public from hazardous asbestos exposures, Japanese epidemiologists are predicting more than 100,000 deaths from malignant pleural mesothelioma in the next 40 years. Had Japan acted on the precautionary principle and banned asbestos sooner, many of these deaths could have been avoided. A graph plotting the number of Japanese mesothelioma deaths against claims reveals a huge disparity with fewer than 100 claims/year being made up until 2003 (in 2003, there were almost 900 mesothelioma deaths) under the Workers Compensation Insurance Scheme (WCIS). After the Kubota Shock, the number of applications for compensation increased fourfold. In March 2006, the Japanese Government established a new disease scheme for asbestos victims not covered by the WCIS: the Asbestos Victims Relief Law. The total number of applications to the WCIS and the new relief scheme in 2006 is expected to reach 5,000; this figure reflects the magnitude of the Japanese asbestos scandal.

Public awareness of Japan's lethal asbestos legacy began on June 29, 2005 when Kubota, a major Japanese company, disclosed data requested by local people on the amount and types of asbestos used at the factory and the number of workers affected by asbestos disease. From 1954-1975, crocidolite and chrysotile were used at this site in the production of asbestos-cement products; from 1971-1997, only chrysotile was used. The first occupational asbestos death caused by the Kanzaki plant occurred in 1979; seven years later, the first Kubota worker died of mesothelioma. By March, 2005, there had been 75 asbestos-related deaths amongst the Kanzaki workforce; by March 2006, this figure had risen to 105. As the factory had employed a total of 1,015 workers, this means that more than 10% of all the workers have died of asbestos-related diseases.

Hazardous exposure was not contained within the workplace, however, and cases of neighborhood exposure have been observed in areas in proximity to asbestos-using factories.¹² Research undertaken by Drs. N. Kurumatani and S. Kumagai charted mesotheliomas amongst people in Amagasaki City living within 1,500 meters of the former Kubota Kanzaki plant. By the end of March 2006, 99 cases of mesothelioma had been confirmed amongst people whose only exposure to asbestos was environmental. In 1975, more than 20% of townspeople (120,000 out of 540,000) lived in areas where asbestos fiber concentration levels exceeded 10 f/liter. To campaign for justice for asbestos sufferers and to negotiate with the Kubota Corporation, the Amagasaki branch of the Japan Association of Victims and Families was formed in 2005; currently, it has 100 members. On December 25, 2005, the President of the Kubota Corporation officially apologized to the Kubota asbestos victims and their families and pledged to set up new compensation procedures to fulfill Kubota's corporate responsibilities. On April 17, 2006, the Kubota victims' association announced that an agreement had been reached under which the company will pay individual mesothelioma claimants whose exposure was environmental sums ranging from 25-46 million yen ($213,157-392,210). While the Kubota Corporation is being proactive in dealing with the fall-out from its asbestos operations, other companies are not following its example.

Groups campaigning on the asbestos issue in Japan include trade unions and NGOs such as BANJAN and JOSHRC which, in cooperation with the Japan Association of Victims and Families, now represent the “voice of the people” in the national asbestos debate. “Working together,” Mr. Furuya said “has magnified the impact of our actions and has encouraged other groups to speak out. Unfortunately, we still have a long way to go. We will continue the struggle to obtain: fair and equal compensation for all those affected by asbestos disease, medical examinations for all the asbestos-exposed as well as an immediate and total ban on all asbestos products.” The asbestos experience in Japan has lessons for other Asian countries:

Adopting the precautionary approach based on the experience of industrialized countries without awaiting the appearance of a national asbestos epidemic is essential.
The introduction of national asbestos bans as soon as possible is critical; a ban on asbestos marks the first step in tackling a wide range of issues which make up national asbestos legacies.
Coordinating the efforts of social partners to maximum effectiveness is important; the empowerment of asbestos victims and their families should be at the heart of an asbestos campaign.
Facilitating global cooperation at various levels and across subject disciplines is also strongly recommended.

Asbestos in Ship-Breaking Industries of Bangladesh: Actions by Workers Initiative was the subject addressed by Repon Chowdhury of the Bangladesh Occupational Safety, Health and Environmental Foundation (OSHE). For more than 20 years, commercial ship-breaking operations have been carried out in Bangladesh; on average 180-250 ships a year are scrapped at 35 yards directly employing 50,000 individuals and indirectly employing 80,000. The work in these yards is labor intensive and carries no job security or social security protection; non-unionized, illiterate local migrants who make up 98% of the workforce have no knowledge of the asbestos hazard. Occupational accidents, injuries and deaths as well as hazardous exposures to a myriad of toxins occur on a daily basis.

There are many natural and political reasons for the growth of ship-breaking in Bangladesh. The coastline is suitable for the beaching of large vessels and the geographical isolation of the shipyards prevents social monitoring of working conditions. The availability of cheap labor, the low cost of machinery and the lack of health and safety legislation keep operating costs low. The resale value of material reclaimed from the ships is high:

re-rolling mills process reclaimed iron ore;
shops sell old ships' furniture;
reclaimed asbestos sheet materials are reused;
second-hand electric equipment and materials are sold as are redundant sanitary equipment, kitchen machinery and cooking appliances.

The removal of and disposal of asbestos waste is unregulated in Bangladesh and the manual crushing and re-use of asbestos from ships is common.

OHSE has recently embarked on an asbestos project in the ship-breaking industry in collaboration with the Netherlands Confederation of Trade Unions which is aimed at: raising asbestos awareness amongst ship-breaking workers, empowering local trade unions to be actively engaged in the social debate on asbestos with government and company officials and developing procedures and regulations to safeguard occupational health and safety. Working with other partners and the media, the project will campaign for a global and national ban on the import of asbestos and asbestos-contaminated ships, a ban on the re-use of redundant asbestos-containing products, government regulation, periodic workplace inspections, compensation and support for asbestos victims.

A recent case study which reveals how effective a tool social pressure can be was the campaign over the prospective ship-breaking in Bangladesh of the asbestos-contaminated ship: the S. S. Norway. Following the February 2006 purchase of the ship for scrapping purposes by a Bangladeshi company, a media campaign by NGOs succeeded in alerting the public and policy makers to the hazardous condition of the vessel. Eventually, a ban on the purchase of this ship was imposed by the Government and it was ordered out of national waters.

Madhumitta Dutta from the Corporate Accountability Desk, India discussed: A Case Study in Global Solidarity: The Clemenceau. The flagship French warship set sail for the Alang shipyard for decommissioning on December 31, 2005 after a ruling by a French administrative court which confirmed the ship's status as “material of war.” Seeking to avoid a large bill for the removal of on-board asbestos, the French Government decided to off-load the work to Indian scrapyards. The Clemenceau was “pure poison” as it contained a range of toxic materials including up to 1,000 tonnes of asbestos, PCBs, PCTs and PBBs. Inconveniently for French decision makers, the international dumping of such contaminated waste infringed the Basel Convention, and the European Waste Shipment Regulation as well as national law.

The actions of the French Government were based on double standards: at home, the import and use of asbestos was banned and yet the Government was prepared for Indians to be exposed to asbestos whilst stripping the ship “with bare hands.” Ms. Dutta's description of the working conditions in Alang included the following:

exploited and illiterate unskilled workers paid US$2/day;
deaths, fatal accidents, minor and major injuries are common and no medical assistance is available;
little or no provision of even the bare minimum of protective gear;
no job security or redress of grievances exist;
the presence of asbestos and the dumping of asbestos and other toxic substances put workers' health at risk both at work and at home as many live on or near the worksite.

A global campaign to send the Clemenceau back to France was mounted by international NGOs led by Ban Asbestos France, Greenpeace and the Platform for Clean Ship-breaking.¹³ Legal proceedings were initiated in France and India by NGOs to force the recall of the ship. After demonstrations by Greenpeace and environmentalists, authorities in Egypt delayed the ship's passage through the Suez Canal claiming they had been misinformed as to the nature of the on-board contamination. Synchronized demonstrations in France, India, Egypt and Bangladesh were covered in media reports that were widely circulated. On February 15, 2006, a French Court suspended the authorization of the Clemenceau's passage; shortly thereafter the French President recalled the ship. On May 17, 2006, the ship returned to its home port of Brest after its fruitless 12,000 mile odyssey.

This case study illustrates, Ms. Dutta concluded, what can be achieved by a multinational, coordinated campaign and the mobilization of NGOs and public interest groups with overlapping interests. The inability of international treaties and national laws to prevent the global trade in toxic waste was clearly exposed by this debacle and has led to renewed efforts to engage with regional authorities such as the European Union to ensure that there is a clampdown on such illegal practices.

Dr. Claudio Bianchi, from the Center for the Study of Environmental Cancer in Monfalcone, Italy, brought his vast depth of knowledge on asbestos epidemiology to bear on the situation in Asia in his presentation: Malignant Mesothelioma in Asia: Paradoxes. Despite the progressive increase in asbestos consumption in Asia over recent decades, the incidence of mesothelioma, a signature disease of asbestos exposure, remains low:

“A major part of the big asbestos producers are located in Asia. In 2000, nearly 70% of the world's asbestos was produced by Asian countries: Russian Federation (Asian part), China and Kazakhstan. During the last decades various Asian countries were also the most important consumers of asbestos in the world. The increase in asbestos consumption was dramatic in Thailand, passing from 6,433 tons in 1960 to 190,205 tons in 1996. Huge amounts of asbestos were used in Japan in the last four decades¹⁴… In Thailand no asbestos-related cancer has been reported. In Japan the number of pleural mesotheliomas was extremely low (about 150 per year) until the early 1990s.”

Highlighting the discrepancies between the incidence of mesothelioma in European and Asian countries, Dr. Bianchi considered the following explanations:

mesothelioma is a particularly difficult disease to diagnose and requires histological examination of neoplastic tissue and/or microscopic identification of the tumor for a reliable differential diagnosis; these techniques are not widely available in some Asian countries;
low life expectancy or competitive causes of death combined with the long latency period of mesothelioma, from 14-75 years, pre-empt deaths from mesothelioma;
the role of co-factors in mesothelioma causation;
the relatively recent industrialization in Asia which means that a sufficient time lapse has not yet occurred for mesothelioma to develop;
widespread underestimation of the true incidence of the disease.

Session 4: Empowerment of Victims / Recognizing Risks

This session was chaired by Dr. Wichai Satimai, the Director of the Office of Disease Prevention and Control, with Dr. Chantana Padungtod, from the Bureau of Occupational and Environmental Diseases, providing the secretariat. The first speaker in this session was Ms. Kazuko Furukawa, a well-known representative of asbestos victims in Japan whose husband died of asbestos-related lung cancer in 2001. In her presentation, The Experience of the Japan Association of Mesothelioma and Asbestos-Related Diseases Victims and their Families, Ms. Furukawa said that when her husband began suffering from lung cancer she first heard the word asbestos from his doctor. “I didn't know what asbestos was. Of course I, like most asbestos victims, did not know how dangerous asbestos was and the link between the disease and asbestos.” Some doctors never even mention the word asbestos to mesothelioma or other asbestos-related disease sufferers and never explain the link between asbestos exposure and the patient's condition.

The Japan Association of Mesothelioma and Asbestos-Related Diseases Victims and their Families (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. Nowadays there are 10 branches of the Association throughout Japan with nearly 400 members. Association representatives assist victims and their families by providing:

a free telephone consultation service;
assistance for patients in bringing compensation claims for occupational and non-occupational asbestos exposure;
opportunities for victims, family members and bereaved relatives to get together to offer mutual support and advice;
coordination of a national lobby for legislation to improve the plight of victims and their families.

The Association holds social events such as picnics during the Cherry Blossom festival so that people marginalized by illness can be resocialized. In November 2004, the Association played a pivotal role in the organization of the Global Asbestos Congress (GAC 2004), which provided a wonderful opportunity for Japanese people to have face-to-face meetings with overseas experts, victims' representatives, victims and bereaved family members. Since then, the Association has 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 meetings and a rally in Tokyo.

Concluding her presentation, Ms. Furukawa said:

“My life has completely changed since my husband died. I spend much of my time traveling throughout Japan to assist other asbestos victims. My husband was exposed to asbestos at the power station where he worked as a welder… Since he died, I have been fighting against asbestos. At the beginning of my struggle against asbestos I was lonely. I started to apply for Workers Accident Compensation Insurance (WACI) but it took a long time to get the application approved. I faced various difficulties. While I was applying for WACI, I came to realize that he had been working in such dangerous and terrible surroundings. They didn't receive safety instructions at the workplace and moreover they were not provided with ventilation systems and personal protective gear… I believe the activities of the Association are essential for the realization of an asbestos-free future!”

Continuing the discussion on the fallout from Japan's asbestos legacy was Dr. Yuji Natori, from the Hirano-Kameido Himawari Clinic, who spoke about: Medical Treatment and Compensation for Asbestos Victims in Japan. Different medical protocols are available in Japan for the treatment of asbestos-related diseases including asbestosis, mesothelioma, lung cancer, benign asbestos pleural effusion and diffuse pleural thickening. The diagnosis of pleural and peritoneal mesothelioma is complex and treatment options include surgery, chemotherapy and radiation. It is crucial, Dr. Natori stressed, to bear in mind the need for mental and palliative care for the patient and his/her family from the time of diagnosis to the terminal stage. Doctors must “tell the truth” about the progression of the disease and the prognosis. Palliative care should include treatment of symptoms such as pain, shortness of breath, fatigue, dry mouth, loss of appetite, gastrointestinal problems, skin problems, anxiety and depression.

Compensation for Japanese asbestos victims is compartmentalized with occupational and non-occupational exposure claimants being eligible under some laws and not under others:

Pneumoconiosis Law (1960 to present) available for workers with asbestosis and lung cancer;
Workmen's Accident Compensation Insurance Law (1947 to present) available for workers with lung cancer, mesothelioma, benign effusion or diffuse thickening;
Act on Asbestos Health Damage Relief (2006) available for mesothelioma or lung cancer victims whose asbestos exposure was domestic or environmental;¹⁵ benefits which can be claimed under this act include: relief benefits, special condolence money for bereaved families, medical compensation and medical treatment pension;
Pleural plaques are not compensated in Japan.

In the next presentation, the President of the Asbestos Disease Society of Australia (ADSA) Robert Vojakovic addressed the issue: Combating Asbestos Injustice in Australia. As a producer of crocidolite and chrysotile and a heavy asbestos consumer, Australia has experienced an epidemic of asbestos cancer which has already caused more than 9,000 deaths. By 2025, scientists predict that there will be a further 45,000 asbestos cancer fatalities in Australia. Asbestos use began in Australia with products imported in 1903 from Poisy, France; within 15 years, Australian companies, Wunderlich Limited and James Hardie began manufacturing asbestos products. James Hardie became a household name with an asbestos-cement factory in every State of Australia as well as in Auckland, New Zealand (1936), Malaysia (1964) and Indonesia (1975). By the 1930s, Wunderlich Limited had asbestos factories in Melbourne, Brisbane, Perth and Adelaide. In 1944, Australia's two big asbestos groups embarked on a joint venture to mine chrysotile in Baryugil, Northern New South Wales through an operating company: Asbestos Mines Pty Ltd. Simultaneously, mining of crocidolite commenced at Wittenoom Gorge by Midalco Pty Ltd., formerly known as the Australian Blue Asbestos Pty Ltd., a subsidiary of Colonial Sugar Refinery (CSR).¹⁶ The horrendous levels of asbestos contamination in Wittenoom which endangered workers and residents defy description and can only be comprehended by the breathtaking photographs shown by Mr. Vojakovic.

The continual cultivation of high-level political connections by Australia's asbestos stakeholders and the propaganda they disseminated ensured that legislation favorable to the industry remained the norm:

as of 1973, compensation claims by injured Wittenoom miners or residents were barred under the Limitation Act;
as of 1979, workers compensation still did not recognize mesothelioma or lung cancer as compensable diseases;
procedures for obtaining social security assistance remained rigid and inaccessible to asbestos victims for decades;
attempts to establish dust controls were assiduously fought;
the existence of government files detailing asbestos contamination at Wittenoom and its concurrent health risks were denied (1979); in 1985, the ADSA located these files.

In this hostile climate, asbestos victims were left high and dry with no jobs, no hope of physical recovery and no compensation. In 1979, a group of former Wittenoom miners, later to become the ADSA, set up an asbestos self-help group in Perth. The objectives of the support group were to:

provide counseling, support and economic assistance for asbestos victims and their families;
increase community awareness of the asbestos hazard and the need for medical research;
raise funds for medical research and support services;
lobby for equitable compensation and amendments to the law.

The ADSA successfully lobbied the Government of Western Australia to amend the Limitation Act and to have mesothelioma and lung cancer listed as compensable diseases under the Workers Compensation Act. In 1988, the ADSA, working with the law firm of Slater & Gordon, demolished the obstructive legal strategy of asbestos mine owners to win compensation from the Supreme Court of Western Australia for two former Wittenoom workers who had contracted mesothelioma: Peter Heys and Tim Barrow. Nowadays, most asbestos cases in Australia settle during the mediation stage. Responding to the needs of so many asbestos-injured Australians, asbestos victims' groups have also been established in the states of Victoria, Southern Australia, New South Wales and Queensland.

In his presentation, Mr. Vojakovic spoke of the effectiveness of the Australian asbestos industry's defensive strategy including its manipulation of medical and scientific research to forestall legislative action and prevent victims' compensation claims from succeeding. The misuse of science by asbestos stakeholders was the subject of Dr. Arthur Frank's contribution Science for Sale. The commercial use of corrupt science and industry-commissioned scientists by vested interests has been on-going for some considerable time. The tobacco industry began honing the use of public relations (PR) companies and disinformation campaigns to confuse smokers and mislead government agencies over the health effects of smoking in the 1950s. The infamous PR company Hill and Knowlton (H&K) which represented big tobacco also represented Johns Manville, the biggest asbestos group in the U.S., and the Asbestos Information Centre, the UK's asbestos trade association. With the involvement of H&K, asbestos stakeholders went on the offensive; whereas formerly their efforts had primarily been on hiding information and suppressing detrimental research findings, H&K coordinated a disinformation campaign with slogans such as: “Where would we be without asbestos,” and “Asbestos – it's a natural.” The objective of the coordinated PR onslaught was to influence worker protection legislation, the outcome of legal cases and Congressional and Parliamentary action which could affect profit margins. Eventually, however, the truth emerged and asbestos litigation began to take its toll, bankrupting major U.S. asbestos producers and users: U.S asbestos liabilities now stand at over $100 billion.

The propaganda which was spread shortly after the attacks on the World Trade Center on September 11 is a classic example of the use of disinformation to muddy the waters. Within days of the attacks, a “so-called” expert was claiming that the reason the buildings collapsed was their lack of asbestos fireproofing! Dr. Frank was confident that, despite the ongoing propaganda campaign on behalf of this moribund industry, progress is being made: 40 countries have banned asbestos, action is being taken on the transborder movement of asbestos-contaminated ships (the Clemenceau), the World Trade Organization upheld a country's right to ban asbestos and the ILO has recently passed a pro-ban resolution. Concluding his talk on an upbeat message, Dr. Frank urged delegates to work together to counter the damage being done to workers and the public by the globalization of capital.

In his presentation on Multinational Claims for Asbestos Compensation, Solicitor Richard Meeran, from Slater & Gordon, explored options available to citizens of developing countries to obtain compensation from multinationals by examining the claim brought on behalf of 7,500 asbestos-injured South Africans against the UK asbestos company Cape plc. “Legal action,” Meeran said, “has a role in compensating victims of asbestos related-disease but equally is important in deterring bad employment practices, so that a company which is hit by an order to pay a large amount of compensation is likely to think twice in the future about behaving so badly.”

The case against Cape lasted from 1996-2003 and was brought on behalf of mine and mill workers and local residents with asbestos-related disease from:

Northern Cape, who were exposed to or worked for Cape plc's crocidolite operations;
Limpopo Province, in the North, who were exposed to or worked for Cape plc's amosite operations.

The evidence obtained of the occupational conditions at Cape's facilities is horrifying; 6% of the claimants were under 7 years old when they worked at the Cape mines.

As the South African subsidiaries of Cape had no money and no insurance, the case was brought in the English Courts against Cape plc, the parent company. To successfully sue a parent company there are substantial hurdles to overcome:

Piercing the corporate veil – despite the fact that the operations of the Cape Group were centrally-run and orchestrated, by law each subsidiary constitutes a separate legal entity; the fact that the parent company knew of the health risks and controlled the South African operations as part of a globally integrated organization were grounds for establishing the English company's liability to the claimants.
Jurisdiction – legal arguments over the appropriate jurisdiction for these claims went on for three years in the English High Court, Court of Appeals and House of Lords. In July 2000, the House of Lords ruled that the case could stay in England, after the South African Government had interceded on the plaintiffs' behalf. The availability of legal aid in the UK but not in South Africa was pivotal to the Law Lords' decision.

One of the most worrying strategies being adopted by multinationals, such as the Australian firm of James Hardie, is corporate restructuring to place their assets out of the reach of asbestos victims. Hardie's relocation to the Netherlands was intended to do just that, but due to lobbying by Australian asbestos victims, victims' groups, trade unions, action by the Australian Government and international support, it looks likely that this ploy will fail. With modern methods of communication, good organization, global cooperation and support, it is possible to hold multinational companies to account not only in their home bases but also in developing countries.

The final speaker in session 4 was Mr. Shigeharu Nakachi, from Environmental Monitoring Laboratory, Japan whose topic was: Recognizing and Minimizing Risks from Installed Asbestos/Asbestos Alternatives. From 1930 to 2004, more than 10 million tonnes of asbestos were imported by Japan. Sprayed asbestos fireproofing and insulation products were used extensively; some sprayed asbestos products were prohibited in 1975 but the use of some sprayed products with lower asbestos fiber concentrations continued until 1995. An investigation of infrastructure contamination by sprayed asbestos which was carried out by three government ministries found that the categories of buildings worst affected were: national universities, private schools, public colleges and hospitals. Whilst, the quantity of sprayed asbestos products in Japan is unknown, the amount of asbestos-containing construction materials has been estimated at 40 million tonnes.

One of the consequences of Japan's widespread use of asbestos was observed after the 1995 Kobe earthquake, when ambient asbestos concentration levels rose in the urban areas affected. Unfortunately, the results of testing done by the Government of airborne asbestos concentrations in 1985, 1991, 1993, 1995 and 2005 near main roads, in residential areas and in industrial areas are inconclusive, with levels of contamination see-sawing inexplicably. In light of public anxiety over asbestos since the Kubota Shock, more research is needed. Efforts in Japan to quantify the amounts of asbestos released into the environment or dumped to waste by industry have been more successful; data collected shows a dramatic decline from 4,162,446 kg/year (2001) to 564,747 kg/year (2004). Adherence to state-of-the-art asbestos removal procedures and protocols is making an important contribution to protecting Japanese society from further hazardous asbestos exposures.

After a day of informative presentations and lively discussion, conference delegates relaxed at an evening reception held by their Thai hosts which featured a splendid buffet of Thai cuisine and a colorful display of traditional dance. After brief remarks by conference organizers who welcomed guests to the festivities, Ms. Kazuko Furukawa, from the Japan Association of Mesothelioma and Asbestos-Related Diseases Victims, presented conference delegates with hand-made chains of origami cranes symbolizing peace and good health. “It is believed,” she said “that 1,000 folded paper cranes make a wish come true. For that reason, members of our association produce thousands of cranes to bring forward the day when asbestos is banned worldwide.”

Session 5: Thai Action on Asbestos

The second day began with a series of presentations and a panel discussion on the Future Trend and Measures for an Asbestos Ban Policy in Thailand. The session chair and secretary were Drs. Wigrom Sengkisiri and Sasitorn Taptagaporn, respectively, with Associate Professor Dr. Chalermchai Chaikittiporn, Dean of Faculty of Public Health, Mahidol University, acting as the moderator. The speakers in this session included Miss Karnchana Karnviroj, from the Department of Labor Protection and Welfare, Dr. Somkiat Siriruttanapruk, from the Department of Disease Control, and Associate Professor Dr. Wantanee Phanprasit, the Associate Dean of the Department of Occupational Health, Mahidol University.

The import of asbestos, which has been used in Thailand for 30 years, is approximately 150,000 t/year or 2.4kg/person and consumption is increasing. Workplace levels of asbestos contamination in Thailand are higher than those allowed in other Asian countries and often exceed the Thai Asbestos Occupational Exposure Limit (OEL) of 5 f/cc.¹⁷ Recent measurements taken by industrial hygienist Ms. Karnviroj in asbestos-cement factories in Thailand found that 30% of samples taken were higher than 5f/cc. The dustiest conditions were experienced by those workers manually handling bags of asbestos fiber and using sandpaper to polish asbestos-cement roof fittings. Despite their occupational exposure, lung function tests of 85% of the factory workers and chest X-rays of 97% were normal. Not one case of asbestos-related disease has, to date, been reported to government surveillance schemes or the Workmen's Compensation Fund even though according to calculations based on the work of Dr. Antti Tossavainen, an annual incidence of 1,103 cases of mesothelioma could be expected. Possible explanations for the lack of registered cases of asbestos-related disease are:

there are no cases of asbestos-related diseases in Thailand;
cases are occurring but are not reported and doctors do not have the knowledge to diagnose these diseases;
the long latency period of these diseases means that symptoms have not developed – YET;
a high turn-over of the workforce in the asbestos industry means that workers did not inhale a sufficient fiber burden to incubate these diseases;
there is neither a follow-up nor a registration system for exposed workers, which means that cases of asbestos-related disease that do occur remain unacknowledged.

The Department of Labor Protection and Welfare (Thailand) has issued regulations, carried out inspections, undertaken training, developed guidelines and provided information to those working in or administering the asbestos industry. Thai regulations which protect occupational health and safety include the: Working Environment Regulation (1977), Harmful Chemicals Regulation (1991), Physical Examination Regulation (2004) and Safety Officer and Safety Committee Regulation. The Government plans to reduce the asbestos threshold level by revising the Working Environment Regulation by the end of 2007. The ratification of ILO Occupational Health and Safety Resolutions by Thailand will also take place in the near future but ILO Resolution 162: Convention concerning Safety in the Use of Asbestos (1986) will not be considered at that time.

There was agreement that the option of doing nothing about the increasing use of asbestos in Thailand was not viable. Inaction would exacerbate the epidemic of asbestos-related disease, incur increased medical and compensation costs, alarm the public, strain the economy and compromise the national reputation. To persuade policy-makers of the need for an asbestos ban, a concerted effort was needed to encourage government agencies to cooperate on initiatives to raise asbestos awareness, collect data and initiate health screening and surveillance of at-risk groups. Thai civil servants stressed the importance of working with local asbestos manufacturers on the transfer to non-asbestos technologies. The best way to protect Thai society from the asbestos hazard is to ban the use of asbestos; until the Government is ready or able to take this step, serious measures need to be adopted and enforced to protect workers and the public from hazardous exposures.

Delegates took the opportunity of a question and answer session following the presentations to expand the discussion. One delegate questioned the necessity of government monitoring of disease levels and collection of data when so much evidence has been accumulated abroad that conclusively demonstrates the hazardous impact asbestos has had on occupational and public health. Another delegate commented on the lack of attention paid to occupational conditions experienced by Thai workers in the informal sector who are, as in most developing countries, more numerous than those with full-time employment in the formal economy. Fiona Murie from the BWI highlighted the notorious conditions in the construction industry; supporting her comments, Ms. Murie referred to findings presented by Dr. Wantanee Phanprasit of elevated fiber concentrations liberated by the cutting of roof tiles by Thai construction workers.

Session 6: Workshops

At 10:30 a.m., the plenary session was adjourned so that conference delegates could participate in workshop sessions:

6.1 Medical Surveillance

Workshop 1 was co-chaired by Dr. Arthur Frank and Prof. Dr. Pornchai Sithisarankul. The first speaker was Dr. Narufumi Suganuma from the University of Fukui, Japan who asked: Is CT Screening for Asbestos-Related Diseases Rational? Though mortality reduction resulting from computer tomography (CT) screening remains unproven, CT, preferably with low dose radiation, may be more effective at detecting asbestos-related diseases than chest radiographs. A pilot survey using low dose multi-detector CT (MDCT) was conducted in Japan among 100 asbestos-exposed workers more than 50 years old who were members of a construction health insurance society, with a total membership of 3,000. The scans, which cost $120/person, revealed 3 lung cancers, 2 of which were surgically resected. If CT screening and/or medical check-ups of at-risk asbestos groups become mandated, who will pay the bill, Dr. Suganuma asked.

Discussion of the same topic continued in the presentation A Proposal on HRCT Images for Merging Helsinki Criteria and ATS¹⁸ Statement for Non-Malignant Asbestos-Related Diseases by Dr. Yukinori Kusaka, also from the University of Fukui, Japan. Dr. Kusaka considered the landmark protocols in diagnosing asbestos-related diseases:

ATS – The Diagnosis of Non-malignant Diseases Related to Asbestos(1986);
Helsinki Criteria – Asbestos, Asbestosis and Cancer, Criteria for Diagnosis and Attribution (1997): reliable work histories are the most practical and useful measures of occupational asbestos exposure; high resolution CT scans facilitate detection of asbestosis and asbestos-related pleural abnormalities, but are not recommended as a screening tool;
ATS Statement – Diagnosis and Initial Management of Non-malignant Diseases Related to Asbestos (2004): the diagnosis of non-malignant asbestos-related diseases is based on “the essential criteria of a compatible structural lesion, evidence of exposure, and exclusion of other plausible conditions, with an additional requirement for impairment assessment if the other three criteria suggest asbestos-related disease.”

While availability of HRCT as a standard method of imaging has increased our ability to detect asbestos lung injury, harmonization of HRCT classification systems within the framework delineated by international guidelines was needed. In 2000, researchers and clinicians from seven countries participated in a study group to develop a classification system for HRCT (ICOERD), based on radiologic-pathologic correlation of dust-induced studies, for occupational and environmental respiratory diseases with guidelines, a standardized coding system, reading sheets and reference films. Results obtained by Dr. Kusaka and his team in collecting typical HRCT images and findings as standardized evidence of structural changes in non-malignant asbestos-related disease were presented. It was proposed that images from this study be included in the ICOERD system as examples of compatible structural lesions of typical non-malignant asbestos-related diseases.

The next two speakers focused on the occupational health effects of asbestos manufacturing in Thailand. Dr. Ponglada Subhanachart from the Chest Disease Institute in Thailand discussed Abnormal Chest Imaging Compatible with Asbestosis and Asbestos-Related Pleural Disease in Fiber Cement Factory. Chest X-rays of 907 workers from an asbestos fiber cement factory were examined by experienced chest radiologists using standard ILO classifications. Where there was a suspicion of asbestosis or early asbestos-related pleural disease, HRCT examinations were undertaken. The results were:

747 workers had normal X-rays;
26 (2.87%) had abnormal chest radiographs and/or abnormal HRCTs;
14 had abnormal X-rays compatible with asbestosis, pleural plaques or calcifications;
7 (0.77%) had very early lung fibrosis: only one patient had lesion profusion 1/1 which is the cut-off point in Thailand for the diagnosis of asbestosis;
24 had pleural lesions such as pleural plaques and/or pleural calcification.

Dr. Subhanachart postulated that the low incidence of disease could be explained by the fact that most patients are in the latent period or that the systems for reporting these diseases in Thailand are inadequate. Concluding that chest radiographs are a useful tool for the screening for asbestosis and asbestos-related pleural disease, he expressed concern at the high level of false readings and suggested that HRCT examinations be done for confirmation in cases with lung lesion profusion >1/1.

Responding in 2005 to a reported epidemic of pleural thickening amongst workers at an asbestos factory in Nakornsithammarat, Thailand, researchers designed and carried out a cross-sectional survey which established that amongst the 40 workers who participated in the study, there were 9 cases of pleural thickening.¹⁹ Almost all those affected were: older than 50, had a history of smoking, had worked in the factory for more than 25 years and had spent time in the asbestos bag opening department, the stripping and mold department, the asbestos mixing department or the rod mill.

The final speaker in the workshop was Dr. Gregory Deleuil, Medical Adviser to the Asbestos Diseases Society of Australia in Perth, whose presentation was entitled Australian Mesothelioma Research. The ubiquitous use of asbestos-containing products and asbestos mining operations have given Australia one of the highest incidences of mesothelioma in the world. The Government's reaction to the country's “worst industrial disaster in our history” has been to devise a “comprehensive, strategic, national effort to help those suffering from asbestos related diseases.” The National Research Center for Asbestos Related Diseases (NRCARD) is being established by the National Health and Medical Research Council; over the next 3 years, A$5 million of government funding will be made available to set up this Center to coordinate the national fight against asbestos cancer; over the next decade, additional funds of A$110 million will be provided for research on 11 different themes including prevention, early diagnosis, treatment therapies and palliative care.

The worst incidence of asbestos cancer in Australia is in the State of Western Australia (WA) due to the presence of the country's only crocidolite mine in Wittenoom, WA. It is now 40 years since the asbestos mining operations in Wittenoom closed down. Since then, many of the town's 6,000+ resident children have contracted mesothelioma from hazardous domestic and environmental exposures. In the last 18 months, 12 former Wittenoom children have been diagnosed with mesothelioma in Perth, a city that has become a focus for international research efforts on asbestos cancer. Dr. Deleuil was optimistic that the Government would decide to set up the NRCARD in Perth in order to capitalize on the presence of so many of the world's leading mesothelioma researchers in the city.²⁰

6.2 Trade Union Action on Asbestos

Workshop 2 was co-chaired by Dr. Yothin Benjawang and Sanjiv Pandita. The first speaker was Ng Wei Khiang from the Institute for Occupational Health, Safety and Environment (OHSEI), Vietnam who presented A Review of ICFTU/OHSEI Action on Asbestos Issues at the Workplace. Groups representing global labor including the International Confederation of Free Trade Unions-Asia & Pacific (ICFTU-APRO) and the OHSEI support the global campaign to ban asbestos and many affiliated unions in the Asia-Pacific region are making this a priority issue. The Japan Trade Union Congress (JTUC-RENGO) and the Australian Congress of Trade Unions (ACTU) have achieved good results working with national policy makers on asbestos bans and health and safety legislation. Labor groups in other countries in the region have not, up till now, had the same success but nevertheless the ban asbestos policy remains a cornerstone of labor action in Asia following the October 2005 Resolution to Ban Asbestos which was adopted at the 81st ICFTU-APRO Executive Board Meeting in Malaysia and the 18th Regional Conference in February 2005 in Nepal. Throughout 2005, work on the asbestos issue has been on-going including the publication of ban asbestos campaign material, training and capacity development of key personnel and joint projects with partners in Bangladesh, Pakistan, Indonesia and the Philippines. In the struggle to improve labor protection and labor relations throughout Asia, the efforts of trade unionists and their social partners will continue to include the need for national bans and occupational safeguards to protect at-risk workers.

Dr. Nhan Hong Quang, from the National Institute of Labor Protection in Hanoi, Vietnam, focused his remarks on The Role of the Vietnam General Confederation of Labor (VGCL) on Occupational Safety and Health and Environmental Protection at Enterprises Using Asbestos. As the most senior institution representing workers' rights in Vietnam, the VGCL plays a role in formulating policies and legislation regarding the commercial use of asbestos, improving occupational health and safety conditions and reducing levels of occupational disease. In Vietnam, asbestos is mainly used in the manufacture of asbestos-cement roofing tiles. Of the 35 asbestos-cement roofing tile companies in Vietnam, 24 (69%), employing 2,427 workers, are owned by the state. The asbestos-cement roofing material sector generates nearly $40 million/year and provides direct employment for 10,000 and indirect employment for many others.

Despite the significant contribution of the industry to the national economy, the Government is concerned about the health impact of occupational and environmental pollution and has taken steps to quantify the adverse impacts of asbestos in Vietnam:

in 1990, NILP staff were sent to Australia for training on asbestos analytical techniques;²¹
in 2000, research was carried out by the NILP at the Dong Anh Roofing Tile Joint Stock Company to measure levels of asbestos dust;
in 2002, NILP undertook a study: Assessment of Current Environmental Status at Asbestos-Cement Roofing Tile Enterprises and its Influence on Workers' Health – Proposal of Solutions;
a recent survey to assess levels of environmental pollution by asbestos-consuming factories found that 9 out of 23 (40%) recorded maximum concentrations ranging from 2.22-4.2 f/cm3;
medical examinations of 1,032 workers in 12 companies showed that 98% had normal X-rays, however, 907/1,032 (88%) reported health problems ranging from difficulty in breathing to chronic nasal inflammation.

Despite a government decision in 2004 to phase-out the use of asbestos-cement roofing materials,²² the transition period has been prolonged due to uncertainty over the existence and cost implications of safer alternatives such as ceramic, glass, stone, quartz, natural organic and/or man-made mineral fibers. During the current phase, regulations have been tightened so that:

asbestos-using enterprises are prohibited from exploiting, manufacturing and importing amphibole asbestos; the use of chrysotile asbestos is permitted;
all asbestos-using enterprises must register plans for technological modernization which include systems of environmental controls; enterprises must conduct environmental monitoring and periodic medical check-ups of workers;
training courses will be organized for all workers in asbestos-cement roofing tile companies;
government agencies will increase supervision to ensure compliance with occupational safety and health regulations.

The Burden of Asbestos-Related Disease in South Africa and the Struggle for Prevention and Compensation was the title of the talk by Fred Gona from the National Union of Mineworkers (NUM), South Africa. For over a hundred years, the mining of three types of asbestos (chrysotile, amosite and crocidolite) took place in South Africa. The impact this industry has had on the health of workers, local people and the environment has been disastrous:

large numbers of retrenched miners, up to 39%, have contracted asbestos-related diseases (ARDS); more than 70% of redundant asbestos miners live in poverty;
amongst female miners from Limpopo Province, 96.2% have ARDS;
in village communities in the Mafefe area of Limpopo Province, 40% of villagers have ARDS from exposure to asbestos tailings dumps;
25% of the population in Prieska in the Northern Cape have contracted ARDS;
the asbestos mining industry in four South African Provinces has left behind 150 asbestos tailings dumps in mainly rural areas;
in addition to people working in the asbestos mines and mills, workers received hazardous exposures in the transport, construction, asbestos-cement, motor, energy, textile and waste-disposal industries.

Clarifying the current situation, Mr. Gona said:

“Construction workers remain at risk because of the continued use of asbestos-cement products in the building of mainly “low-cost houses.” These asbestos- containing building materials are imported mainly from Zimbabwe. Asbestos was used extensively in the building industry in the past and many homes, schools, libraries, hospitals and other public buildings have asbestos in place. Exposure takes place when the asbestos-cement products become friable with age and acid rain and the asbestos fibers become airborne when installations, renovations and/or changes are made to the buildings. Harvesting of rainwater is a common practice especially in rural communities. Asbestos-cement roofs and water storage tanks therefore continue to pose a risk to health.”

Obtaining compensation for ARDS in South Africa is a cumbersome process with many pitfalls. Injured workers must be diagnosed with a recognized ARD; given the lack of medical and health service awareness of ARDS, this is neither quick nor straight- forward. If a claimant overcomes all the obstacles, the sums paid out are minimal, ranging from ZAR25,000-ZAR85,000 (US$3,455-$11,750). Some categories of occupational asbestos victims, such as women and children who worked at the mines, are prevented from bringing claims due to lack of proof of employment. ARDS contracted from environmental exposure are not compensable under the Occupational Diseases in Mines and Works Act.

The NUM continues to work closely with social partners including government agencies, community groups, other trade unions, civil society organizations and lawyers to quantify the situation and devise strategies to secure long-term objectives such as:

addressing asbestos-related poverty, ill-health and poor quality of life;
banning the import and use of asbestos fiber and asbestos-containing products;
preventing future hazardous exposures;
rehabilitating asbestos-contaminated land;
planning and implementing sustainable development programs.

Investigation of Asbestosis (Thailand) from 2003 to 2004 by Vichuda Lojananont and Ms. Churairat Srimanee from the Ministry of Public Health, Thailand was the next presentation. Over the last decade, asbestos imports into Thailand have been substantial as documented by the Thai Customs Department.

Asbestos Imports into Thailand (1997-2004)

Year	Quantity (kg)	Value (US$)
1997	177,123,729	56,879,810
1998	60,092,992	27,020,559
1999	100,423,242	38,466,601
2000	120,563,168	44,614,534
2001	126,515,184	45,758,518
2002	181,348,064	55,004,723
2003	166,483,431	49,362,921
2004 (Jan.-July)	106,793,735	29,291,799

A study was undertaken to investigate cases of asbestosis and lung abnormalities in Thailand in 2003-2004 amongst people with occupational exposure to asbestos in the production of cement or friction products. Using questionnaires, chest radiographs, HRCT, air sampling and physical examinations, 41 out of 140 workers were found to have lung abnormalities. All those exhibiting the symptoms of asbestosis reported a past history of occupational asbestos exposure Air samples collected in 2003 showed that 12 out of 25 samples were over the standard set by the ACGIH;²³ 6 out of 40 samples collected in 2004 exceeded the standard. Mr. Lojananont urged that:

efforts be made to raise awareness of the hazardous nature of asbestos;
the national policy on asbestos should be reviewed;
no-smoking initiatives be implemented;
greater numbers of occupational physicians should be trained and a further cohort study should be undertaken.

Canadian trade unionists Lyle Hargrove and Paul Goggan, representing the Canadian Autoworkers Union (CAW), spoke on The Controversy About Chrysotile Asbestos in Canada. The CAW, the largest private sector trade union in Canada, was founded in 1985 and has been lobbying on asbestos issues for many years. Many Canadian workers have died from hazardous asbestos exposures as have loved ones who were exposed to asbestos through domestic contact with contaminated work clothes. Knowledge about the asbestos hazard goes back many decades and it is inexplicable that its use still continues. In Quebec, asbestos communities are surrounded by mountains of contaminated mining waste which endanger the health of those who live and work in towns such as Thetford.

Having acknowledged the severity of the asbestos hazard, the Government of Ontario introduced an Occupational Exposure Limit of 0.1 f/cc; even this level of exposure is associated with lifetime risks of 5/1,000 lung cancers and 2/1,000 cases of asbestosis. The federal chrysotile threshold of 1f/cc will produce an even bigger crop of asbestos-injured in years to come. Although some asbestos-cement is still being used in the building of new housing in Toronto and elsewhere in Canada, most Canadian asbestos is exported. Photographs shown of asbestos use in Brazil and Peru clearly illustrated the hazardous nature of the “controlled use of asbestos” in the developing world. Concluding their presentation, the speakers said that Canada must ban asbestos at home and stop exporting it forthwith, at the same time as it puts in place a just transition program for affected workers and communities which would include financial assistance with relocation, training and pensions.

The final speaker in the workshop was Dr. Nalinee Sripaung from the Ministry of Public Health whose subject was Analyzing the Economic and Health Costs of Asbestos Use. While some countries have reacted to the hazards of asbestos by banning the use of this acknowledged carcinogen, its ubiquitous presence and its importance to some national economies mean that it is logical to explore strategies to minimize the harmful effects of both past and continued asbestos consumption. Economic reasons supporting the continued use of asbestos in Thailand include: cheap prices of asbestos products, higher prices of non-asbestos substitutes, the growth of asbestos production and exports and the benefit to the national economy of the thriving asbestos industrial sector. Health considerations such as the elevated risk of contracting asbestos disease by increasing asbestos contamination of the infrastructure and environment and the increasing medical and welfare costs of treating/supporting asbestos victims in the future must also be factored into the national asbestos debate.

In Thailand, there is existing legislation such as the Clean Air Act which, with some adaptations and stricter enforcement, could better control the industrial asbestos hazard and improve environmental and health surveillance. A higher tax should be imposed on asbestos products so that the use of asbestos would be more expensive than that of safer substitutes. Occupational work histories should be taken of asbestos-related disease patients so that their source of exposure can be recorded in order to identify at-risk groups.

6.3 Issues Affecting Asbestos Victims

Workshop 3 was co-chaired by Dr. Wigrom Sengkisiri and Dr. Panompan Siriwattananukul. The first speaker was Rose Marie Vojakovic from the Asbestos Diseases Society of Australia whose subject was: Supporting Asbestos Sufferers in Western Australia. The first Australian cases of asbestosis and mesothelioma were reported in 1933 and 1962 respectively. By the late 1970s, although the incidence of asbestos-related diseases was increasing in Australia, sufferers received no assistance in dealing with the immense problems they faced. The Asbestos Diseases Society of Australia was formed to fill the vacuum by: providing counseling, support services and economic assistance, lobbying government for improved treatment of the injured, raising funds for medical research and working to raise community awareness of the Australian asbestos legacy.

A diagnosis of asbestos cancer creates a range of pressing needs for patients and their families. Since its foundation, the Perth-based group has worked assiduously to meet these needs by ensuring that the following key concerns are addressed:

Medical

full access to diagnostic evaluations;
basic understanding of asbestos-caused diseases, terminology and symptoms;
choice of medical specialists and access to a second opinion if required;
access to pain control clinics and therapies;
access to appropriate prescribed medication with full disclosure of potential side effects;
access to care-giver for those with no immediate family.

Social

diminished income or complete loss of income leading to a burden of debt;
loss of self-esteem and social contact;
isolation, feelings of frustration and guilt.

Legal

making a claim for compensation is important and often has positive effects on asbestos disease sufferers;
the successful resolution of a claim affords a dying patient peace of mind knowing that the financial pressures on his/her family are eased;
obtaining compensation can allow a dying patient the opportunity to fulfill a lifetime wish; it also provides increased choice as to care options.

Psychological

being diagnosed with an asbestos disease has an enormous impact on the person and his/her family;
feelings of blame, anger, betrayal, despair and depression are not uncommon.

Bereavement

pastoral needs, home visits, grief and grieving.

Unfortunately, the Australian epidemic of asbestos-related disease shows no sign of slowing down. The staff and volunteers at the Asbestos Diseases Society of Australia will continue their activities and invite colleagues attending the Bangkok conference to work with them to achieve our goals in Australia and abroad.

It is ironic that a substance as deadly as asbestos was so widely used in hospitals. Dr. Nopadol Suchat, from Buddhachinaraj Hospital, asked: Is there Asbestos in Buddhachinaraj Hospital, Thailand? Considering the traditional use of asbestos on steam pipes, boilers, furnaces and in floor tiles and roofing materials, it was not unreasonable to suspect the presence of asbestos at the 904 bed regional public facility. Dr. Suchat undertook a cross-sectional descriptive study in March 2006, which included a survey of all 96 hospital buildings and steam pipelines, boiler rooms and autoclave rooms. Pictures he showed of the facilities illustrated the detailed examination he conducted. While no asbestos was found in the walls, floors, autoclaves, boilers, steam pipelines and garbage burner, there was asbestos in asbestos-cement roofing materials and sewage pipelines. Dr. Suchat recommended that when these materials are removed, a wet process should be used and workers should be provided with personal protective respiratory protection.

The Struggle of Asbestos Victims and their Families was the subject of the presentation by Ms. Kazumi Yoshizaki, of the Japan Association of Mesothelioma and Asbestos-Related Diseases Victims and their Families, Japan. Through a series of family photographs, Ms. Yoshizaki showed the devastation caused by her father's mesothelioma. Mr. Yoshizaki had worked at the Nichias Corporation factory in Oji, Japan. Since 1896, this company had been a respected manufacturer of thermal insulation materials in Japan. Unfortunately, their products used asbestos and many former employees, like Mr. Yoshizaki, are now paying the price for the company's negligent use of such a dangerous substance. Speaking from the heart, Ms. Yoshizaki told the workshop that she loved her father and hated asbestos. She pledged that her family would continue to campaign for a global asbestos ban and justice for all asbestos victims.

Another person who has been bereaved by asbestos is Ms. Linda Reinstein, the Executive Director and Cofounder of the Asbestos Diseases Awareness Organization (ADAO) whose husband, Alan Reinstein, died of mesothelioma in May 2006. The presentation by Ms. Reinstein Grassroots Advocacy: Turning Anger to Action described how her husband's mesothelioma diagnosis was the spark which led to the formation of the ADAO, a new advocacy group which has become a national voice in the U.S. asbestos debate in the last two years.

ADAO Action Summary

launched an international asbestos awareness campaign in 2004;
developed an international virtual community with resources in English, Spanish and French;
created and manages a growing database of information;
shaped U.S. legislation: the Asbestos Awareness Day Resolution;
honors and remembers asbestos victims;
participates in medical and advocacy forums;
organizes annual asbestos awareness day conferences: the 3rd such event will take place in Philadelphia in April 2007.

Although the ADAO has thousands of supporters all over the world, it remains an independent organization staffed by volunteers. Ms. Reinstein explained:

“The strategy behind the ADAO is to blend volunteerism, science and public policy. This invaluable integration creates strategic alliances with various stakeholders thus strengthening advocacy efforts. These incurable malignant and non-malignant asbestos-related diseases evoke anger and victims want to be heard. The ADAO strives to turn anger into action; thus by helping others we ease our own hopelessness and grief. Each volunteer has a particular interest area and strength – finding the right task for each volunteer is imperative to our effectiveness.”

Education is the key to ending the global asbestos disease epidemic, and to this end the ADAO has dedicated time and resources to raising awareness of the asbestos hazard. Current projects include the mobilization of politicians and community leaders, improving availability of asbestos-related disease data, implementing an international database and working with victims and other stakeholders to ban asbestos, raise asbestos awareness and increase funding for medical research.

Asbestos consumption is increasing daily in India, said Professor Tushar Kant Joshi, from the Centre for Occupational and Environmental Health, New Delhi during his presentation: Issues Affecting Asbestos Workers in India. As of 2003, 32 asbestos- cement plants located in 15 Indian States used chrysotile asbestos to produce 1,387,000 tonnes of asbestos-containing materials. From 2001 to 2002, asbestos imports into India rose by more than 60%; the biggest exporters to India are shown in the following table:

Asbestos Exports to India (2001-2002)


Country	Tonnes
Russia	36,994
Canada	32,180
Zimbabwe	11,933
Brazil	7,126
Kazakhstan	5,842
Others	3,809
Total	97,884

Asbestos-cement companies are unable to provide any statistics on asbestos morbidity amongst their workforce. The lack of data and weak national legislation are being exploited by industry stakeholders to convince decision makers that the use of asbestos in India has no significant impact on health. It is clear, however, that the escalation of asbestos use in India is a “silent time bomb”:

“An inappropriate strategy to protect workers, lack of hazard communication, poorly trained staff in enforcement, meager industrial hygiene and occupational health expertise make chrysotile use so very risky in India. Indian asbestos industry propagates the fantasy of 'controlled use of asbestos' citing unsubstantiated Canadian data.”

Despite a well-financed and influential Indian asbestos industry, the ban asbestos movement has gained momentum over recent years. Concluding his talk, Prof. Joshi said that more debate and more evidence is unnecessary; what is needed to protect the Indian population from hazardous asbestos exposures is the political will to use safer materials.

The final speaker in this workshop was John Flanagan from the Merseyside and District Asbestos Victims Support Group (MAVASG) who addressed the subject: Asbestos: Industrial Weapon of Mass Destruction. Despite the fact that the new use of asbestos is now illegal in the UK, one hundred years of use has had a major impact on the country's health and environment. The fatal exposure received by one MAVASG member is typical. Mr. J is an 84 year old Lancashire man who went to work in the mines as soon as he had finished school. In 1940, he joined the Navy; after he was demobbed, he worked on steam engines and in a power station. Considering the asbestos exposures which were typical in both industries, the fact that he contracted an asbestos-related disease was sadly all too predictable.

Asbestos is not a “dead issue,” Mr. Flanagan said. Its effects still linger in the lungs of our countrymen and women and in the effects on the landscape. In Rochdale, near Manchester, an asbestos-contaminated site has been earmarked by developers for a housing estate. In the absence of a proper environmental audit, local people, many of whom had worked at the asbestos factory which was responsible for the contamination, began a campaign to stop construction. After some persuading, the local authority accepted that an environmental audit was required before 600+ homes and a private nursery could be built on this site. To ensure that the needs of UK asbestos sufferers are high on the national agenda, nine asbestos victims' groups from the North of England and Wales formed a campaigning body called the Asbestos Victims Support Groups Forum. Working with the Parliamentary Asbestos Sub-Committee, some progress has been made on medical, treatment, social security, legal and political issues.

Session 7: Regional Action on Asbestos

After the lunch break, the plenary sessions resumed with session 7 chaired by Dr. Yothin Benjawang with Ms. Chittima Veeradejkriengkrai as the session secretary. The first speaker Sanjiv Pandita, from the Asia Monitor Resource Center (AMRC), Hong Kong focused on The Ban Asbestos Campaign in Asia - Experiences of the Asian Network for the Rights of Occupational Accident Victims (ANROAV). Mr. Pandita confirmed that Asian countries account for 60% of global asbestos consumption with China (410,190 t), Indonesia (124,516 t), Thailand (120,563 t) and India (110,000 t) being the largest users. In Asia, only Saudi Arabia, Kuwait and Japan have banned asbestos. Key areas of concern over increasing asbestos use in Asia include asbestos exposures experienced by:

workers from roofing, insulation and friction materials;
chrysotile miners in China and Kazakhstan;
workers involved in ship-breaking operations in India, Bangladesh and China;
the community.

The global misinformation campaign, spearheaded by Canadian asbestos stakeholders, has targeted developing countries. Statements such as the following have been reported in Asia:

“The latest scientific study shows that chrysotile asbestos is safe” (Chandra Alifen, Vice President of PT Siam-Indo Concrete Products);
“What we need is to push for a responsible approach that focuses on minimizing chrysotile exposure” (Mr. Sjahrul, Chairman of the Indonesian Science Committee);
“Yes, the risk is there, but it is small compared to smokers, who have a higher risk, 880 out of 10,000… as long as there was no scientific proof, chrysotile should still be used” (Srichant Uthayopas, Director of the Industrial Works Department's Hazardous Substance Control Bureau, Thailand).

If “controlled conditions” for using asbestos cannot be achieved in industrialized countries, it is almost impossible to have such conditions in Asia, with its lax implementation and enforcement. “In Asian countries,” Mr. Pandita said “workers often cut asbestos bags open manually or use hammers to break open the bags. Asbestos dust gets everywhere.” In the ship-breaking yards, asbestos insulation is removed by hand and dried in the sun to re-sell. In view of the horrific levels of exposure, it is surprising that few cases of asbestos-related disease have been reported in the majority of Asian countries.

ANROAV is working to raise awareness of asbestos issues throughout Asia and has played a major part in the asbestos campaign mounted by NGOs such as BANJAN and JOSHRC in Japan. The asbestos problem epitomizes bigger problems embedded in Asia, such as the epidemic of industrial deaths from silicosis. Grass-roots mobilization linked to international advocacy is critical for a “sustained and holistic improvement” for workers in the region. The practical support of doctors and lawyers for the movement is essential as is the collaboration of groups involved in environmental and health issues. Summing up, Mr. Pandita said:

“Workers in Asia should not need to go through the same painful experience as workers in industrialized countries before a complete ban on asbestos is introduced.”

As a close observer of the Japanese asbestos scandal, Professor Ken Takahashi, from the University of Occupational and Environmental Health (Japan), was able to draw on first-hand experience in the proposal he put to the conference entitled: An Asian Action Plan. The correlation between national asbestos consumption and the subsequent incidence of mesothelioma in several industrialized countries leaves little doubt about what will happen in Asia. A graph showing historical asbestos consumption of countries grouped by income level was informative. Throughout the 20th century, the countries with the highest incomes were the biggest asbestos consumers; in the 21st century, the biggest consumers are upper middle and lower middle income countries. In Japan, for many decades government reaction lagged far behind international developments. Only after the Kubota Shock occurred was ILO Convention Number 162 ratified, a new compensation law enacted and the decision taken to ban asbestos.

Discussing the Asian Action Plan, Dr. Takahashi stated that:

the impact national data has on administrators and the public validates efforts to replicate studies done elsewhere;
the ILO asbestos resolution should be put into practice by all countries not just Member States;
a pragmatic approach to challenges, such as the implementation of an asbestos road map, is recommended;
the “controlled use of asbestos” must be rebutted as a matter of policy;
national comparisons with “good practices” adopted by other governments can be used to pressurize policy-makers;
an Asian Action Plan must include: measures for prevention of all types of asbestos exposure, simultaneous national bans to prevent the transfer of hazardous technologies, systems for monitoring actions taken and progress made.

Fiona Murie, the Director of Health, Safety and the Environment for the Building and Woodworkers International (BWI), the final speaker in this session, addressed: The Trade Union Campaign for a Global Asbestos Ban. In 1989, the BWI designated a global asbestos ban as a top priority. Reflecting on the work undertaken during the last 17 years, Ms. Murie stressed the continuing vulnerability of informal workers in the Asian construction industry:

“It is urgently needed to stop introducing asbestos into the built environment and to protect workers who may be exposed during maintenance, renovation and demolition activities in buildings that contain asbestos.”

BWI action on asbestos has taken place at national and regional levels, at tripartite meetings, in discussions with international agencies and in campaigns with NGOs and other unions; it has addressed 4 key areas:

marketing campaigns by global asbestos producers and the role of the Government of Canada in industry-sponsored events such as the 2006 meetings in Jakarta and Montreal;
the availability of safer substitutes; evaluations by the WHO-IARC confirm that alternatives such as cellulose, polyvinyl alcohol, p-aramids and polypropylene are safer than chrysotile;
the need to protect workers and end users from hazardous exposures; the ILO Asbestos Resolution passed in June 2006 was a major victory as it clearly stated that there is no such thing as the safe use of asbestos. The ubiquitous use of asbestos-cement presents a serious challenge to occupational health especially for those workers who cut it, break or saw it, perforate or handle these products;
the rights of those affected by asbestos injuries; improvement of medical surveillance for early diagnosis, treatment and compensation.

During 2005, the global asbestos campaign has made great strides. The BWI, in cooperation with its social partners, will continue to push for the exclusion of asbestos from construction projects, a global asbestos ban, effective implementation of ILO Convention 162, the elimination of dry stripping, the introduction of compulsory asbestos audits and the adoption of best practice guidelines for asbestos removal work. The photographs shown by Ms. Murie of hazardous occupational conditions which persist in the Asian construction industry constituted a fitting summation of her presentation and a dramatic reminder of why AAC 2006 had been convened in the first place.

Session 8: Conference Resolution

This session was chaired by Professor Dr. Yoshiomi Temmyo, who was also the chair of the Conference Resolution Working Party;²⁴ the session moderator was Dr. Adul Bandhukul. Delegates debated and amended the draft text. It was resolved that The Bangkok Declaration on the Elimination of Asbestos and Asbestos-related Disease be issued (Appendix A) by the conference. This document calls for a total elimination of the use of asbestos and asbestos-containing products, highlights the importance of primary prevention and the application of practical guidelines for good practice, points out that safer alternatives are available and should be used and emphasizes the need for early disease detection, appropriate medical treatment and prompt payment of government benefits and compensation claims.

General Thoughts and Reflections

On several occasions, conference delegates pointed out that differing realities determined the feasibility of some courses of action in individual countries. One example is religious sensitivities over pathology tests of lung sections to establish the cause of death; whilst a finding of death by asbestos might bring legal or other benefits, cultural issues cannot be ignored. On the whole, however, many factors remain constant throughout Asian countries:

the construction industry is notoriously dangerous and even minimal compliance with health and safety legislation is rare in most Asian countries; workers in the construction and demolition industries will continue to receive hazardous exposures as long as asbestos products are being used;
there is an almost total lack of government surveillance of occupational conditions at asbestos-using production facilities;
deadly economic exploitation of unskilled and uneducated workers exposed to asbestos in the informal sectors is widespread;
the transfer of hazardous asbestos technology from developed to developing countries: the expansion of the Korean asbestos industry in the 1960s and 1970s was fuelled by investment from Japan²⁵ and Germany; as regulations tightened in the 1990s, Korean producers of asbestos textiles and brake linings relocated to China and other countries in Southeast Asia;
the existence of aggressive and well-financed misinformation campaigns, using industry-funded “experts” citing “voodoo science” to mislead governments and consumers;
a lack of political will to tackle national asbestos legacies; a typical example of this is decades of government inaction in Japan; even when governments acknowledge the asbestos hazard, there is no sense of urgency in dealing with the problems it has created;
the lack of coordination among government agencies with, for example, the Ministries of Health and Environment supporting an asbestos ban and the Ministry of Industry opposing it;
the almost total absence of provision for the controlled disposal of asbestos waste.

Variations in national economies notwithstanding, experts repeatedly warned that there is no level of asbestos exposure which is “safe,” and that the concept of the “controlled use of asbestos” is an industry fallacy. If countries are not ready to ban asbestos and are serious about minimizing the asbestos risk to the population, they should impose the strictest controls possible; even with TLVs of 0.1 f/cc, as many as 5 out of 1,000 workers will die from asbestos-related lung cancer, if the TLV is 2 f/cc, 64 out of 1,000 will die. Concerted regional action on asbestos in Asia is recommended, as history has shown that unilateral asbestos bans result in hazardous technologies being dumped on the most vulnerable workers in countries with no bans. It was suggested by one speaker that such action could start with a coordinated campaign to highlight the role of the Canadian Government in the global pro-asbestos lobby which is targeting markets in developing countries. It was noteworthy that conference delegates included representatives from asbestos-cement manufacturing companies from Vietnam and Thailand; upon the conclusion of the conference, one industry representative remarked that even in the absence of government action, the transition to non-asbestos technology would be mandated by market forces.

Session 9: Closing Ceremony

During the final session, awards were presented to honor individuals who had lost their lives to asbestos disease:

The Ray Sentes Award 2006 was presented by Dr. Barry Castleman to Ms. Fiona Murie, Director of Health, Safety & the Environment of the Building and Woodworkers International;
The Norio Kato Award 2006 was presented by Dr. Temmyo Yoshiomi, Chairperson of the Global Asbestos Congress 2004 Organizing Committee, to Ms. Kazuko Furukawa of the Japan Association of Mesothelioma and Asbestos-Related Diseases Victims and their Families;
The Alan Reinstein Memorial Award was presented by Ms. Linda Reinstein to Dr. Thawat Suntrajarn, the Director-General of the (Thailand) Department of Disease Control, Ministry of Public Health; the award was accepted on his behalf by Dr. Kamjad Ramakul, the Director of the Bureau of Occupational and Environmental Diseases.

Dr. Saravudh Suvannadabba, Senior Expert in Preventive Medicine of the (Thailand) Department of Disease Control, Ministry of Public Health brought AAC 2006 to a close saying:

“the outcome of this conference will pave the way to minimize or even eliminate the danger of asbestos in the future… this conference has provided the opportunity for overseas experts to share their knowledge on the prevention and control of asbestos-related diseases and has established networks which will further international collaboration on action to prevent and control these diseases in the future. The most meaningful outcome of this conference is the Bangkok Declaration which outlines an excellent strategy of what is to be done in the future and pledges the commitment of conference delegates to work towards its objectives. The most important thing to do now is to make this declaration come true.”

Thanking the conference organizers, sponsors and delegates and wishing everyone a safe homeward journey, Dr. Saravudh Suvannadabba officially closed the conference.

Concluding Thoughts

While the level of ban asbestos mobilization is increasing, some governments in Asia remain unable or unwilling to impose national restrictions on the use of this hazardous substance. Nevertheless, serious efforts are being made to raise awareness amongst workers in Bangladesh, India, Indonesia, Japan, Korea, Pakistan and Vietnam by asbestos victims' groups, trade unions, medical professionals, civil servants and academics. Networking at AAC 2006 established new links between groups which, in the months following the conference, produced tangible results:

the Bangkok Declaration on the Elimination of Asbestos and Asbestos-Related Diseases was widely disseminated through many networks;
experts who participated at AAC 2006 were invited to take part in high-profile asbestos meetings in Asia such as a meeting in New Delhi held (December 3) by Dr. TK Joshi of the Center for Occupational and Environmental Health and one in Bangladesh entitled Banning Asbestos in South Asia (December 14-17);
work on joint initiatives for dealing with asbestos-related problems in Asian ship-breaking yards was progressed; extensive discussions at the Conference of the Parties to the Basel Convention, held in Nairobi, Kenya (November 27-December 1), on problems arising from asbestos contamination of end-of-life ships took place;
international agencies began constructive discussions at meetings in Asia with national stakeholders; subjects on the agendas of these meetings included: the need to train doctors in the diagnosis of asbestos-related diseases, the lack of up-to-date information on asbestos alternatives and the hazards created by the current use of asbestos-containing products in tsunami reconstruction projects;
work by BWI affiliates continued throughout the year with asbestos being an action point at events such as the three-day regional meeting on occupational health and safety held in Chennai, Tamil Nadu (India) attended by trade unionists from Tamil Nadu, Kerala, Maharashtra and Malaysia.

Media coverage of AAC 2006 in Canada, Japan, Thailand and the U.S. brought the conference to wider notice. Canadian MP Pat Martin's criticism of his Government's pro-asbestos stance was reported in articles such as that published on July 25, 2006 entitled Canada Tarnished by Asbestos Trade²⁶ which reported Martin as saying:

“While the rest of the developed world is banning asbestos in all its forms, Canada is busy exporting over 220,000 tonnes per year into under-developed and Third World countries where health and safety regulations are non-existent or not enforced, thereby exposing millions of ill-informed and unsuspecting people to its hazards. Without exaggeration we are exporting human misery… Canadian government officials have taken on the role of globe-trotting, asbestos industry propagandists.”

In the aftermath of the conference, MP Martin, working with fellow AAC 2006 speakers Fiona Murie (BWI) and Laurie Kazan-Allen (IBAS), cooperated on the publication of a dossier entitled: Chrysotile Asbestos: Hazardous to Humans, Deadly to the Rotterdam Convention which was distributed at the October 2006 meeting of the United Nations Rotterdam Convention in Geneva, Switzerland.²⁷

By offering speakers the opportunity to present up-to-date and accurate information on the asbestos hazard, AAC 2006 succeeded in exposing industry propaganda such as reassurances that “the controlled use of asbestos” is safe. No delegate to the conference could have left Bangkok with any illusions about the potential for lasting harm posed by the use of asbestos and asbestos-containing products. Highlighting the importance of the conference for Thai delegates, Dr. Somkiat Siriruttanapruk, one of the conference organizers, reported that:

“Since the conference, the asbestos issue has been the focus of meetings and discussions amongst civil servants, government personnel and occupational health professionals in Thailand. We are determined to build on the momentum generated by the July meeting so that improvements will be made and the population will be better protected from the asbestos hazard. Thailand was honored to have so many distinguished international experts attend this event and we look forward to working with this global network in the future.”

AAC 2006 would not have been possible without the financial and political support received from Thai Ministries; government representatives speaking at the conference expressed serious concern about the adverse impact of asbestos use on the health of workers and members of the public.

This landmark conference expanded the debate, begun in Tokyo two years previously, on Asia's increasing consumption of asbestos. Discussions which took place in Bangkok have already resulted in initiatives to minimize hazardous asbestos exposures with more projects in the pipeline. Recent events throughout Asia demonstrate a heightened awareness of the region's asbestos hazard and a growing willingness of individuals and groups to work together to achieve a common goal: an asbestos-free future. The struggle continues!

March 15, 2007

Appendix A

Asian Asbestos Congress 2006
Bangkok, Thailand

The Bangkok Declaration on elimination of asbestos and asbestos-related diseases

Preamble

The Asian Asbestos Conference 2006 was organized by the Ministry of Public Health, Thailand on 26-27 July, 2006, with Co-organization of the Ministry of Labour, Thailand and co-sponsored by the International Labor Office (ILO), the World Health Organization (WHO), International Ban Asbestos Secretariat (IBAS) and the International Commission on Occupational Health (ICOH). The conference was attended by 300 participants from 26 Asian Pacific, African, European and North American Countries, including experts, administrators, representatives of Building and Woodworkers International (BWI) and industries.

The Conference,

– recalling the ILO resolution on Asbestos, the ILO Conventions on Occupational Cancer (No. 139), Safety in the Use of Asbestos (No. 162), Occupational Safety and Health (No. 155), Occupational Health Services (No. 161) and Labour Inspection (No. 81),

– recalling the WHO Global Strategy on Occupational Health for All and the WHA Resolution 58.22 on Cancer Prevention and Control,

– considering the ICOH International Code of Ethics for Occupational Health Professionals, and having discussed the situation of asbestos exposures and related morbidity and mortality in Asia, and compared national asbestos experiences and highlighted international developments regarding the global asbestos epidemic, has thereby agreed on the following appeal to Governments, Inter-Governmental and other International Organizations, NGOs, Professional Occupational Health and Safety and Public Health Organizations, Industries, Businesses and other Communities:

1. Total Asbestos Ban

Asbestos mining, the use and recycling of asbestos and asbestos-containing products should be totally banned in all countries. The removal and disposal of existing asbestos must be conducted under stringent regulations and control by following the principle of highest level of protection.

2. Protection of Workers and the Public

n protection of health and safety of workers from asbestos hazards, primary prevention must be taken as an over-arching principle. Good practices guidelines by Inter-Governmental Organizations on prevention and elimination of asbestos hazards must be considered and implemented at national level.

Without prejudicing the primary responsibility of the Employers and Producers of asbestos and related products and the responsibility of national governments to safeguard the safety and health of workers and the general population, the programs and measures for asbestos risk management must be developed in collaboration and with the active participation of the at-risk groups.

3. Alternatives

Numerous safer alternatives are available and should be used in substitution for asbestos. International databank and guidance on the properties of substitutes, their availability and use should be organized.

4. Information Exchange

Up-to-date and accurate information on the health hazards related to the use of asbestos should be accumulated and disseminated through collaborative actions taken by Inter-Governmental Organizations, national governments, occupational health and safety experts, interest groups and other relevant organizations including Trade Unions and Employers' Organizations.

Awareness raising campaigns on asbestos hazards must be undertaken and monitored systematically.

5. Just Transition and the Prevention of Asbestos Dumping

Every effort should be made to secure effective transition towards non-asbestos technologies. Moves to transfer asbestos production and disposal to developing and newly industrializing countries should be prevented through Inter-Governmental and other International Organizations by using their instruments and through national legislation and other national actions, including National Action Programs on Asbestos.

6. Corporate Social Responsibility

Multinational Corporations with major production facilities in countries where asbestos is banned must adopt corporate global policies for avoiding the use of new asbestos products and carefully managing in-place asbestos products in existing infrastructure.

7. Surveillance, Fair Compensation and Treatment of Asbestos-related Diseases

Programs for the earliest possible detection and appropriate surveillance of asbestos-related diseases among exposed workers must be organized at national level. Asbestos patients and their families must be appropriately and without delay compensated. The asbestos-injured patient must have access to competent diagnostic and treatment services and necessary support services must be provided. Empowerment of patients and their families should be regarded as a high priority.

8. International Collaboration

International collaboration on asbestos elimination, management and control must be strengthened. Such collaboration must include the active participation of asbestos patients, workers, trade unions, politicians, employers and their organizations, academics and researchers, lawyers, grassroots organizations, other relevant agencies and interested groups in industrialized and in developing countries in both the Northern and Southern hemispheres. Successful strategies identified through such collaboration should be exchanged through existing and new networks.

International Development Banks must adopt best practice policies to avoid the use of asbestos and asbestos products in new projects, carefully manage in-place asbestos products and support the development of safer alternatives in order to facilitate the effective implementation of national asbestos bans.

Human beings have the right to work and to live in a healthy environment. The tragic repercussions of the widespread epidemic of asbestos-related diseases must be prevented as a fundamental human right.

Bangkok 27 July 2006

_______

¹ Throughout this document, “t” will denote tonnes.

² Before the Government banned the import of asbestos, Japan used to purchase 12% of Canada's annual asbestos production. Nowadays, India is the largest importer of Canadian chrysotile and Thailand is the 2nd largest; in 2004, Thailand imported 18% of Canadian production.

³ Current global asbestos production is 2,230,000 t of which 95% is from Russia (875,000 t), China (355,000 t), Kazakhstan (346,000 t), Canada (200,000 t), Brazil (194,000 t) and Zimbabwe (152,000 t).

⁴ The economic consequences of the Finnish transition to non-asbestos technology were “not substantial.”

⁵According to calculations by Dr. Antti Tossavainen, every 270 t of asbestos used produces 1 case of mesothelioma in a country. Thailand is currently consuming 121,000 t/year which should produce a minimum of 711 cases of mesothelioma and 2,135 cases of asbestos-related lung cancer/year.

⁶ Thailand banned the import and use of crocidolite in 1992 and recently banned amosite; chrysotile is the only legal form of asbestos in Thailand. Over recent years, the major asbestos exporters to Thailand have been Canada, Russia, Greece, Zimbabwe, Brazil and Kazakhstan; in the period 1997-2003, Canada and Russia each exported more than 300,000 t to Thailand.

⁷ A range of asbestos products were produced in Japan including asbestos-cement building, sewage and drainage products, insulation boards, insulation products including sprayed asbestos, joints and packing, friction materials, floor tiles and sheets, molded plastics and battery boxes (containing 55-70% asbestos) and fillers, reinforcements, felts, millboards, paper, filter pads for wines and beers, underseals, plastics, adhesives and coatings.

⁸ OSHA: Occupational Safety and Health Administration, U.S.

⁹There is no asbestos health and safety legislation in Pakistan and no procedures for awarding compensation for occupational asbestos injuries.

¹⁰ Asbestos imports more than doubled between 1999 and 2004; the latest data shows annual consumption of 65,000 t/year. After the tsunami in December 2004, “a generous country (a big chrysotile exporter) shipped material containing asbestos to Indonesia.” In May 2006, a government official announced that more cement and asbestos were needed for reconstruction after the earthquake in Yogyakarta.

¹¹ The positions of various Ministries conflicted:

the Ministry of Trade said there were no regulations on the import or export of any type of asbestos including amosite and crocidolite;
the Ministry of Environment said the reuse of asbestos waste is permissible;
the Ministry of Health said the asbestos TLV (threshold limit value) is 5 f/cc but admitted that there was no regulation of any sort of asbestos exposures in offices or housing;
the Ministry of Manpower said that the use of crocidolite was banned and that the TLV for chrysotile was 2 f/cc.

¹² Neighborhood victims contract mesothelioma at a younger age than occupational victims because their exposure to asbestos began at an earlier age.

¹³ The groups which are part of this platform are: Greenpeace, the International Federation for Human Rights, the European Federation for Transport and Environment, North Sea Foundation, Bellona, the Ban Asbestos Network and the International Ban Asbestos Secretariat.

¹⁴ Data presented by Dr. Bianchi showed that the peak use of asbestos in Japan, Singapore and Thailand was 398,877 t (1980), 8,671 t (1975) and 190,205 t (1996), respectively. Comparing the number of cases of mesothelioma in two similar sized shipyard areas in Japan and Italy in the last 3 decades of the 20th century showed the huge differential with 48 cases in Yokosuka and 557 cases in Trieste-Monfalcone.

¹⁵ Claims for asbestosis, benign pleural effusion and diffuse pleural thickening cannot be brought under the new Act.

¹⁶ Approximately 7,000 people worked for CSR at Wittenoom and a further 13,000 resided in the township, including 6,000+ children. On December 31, 1966, CSR closed down the asbestos mining operations at Wittenoom on the grounds that falling asbestos prices made production unprofitable.

¹⁷ Other Asian OELs (f/cc) are: 0.1 in Malaysia and Singapore, 1 in Vietnam, 2 in the Philippines.

¹⁸ ATS: American Thoracic Society

¹⁹ The factory employed 146 workers to produce 220 million kg/year of asbestos insulation board using chrysotile asbestos.

²⁰ In due course, it was announced that the NRCARD would be sited at the University of Western Australia, Perth; the opening ceremony was held on November 20, 2006.

²¹ NILP: National Institute of Labor Protection, part of the VGCL.

²² In 1998, the import and use of amphiboles such as amosite and crocidolite were banned in Vietnam by Interministerial Circular No. 1529/1998; only chrysotile asbestos is used in the production of roofing materials.

²³ ACIGH: American Conference of Industrial Hygienists.

²⁴ Other members of the conference resolution working party were: Dr. Somkiat Siriruttanapruk, Prof. Dr. Pornchai Sithisarankul (Thailand), Dr. Noor Jehan (Pakistan) and Dr. Domyung Paek (Korea).

²⁵ From the 1970s-1990s, Japanese asbestos companies such as Nichias, Oriental Metal, Nippon Asbestos, NHK, Meisei etc. invested in companies producing asbestos gaskets, insulation products, friction materials and textiles in Korea, Taiwan, Thailand, Singapore, Malaysia, the Philippines, India and Indonesia.

²⁶ Harris K. Canada Tarnished by Asbestos Trade. Ottawa Sun. July 25, 2006.

²⁷ http://www.lkaz.demon.co.uk/chrys_hazard_rott_conv_06.pdf

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