A cross-country comparative overview of the asbestos situation in ten Asian countries

Our plain-English summary of A cross-country comparative overview of the asbestos situation in ten Asian countries, by K. Takahashi, A. Karjalainen (International Journal of Occupational and Environmental Health, 2003).

The study

• Authors: K. Takahashi, A. Karjalainen
• Journal: International Journal of Occupational and Environmental Health
• Published: 2003;9(3):244-8
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Information about asbestos issues at the national level was compiled for ten Asian countries (China, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand, and Vietnam) regarding 1) bans and consumption levels; 2) occupational exposure limits (OELs) and medical follow-up schemes; and 3) statistics and compensation status of asbestosis and mesothelioma victims. Only Singapore and recently Japan have adopted a total ban an asbestos. China, a major producer of chrysotile, showed an increasing consumption trend, which was typical of the less industrialized countries. Considerable differences between countries existed in OELs (0.1 to 5.0 fibers/mL) and medical follow-up of exposed workers. National statistics for asbestosis and mesothelioma were available for only the industrialized countries, where reported cases as well as compensated cases were relatively few. There is need to improve the quality and quantity of information, but the available information attests to unfavorable conditions in the less industrialized countries. Hence the experience of industrialized countries regarding asbestos and its use should be utilized to the fullest to improve the situation worldwide.

In plain English

In this comparative overview, the authors compiled national asbestos reports from ten East and Southeast Asian countries, presented at a conference in Kitakyushu, Japan, in September 2002 and updated with the country representatives. Singapore had virtually banned chrysotile, and Japan had decided on a total ban. Most countries banned crocidolite, but amosite was not banned in China, Malaysia or Thailand. Excluding the Philippines and Indonesia, where little or no information was available, current use ranged from 0 kg per person per year in Singapore to 1.9 in Thailand (2001). More industrialized countries showed decreasing use and developing countries increasing use. Workplace exposure limits in the comparison ranged from 0.1 fibers/mL (Singapore, Malaysia) to 5.0 fibers/mL (Thailand). A personal communication reported that Thailand had recently adopted 0.5 fibers/mL. National mesothelioma statistics existed only for Japan (772 deaths in 2001), Korea (45 deaths in 2000) and Singapore (average 2 deaths per year, 1967 to 2000). The authors called the data crude and noted conflicting reports they could not resolve. They concluded that the available information attests to unfavorable conditions in less industrialized countries.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-country comparative overview compiled from national country reports presented at a conference (descriptive compilation, not an epidemiological study)
• Who was studied: Ten East and Southeast Asian countries (China, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand, Vietnam), based on country reports from the Asbestos Conference for the Asian Countries, Kitakyushu, Japan, September 2002
• Exposure: National asbestos use: bans by fiber type (crocidolite, amosite, chrysotile), consumption levels and trends, occupational exposure limits, medical follow-up schemes, and statistics and compensation for asbestosis and mesothelioma
• Main results:
  • Singapore was the only country that had virtually banned chrysotile. Japan was amending its laws after a government decision to adopt a total ban. In the other countries an asbestos ban was not on the agenda, at least officially.
  • Amosite was not banned in China, Malaysia, Thailand, and possibly Vietnam. No information was available for Indonesia and Korea.
  • Excluding the Philippines and Indonesia, where little or no information was available, current per-capita consumption ranged from 0 in Singapore to 0.9 kg/capita/yr in Malaysia (1994) and 1.9 kg/capita/yr in Thailand (2001).
  • In Japan, the 2001 level of 0.6 kg/capita/yr (79,463 metric tons) followed a marked decrease from a peak of 3.1 kg/capita/yr (352,110 metric tons) in 1974.
  • More industrialized countries showed a steady decrease in consumption, while developing countries showed a definite increase. At least half of the countries continued to increase consumption.
  • Occupational exposure limits in the comparison ranged from 0.1 fibers/mL in Singapore and Malaysia to 5.0 fibers/mL in Thailand. A personal communication reported that Thailand had recently adopted 0.5 f/mL. China was the only country using a gravimetric (weight-based) method rather than fiber counting.
  • Where medical follow-up schemes existed, they mostly covered asbestos mining and manufacturing workers. End-users of asbestos products were usually not covered.
  • Asbestosis cases reported: a cumulative 4,300 in 40 years in China and several hundred prevalent cases in Japan. Singapore reported about one case annually on average, Korea five cumulative and Taiwan one cumulative. No statistics were available for Indonesia, Malaysia, Philippines, Thailand or Vietnam.
  • National mesothelioma statistics were available only for Japan (772 deaths in 2001), Korea (45 deaths in 2000) and Singapore (average of 2 deaths/yr in 1967-2000).
  • The proportion of mesothelioma cases compensated was described as about 3% of cases in Japan, a few cases annually in Korea, and about 50% of cases in Singapore.
  • Asbestosis was subject to compensation in most countries except Vietnam and Taiwan. Mesothelioma was compensated in most countries except Indonesia and Taiwan.
• The authors' conclusion: The authors concluded that the quality and quantity of information need to improve, but the available information attests to unfavorable conditions in less industrialized countries. They concluded that the experience of industrialized countries should be used to the fullest, and that care should be taken that a ban in one country does not shift the burden to another.
• Limitations the authors state:
  • Data were being collected and applied to these indicators for the first time in many countries, so the compiled data were crude.
  • Participants from the same country gave conflicting details, for example on exposure limits and the government stance on a ban, and there was no means to assess which was correct.
  • Most countries lacked historical consumption data, so only current rather than cumulative consumption could be compiled.
  • Valid cross-country comparisons of disease statistics were difficult with the available data.
  • Under-diagnosis and under-reporting were likely, particularly in less industrialized countries.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Mesothelioma, Chrysotile.

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