Asbestos in Poland: occupational health problems

Our plain-English summary of Asbestos in Poland: occupational health problems, by N. Szeszenia-Dąbrowska, B. Swiątkowska, Z. Szubert, et al (International Journal of Occupational Medicine and Environmental Health, 2011).

The study

• Authors: N. Szeszenia-Dąbrowska, B. Swiątkowska, Z. Szubert, U. Wilczyńska
• Journal: International Journal of Occupational Medicine and Environmental Health
• Published: 2011;24(2):142-52
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The presentation addresses current problems of health risk and health effects associated with exposure to asbestos, including data on historical exposure and on currently valid occupational exposure limits. The quantity and types of the raw material used for the production of various asbestos products have also been discussed in relation to the particular types of asbestos-induced occupational diseases. The authors describe the medical care system for former asbestos workers and those currently exposed during removal of asbestos-containing products. The national system for medical certification of occupational asbestos-related diseases and the compensation procedure have been outlined as well. According to the parliamentary Act of 1997, importing, manufacture and sale of asbestos and asbestos-containing materials are prohibited in Poland. Thus, the assessment of asbestos exposure and the monitoring of health conditions of workers at asbestos-processing plants have become irrelevant. However, the delayed health effects attributable to past exposure continue to be the matter of concern for public health. Likewise, the environmental pollution from asbestos waste landfills in the vicinity of asbestos-processing plants (where high levels of asbestos fibre in ambient air have been recorded) will continue to be a serious public health problem. Presently, two programmes aimed at minimising the adverse effects of asbestos on population health are underway. One of them is the governmental programme for "Elimination of asbestos and asbestos-containing products used in Poland, 2002-2032". The programme was updated in 2009 to cover the workers contracted to perform demolition works and provide protective covers to asbestos waste landfills. This will be the exposed group who need prophylactic health care. The other is a programme of prophylactic examinations for former asbestos workers and is referred to as the AMIANTUS programme. Both programmes have been briefly described.

In plain English

This article was an overview of asbestos as an occupational health problem in Poland. It also reported data from the AMIANTUS examination programme for former asbestos workers, which the authors' institute supervises. The authors reported that Poland imported about 2 million tonnes of asbestos after 1945, mostly chrysotile from the former Soviet Union. Crocidolite and small amounts of amosite were also used until the mid 1980s. From 1976 to 2010, 4253 cases were recorded as occupational diseases from asbestos dust. The text gave asbestosis 64%, lung cancer 12.2%, diseases of pleura 9.7% and pleural mesothelioma 6.4%, but the article's own table counts give slightly higher shares. In the AMIANTUS programme, asbestosis was diagnosed in 1476 workers, 21.5% of the 6853 examined. The authors attributed the rise in asbestosis largely to better detection. They considered the occupational share of pleural mesothelioma underrated, mainly because clinicians knew too little about its occupational causes. The article also described exposure limits, medical care, certification, compensation and government programmes. The authors concluded that delayed effects of past exposure remain a public health concern.

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: Descriptive overview of asbestos use, exposure, occupational disease records, health care, compensation and government programmes in Poland. It includes national register counts and data from the AMIANTUS prophylactic examination programme, and is published in the journal's Original Papers section.
• Who was studied: Workers in Poland occupationally exposed to asbestos. About 33 000 were estimated to have worked at asbestos processing plants, and about 150 000 in other sectors were estimated to have intermittent exposure. Also covered: national records of asbestos-related occupational diseases for 1976 to 2010, and AMIANTUS programme data on 6853 former asbestos workers for 2000 to 2010.
• Exposure: Asbestos used in Polish manufacturing, mainly asbestos-cement. Mostly chrysotile, with about 86 000 tonnes of crocidolite and about 8500 tonnes of amosite. Crocidolite was used mainly for pressure pipes until the mid 1980s. Current exposure is in maintenance and removal of asbestos-containing materials.
• Main results:
  • From 1976 to 2010, 4253 cases of disease in Poland were recorded as deriving from occupational exposure to asbestos dust
  • The text gives the most prevalent recorded diseases as asbestosis (64%), lung cancer (12.2%), diseases of pleura (9.7%) and pleural mesothelioma (6.4%)
  • Table 2 gives totals for 1976 to 2010 of 2801 asbestosis, 537 lung cancer, 279 pleural mesothelioma, 427 diseases of pleura or pericardium, 130 other neoplasms and 79 other non-malignant diseases, out of 4253. These counts give shares of about 65.9%, 12.6%, 6.6% and 10.0%, slightly higher than the text's percentages.
  • The AMIANTUS programme database held medical data on 6853 former asbestos workers, drawn from 18 955 examinations
  • Among the AMIANTUS-examined workers, asbestosis was diagnosed in 1476 cases (21.5% of the examined workers), lung cancer in 68 cases and mesothelioma in 40 cases
  • Among examined former workers, diagnosed asbestosis increased from 7% in 2000 to 26% in 2010. The authors attributed this largely to better detection through the programme.
  • The text says 280 cases of pleural mesothelioma were classified as occupational from 1976 to 2010 (Table 2 gives 279). Those recorded from 1980 to 1996 were 2.4% of all pleural mesothelioma cases in the general population (3.2% in males, 1.5% in females).
  • The authors considered the occupational share of pleural mesothelioma underrated, mainly because clinicians had insufficient knowledge of its occupational origin and did not take detailed work histories
  • Asbestos-related lung cancer accounted for 40% of all occupational lung cancer cases recorded in Poland from 1978 to 2010
  • Earlier studies cited by the review measured asbestos fibre concentrations of 0.001 to 0.080 f/cm3 in the breathing zone of workers removing asbestos cement goods
• The authors' conclusion: The authors concluded that, although asbestos is banned in Poland, delayed health effects of past exposure continue to be a public health concern
• Limitations the authors state:
  • The low exposure measurements for removal workers came only from leading, well-equipped companies and should be interpreted cautiously
  • High historical dust concentrations at asbestos-cement plants were recorded only as mg/m3, not as fibre counts
  • No register of occupationally exposed workers existed before the AMIANTUS programme began in 2001

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Occupational Disease, Asbestos-Containing Material (ACM), Asbestos Exposure.

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