Asbestos was long considered one of the most versatile minerals because of its flexibility, tensile strength, insulation from heat and electricity, chemical inertness and affordability.
This made it attractive to many industries and it is known to have more than applications worldwide. Australia was one of the highest users of asbestos per capita in the world up until the mid s, including a significant number of asbestos products in homes.
The widespread use of asbestos has left a legacy of asbestos-containing materials ACMs in our built environment. Asbestos is a known carcinogen. Inhalation of fibres is associated with increased incidences of a number of respiratory diseases including asbestosis, mesothelioma, pleural and lung cancers.
The World Health Organisation i and the International Agency for Research on Cancer ii , iii have stated there is no identified safe threshold for exposure to asbestos. Even limited or short-term exposure to asbestos fibres can be dangerous; however exposure does not necessarily make development of mesothelioma inevitable.
There is still much unknown about why some people are susceptible to mesothelioma, while others who have been regularly exposed to asbestos do not develop any asbestos-related disease. This is why a precautionary approach to exposure to asbestos fibres is adopted.
Australia has the highest reported per capita incidence of asbestos-related disease in the world, including the highest incidences of mesothelioma iv. In , Australians died from mesothelioma v. National asbestos profiles assist countries in defining the baseline scenarios for asbestos consumption and asbestos-related disease, including population groups at most risk of asbestos exposure.
Profiles also include information about enforceable asbestos exposure limits. Despite the excellent work of the agency, there are discussions at the time of writing this article within the public sphere of integrating the agency within a Commonwealth Government Department. However, in our view, this may detrimentally affect the ongoing need to have a high priority on actions and resources to prevent asbestos-related disease in Australia.
Since the mids, Australia has made significant investment in collecting asbestos exposure data from people newly diagnosed with malignant mesothelioma. Three different iterations of this system were implemented—the Australian Mesothelioma Surveillance Program that operated between and [ 2 ], the Australia Mesothelioma Register — [ 3 , 18 ], and the recently re-established Australia Mesothelioma Registry operating since [ 32 ].
In July , the Australian Mesothelioma Registry was reestablished as a consortium arrangement based at the Cancer Institute NSW with Safe Work Australia and academic, cancer registration, and other occupational health and safety groups [ 33 ]. The registry was fully in operation by 1 January The main aims of the Australian Mesothelioma Registry include to: 1 better understand the relationship between asbestos exposure and malignant mesothelioma; 2 identify the circumstances under which groups of individuals are exposed to potentially dangerous levels of asbestos and to facilitate prevention; and 3 assist the development of policies to best deal with the asbestos still present in our environment.
Detailed methods for the manner in which asbestos exposure data was assigned are published elsewhere [ 32 , 34 , 35 ]. Briefly, following the receipt of a confirmed malignant mesothelioma case, each cancer registry contacts the relevant clinician in order to obtain consent to contact the person with malignant mesothelioma.
Consent is provided if the subject was diagnosed with malignant mesothelioma since 1 July , is living at the time of the consent being given and is well enough to participate. Once clinician consent is granted, the person with malignant mesothelioma is contacted by the cancer registry to ask for his or her consent to participate in the collection of asbestos exposure data. Each consenting individual is provided with a postal questionnaire relating to his or her asbestos exposure history.
Based upon data collected from the postal questionnaire, a tailored telephone interview is then conducted using a Web-based application called OccIDEAS [ 36 , 37 ]. All participants, regardless of their occupational history, are asked about asbestos exposure in occupational and non-occupational environments, including their home renovation activity.
Exposure assessment algorithms available in OccIDEAS then determine the likelihood of asbestos exposure in occupational and non-occupational settings. Asbestos exposure data for people who developed malignant mesothelioma in Australia between and is detailed in Section 5. In terms of asbestos exposure in the wider context, van Oyen and colleagues estimated asbestos exposures for combinations of occupations and 60 industries for four time periods between and The highest average asbestos exposures were thought to have occurred in the shipyard, insulation and asbestos manufacturing industries.
Forty-six combinations of occupation and industry categories were considered by the researchers to have had exposures exceeding the current Australian exposure standard 0. An ongoing challenge in the efforts by the public health and trade union movement in Australia in preventing asbestos-related disease has been attempts to close down the various iterations of the national mesothelioma surveillance program, including attempts to close the program and registry down in , and There was strong lobbying from the trade union movement in to have the Australian Mesothelioma Registry re-established.
The future of the Australian Mesothelioma Registry was again reviewed in In recognising that the Australia community will continue to be at risk from asbestos-related disease through occupational and non-occupational asbestos exposure, a public asbestos awareness campaign was set up.
The Asbestos Awareness Campaign and the asbestosawareness. Since launching the campaign in New South Wales in , the campaign was rolled out nationally and works closely with community stakeholders including local and state governments as well as businesses, leveraging the media to increase awareness of the dangers of asbestos and how to manage it safely.
The national Asbestos Awareness Campaign has been highly successful and has won a number of international high-profile communications awards. A flagship asbestos awareness campaign in Australia is the Betty House. Betty is designed as a mobile home unit that can be driven around different locations to engage the general public about where asbestos can be found in Australian homes that are built or renovated before On the outside, the Betty House is similar in appearance to a typical Australian home built with asbestos-containing materials.
Inside, Betty provides audiovisual explanations of asbestos-containing materials and products in the main parts of a house including the bathroom, kitchen, and living room. Importantly, when the Betty House travels around different areas, asbestos awareness campaigns are also simultaneously timed to occur in local media and in partnership with local governments in that area. The website provides a plethora of information on the dangers of asbestos and how to manage it in various circumstances Table 1.
On-line guides, fact sheets, handbooks, videos and database Australian asbestos awareness resources available from the website AsbestosAwareness. Safe practices for homeowners repairing or removing small amounts of asbestos materials. Despite a complete asbestos ban being in place since , malignant and non-malignant asbestos-related diseases ARDs continue to be diagnosed in Australia. While the incidence of malignant mesothelioma appears to be stabilising, if not slowing, there were still people newly diagnosed with malignant mesothelioma in [ 32 ].
Tracking malignant and non-malignant ARDs will help inform researchers and policy makers of the effectiveness of implemented asbestos bans and of ongoing or new occupational or non-occupational asbestos exposure risks. Asbestos use in Australia has resulted in a significant ARD burden including malignant and non-malignant disease.
Incidence of malignant mesothelioma, Australia, —, using data published by the Australian Institute of Health and Welfare. It is possible to correlate asbestos consumption at the population level in previous decades to more current occurrence of asbestos-related disease. In Australia, around tonnes of asbestos consumed has led to around one death due to malignant mesothelioma. Further research is required to collate, estimate and critique the correlations shown by various researchers between previous asbestos consumption and the burden of asbestos-related disease that occurs decades later.
Age-standardised malignant mesothelioma incidence rates per , for males and females combined were highest in the s. For example using the Australian standard age population, the combined male and female incidence rate per , in was 3.
The highest male malignant incidence rate, also in , was a rate of 5. Like many other countries, female malignant mesothelioma incidence rates are substantially lower than male rates. Since , the age-standardised incidence rate for women diagnosed with malignant mesothelioma in Australia has ranged between 0. Given the rapid mortality between a malignant mesothelioma diagnosis and death, mortality rates are close in value to the incidence rates.
Asbestos-related diseases also include non-malignant diseases such as asbestosis. Australian data on non-malignant ARDs need to be interpreted with some caution as legal disease registry reporting requirements differ from that for malignant diseases.
However, a view of Australian hospitalisation data is insightful. These hospitalisation data reflect the number of separate hospital episodes rather than the number of people hospitalised [ 40 ]. This can be compared to hospitalisations during the same period for respiratory conditions due to inhalation of chemicals, gases, fumes and vapours ICD code J68 and hospitalisations for silicosis ICD code J62 Figure 2 a. Hospitalisation data is also collected and reported for pleural plaques with and without the presence of asbestos ICD code J National hospitalisation data suggest that there were hospital episodes for pleural plaques between July and June Figure 2 b.
Data were not available from July through to June In the Australian Mesothelioma Registry, each person who had asbestos exposure data collected is assigned as having probable, possible, or unlikely asbestos exposure above background exposure levels, with probable exposure further defined into high, medium, and low likelihoods for asbestos exposure. The assessment of asbestos exposure does not account for duration, frequency, or intensity of asbestos exposure.
A sequential process is used such that occupational asbestos exposure is first assessed. If an individual completed a number of job-specific questions in the same field, then the highest probability of exposure is recorded. The most recent report from the Australian Mesothelioma Registry presents data on the number of people recorded as having occupational or non-occupational exposure [ 32 ]. Asbestos exposure data from the Australian Mesothelioma Registry is available for people whose asbestos exposure data was collected between 1 July and April Figure 3.
Fifty people were assigned as having no evidence of occupational or non-occupational asbestos exposure. Number of people recorded as being exposed to asbestos through occupational and non-occupational in settings in Australia, 1 July through to April , using data reported the Australian Mesothelioma Registry.
It is widely recognised that the devastating burden of malignant and non-malignant asbestos-related disease is preventable.
One of the main actions that countries can take to prevent asbestos-related disease is to implement bans on the use of asbestos and asbestos-containing products Box 2. Working across different government, non-government and private sector agencies is vital to ensure a comprehensive understanding of asbestos consumption volumes and patterns in a country including the import and export of asbestos or asbestos-containing materials and products.
These data can be directly used in the development of the national asbestos profile. It is important to bring various government, non-government and industry sector groups to the table to discuss the health, social and employment impacts of the introduction of an asbestos ban. Implementing a ban on the import or export of asbestos or asbestos-containing products will not lead to an immediate impact on the incidence of asbestos-related disease, these effects may take decades to become apparent.
Even once asbestos has been banned, many years of public health preventative action is required. This includes safely handling or eradicating asbestos and asbestos-containing materials from occupational and non-occupational environments to avoid exposure to asbestos in its breathable form. However, neither the task of banning of asbestos nor the community prevention actions required to prevent epidemics of asbestos-related disease are easy to implement.
Ensuring that governments take timely policy and regulatory decisions to implement asbestos bans often involves continuous and sustained advocacy efforts from the non-government sector, including the trade union movement. Germany prohibited the use of chrysotile, crocidolite, and amosite in , with a few minor exemptions.
The increased availability of alternatives to asbestos, and bans introduced in other countries, meant that asbestos consumption fell dramatically by the early s. Per capita, Australia was one of the highest users of asbestos in the world, and operated a large site at Wittenoom where crocidolite blue asbestos was mined.
This is regarded as the most dangerous form of asbestos, but the mining, manufacture and use of crocidolite and amosite were not banned in Australia until the mids. In , the import, use and sale of products containing chrysotile asbestos were banned. A final ruling was issued in with a view to banning most asbestos-containing products, but unfortunately this was overturned in This week, Canada announced its intention to ban asbestos by , a move many regard as long overdue.
Asbestos campaigners struggle to have their voices heard in Canada, at a time when awareness of the dangers presented by asbestos is at its highest.
So with one of the highest mesothelioma rates in the world, why has it taken so long for Canada to ban asbestos? Local industry in Canada tends to receive specific protection from the government.
Asbestos mines in Quebec played a significant part in the global asbestos industry, as well as providing employment and income for the surrounding communities.
Asbestos History. Banning Asbestos. The continuation of the international asbestos industry into the twenty-first century At the beginning of the new century Russia and Kazakhstan, China, Canada, Brazil and Zimbabwe were the major producers of asbestos fibre.
The download speed is dependent on your internet connection.
0コメント