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Estimate of burden of disease due to asbestos use in WHO-South East Asia Region countries. Dr. Habibullah Saiyed Regional Office for South-East Asia World Health Organization New Delhi. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“
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Estimate of burden of disease due to asbestos use in WHO-South East Asia Region countries Dr. HabibullahSaiyed Regional Office for South-East Asia World Health Organization New Delhi National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok 05-06th Aug 2008
Summary of Presentation • Why estimates? • Data sources and approach • Methods used in Estimation. • Limitations of the methods used • Conclusions and recommendations National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Asbestos Consumption in World and SEARO (Thousand – MT) National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Why Future Projections • Policy makers need evidence for decision making • Long latent period of Asbestos-related disease (asbestosis and malignances) • Complaisance in developing countries due to non-availability of information on existing cases due to • Inadequate maintenance of records • Lack of awareness amongst affected population and physicians • Scarcity of experts to diagnose asbestos-related diseases • Misinformation National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Why Future Projections • Significant linear correlation exists between asbestos used and cases of mesothelioma and asbestosis after 3 decades (Ro-Ting Len et al Lancet 2007; 369: 844–49; Dtechn, Int J Occ Env Hlth, 2004, 10:22 -25) • The quantity of asbestos consumed can be as predictor of estimates cases of asbestos-related disease after the latent period. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Available methods for estimates • Ro-Ting Len et al Lancet 2007; 369: 844–49 • All mesothelioma in male = 0.382 x ACKCP - 0.135 • All mesothelioma in female = 0.208 x ACKCP - 0.326 • Asbestosis in male = 0.439 x ACKCP - 1.255 • Asbestosis in female = 0.050 x ACKCP - 1.513 • Dtechn, Int J OccEnvHlth, 2004, 10:22 -25 • Y (cases/million/year) = 6.82 X kg/capita/year) + 0.43 or 1 death from mesotheolima per 170 tons of asbestos use. • Global Trade Unions on Occupational Health and Safety profiling of countries http://old.global-unions.org/pdf/ohsewpG_1b.EN.pdf • 170 tons of asbestos use = 1.6 lung cancer, 1 case of mesothelioma and 0.7 cases of asbestosis ACKCP = Annual consumption of asbestos in Kg/per capita per year National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Production, imports and exports of asbestos (MT) in SEAR countries in 2006 National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Estimated Annual burden of Asbestos-related Diseases in SEAR countries National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Limitations • Assumption of • Similarity in exposures and precautions. • Similarity in susceptibility • Exposure to other modulating factors e.g. age of first exposure, life expectancy, exposure to other carcinogens e.g. tobacco smoke and/or other environmental carcinogens. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
Conclusions and recommendations • In recent years there is significant increase in consumption of asbestos in SEAR countries • Extrapolation of results of results of well accepted eco-epidemiological studies indicate possible epidemic of asbestos-related diseases including cancer in near future. • Asbestos can not be handled safely and safer substitutes are available • There is urgent need to take adequate steps to avert the future catastrophe. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.
National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6th Aug 08.