Asbestos-related health risks in Estonia

Our plain-English summary of Asbestos-related health risks in Estonia, by M. Kangur, P. Krooni (International Journal of Occupational Safety and Ergonomics, 2003).

The study

• Authors: M. Kangur, P. Krooni
• Journal: International Journal of Occupational Safety and Ergonomics
• Published: 2003;9(1):97-101
• Read it: PubMed · Publisher

Abstract

Asbestos has been declared a proven human carcinogen by the U.S. Environmental Protection Agency and by the International Agency for Research on Cancer of the World Health Organization. Since 1983, the European Union has enforced health protection directions in this field, which have been the basis for legal acts of Member States. The Estonian Republic is a country where asbestos and asbestos-containing materials have been used in quite large quantities, especially during the Soviet period. Today the use and sale of asbestos minerals and asbestos containing products are prohibited in Estonia. Unfortunately there has been no substantial overview of the health status of workers exposed to asbestos. The objective of this study was to evaluate the extent of health risks of workers exposed to asbestos in Estonia.

In plain English

This short report from Estonia described a questionnaire survey of asbestos-exposed workers. In 1995–1997 the Health Protection Inspectorate collected personal questionnaires covering age, gender, length and daily hours of exposure, smoking and use of protective equipment. Three hundred and twenty were completed, 86% by men. The workers' average age was 43.0 years. Mechanics (26.5%) and machine operators (24.4%) were the largest job groups, followed by construction workers and thermal insulators. Workers reported 26 different asbestos products, most often asbestos cement, asbestos textiles and friction materials, and 12.8% used raw asbestos. Most (59.1%) had been exposed for up to 10 years. Of one hundred and eighty-nine workers who answered a question about lung disease, thirty-five (18.5%) said they had or had had one, mostly bronchitis and pneumonia. The authors noted that asbestosis had not been registered in Estonia during 1993–1997, although they stated that workplace investigations and long-term asbestos use presume it. They stated the analysis was incomplete because data were missing from some enterprises, including ship repair factories, and from small companies. The authors concluded that the problem needs further study and recommended continued exposure monitoring, better medical surveillance and improved diagnosis.

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-sectional questionnaire survey of asbestos-exposed workers (short report in the journal's Notes section)
• Who was studied: Three hundred and twenty asbestos-exposed workers in Estonia (86% men, 14% women) who filled in personal questionnaires in 1995–1997; 54% of questionnaires came from the North-East of Estonia and Harju County (including Tallinn); participation was voluntary
• Exposure: Occupational exposure to 26 different asbestos products, most often asbestos cement products (roofing sheets, pipes), asbestos textile products and friction materials; 12.8% of subjects used raw asbestos, mostly to prepare insulation mixtures. The article does not state which fiber types were involved.
• Main results:
  • Average age of the exposed workers was 43.0 years; 81.25% were older than 30
  • Mechanics-locksmiths, machine operators, construction workers and thermal insulators were the most exposed groups (figure: mechanic 26.5%, operator 24.4%, construction worker 17.2%, thermoinsulator 15.3%, welder 5.6%, turner 4.4%, other 6.6%)
  • Raw asbestos was used by 12.8% of the subjects
  • Thermal insulation work had the highest airborne concentrations, 0.30–0.49 f/cm3; friction-material removal in transport enterprises reached up to 0.15 f/cm3 (measurements the article cites from an earlier publication, Kangur et al., 2001)
  • Duration of exposure among the workers: 59.1% up to 10 years, 30.3% from 10 to 20 years, 10.6% more than 20 years
  • Daily exposure lasted less than 1 hour for 47.8% (153 workers), 1 to 4 hours for 26.9% (86 workers), and 5 to 8 hours for 25.3% (81 workers)
  • One hundred and seventy-two workers (53.8%) were active or ex-smokers, one hundred and thirty-seven (42.8%) did not smoke and eleven (3.4%) did not reply; average smoking duration was 18.25 years
  • Of one hundred and eighty-nine workers who answered about lung diseases, thirty-five (18.5%) reported having had or having one, mostly bronchitis (chronic, allergic) and pneumonia
  • One hundred and ninety-four workers (60.6%) used personal protective equipment, 16.6% did not answer, and the rest did not use it
  • Pneumoconiosis (asbestosis) caused by asbestos and other mineral fibres had not been registered in Estonia during 1993–1997, although the authors stated that working-environment investigations and long-term asbestos use presume it
• The authors' conclusion: The authors concluded that the results reveal the importance of the problem and indicate a need to intensify these studies. They recommended continued exposure monitoring, continued and improved medical surveillance of exposed workers, measures to minimize risk, and improved diagnosis of asbestos-induced diseases.
• Limitations the authors state:
  • The analysis was incomplete because data were not received from all enterprises involved, for example ship repairing factories
  • It was difficult to obtain information about asbestos-exposed workers in small-scale companies

Topics

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

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