Bilateral environmental and occupational health program with India

Our plain-English summary of Bilateral environmental and occupational health program with India, by M. Allred, S. Campolucci, H. Falk, et al (International Journal of Hygiene and Environmental Health, 2003).

The study

• Authors: M. Allred, S. Campolucci, H. Falk, N.K. Ganguly, H.N. Saiyed, B. Shah
• Journal: International Journal of Hygiene and Environmental Health
• Published: 2003;206(4-5):323-32
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In spite of considerable economic progress in recent years, India continues to face challenges dealing with poverty, unemployment, malnutrition, disease and disability. The governments of India and the United States have formed a collaborative effort to address outstanding issues in the fields of environmental and occupational health. The Joint Statement on Indo-U.S. Collaboration in Environmental and Occupational Health, which was approved by the Minister of the Indian Union of Health and Family Welfare and the Secretary of Health and Human Services of the United State in Geneva in May of 2002, formalizes the collaborative relationship and calls for the development of Implementation Guidelines. The Implementation Guidelines establish a Joint Working Group, which is responsible for identifying and implementing the collaborative projects. The collaborating organizations have identified three broad areas for collaboration: emergency preparedness and response; training, education, and technology transfer; and research. Within the three broad areas, the organizations have identified two subject areas for initiation: arsenicosis and asbestosis. Researchers and health officials in both India and the U.S. share interest in both research and interventions efforts in these subject areas. As many as 42 million people in the West Bengal area of India may be exposed to arsenic in drinking water at concentrations of health concern. Similarly, as many as 10 million industrial or mine workers in India may be exposed to asbestos or other dusts at concentrations of health concern. The first Joint Working Group meeting is scheduled for March 2003 in New Delhi and will consider these subject areas in developing collaborative projects. Other tasks being undertaken by the signatory agencies include expanding the relationship to include academic and nongovernmental organizations and obtaining funds for the various projects from governmental and nongovernmental sources.

In plain English

This article was not a research study. It described a program in which United States and Indian government health agencies agreed to work together on environmental and occupational health. The lead agencies were the U.S. Agency for Toxic Substances and Disease Registry (ATSDR) and the Centers for Disease Control and Prevention, and the Indian Council of Medical Research. A Joint Statement signed in Geneva in May 2002 formalized the collaboration. The agencies named three broad areas, eight focus areas, and two first topics: arsenicosis and asbestosis. Citing an Indian government working group report, the authors wrote that more than 10 million Indian workers were in industrial or mining jobs with substantial exposure to mineral dusts, and that two to three million might be suffering from exposure to asbestos and other dusts or fibers. As background, they summarized ATSDR's separate medical testing in Libby, Montana, where the vermiculite ore contained tremolite, actinolite, richterite and winchite. In that testing, 1,186 of 6,668 participants had pleural abnormalities. The authors wrote that research on low-level asbestos exposure would improve understanding in both 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: Description of a government collaboration program (policy and program report), not original research. The asbestos data it mentions come from other sources: ATSDR reports and an Indian government working group report.
• Who was studied: No study population. The subject is U.S. and Indian government health agencies. ATSDR and CDC were the U.S. lead agencies and the Indian Council of Medical Research was the Indian lead agency.
• Exposure: Topics were arsenic in drinking water and occupational exposure to asbestos and other mineral dusts in India. The background section described Libby, Montana vermiculite ore, whose fiber content is referred to as Libby asbestos.
• Main results:
  • The Joint Statement was signed on May 14, 2002, in Geneva, at the 55th World Health Assembly.
  • The collaborating organizations named three broad areas for collaboration.
  • Senior Advisors identified eight focus areas, and arsenicosis and asbestosis were chosen as the first subject areas.
  • Citing the Indian government's 2001 working group report, the authors wrote that more than 10 million Indian workers were in industrial or mining jobs that exposed them to substantial concentrations of mineral dusts.
  • Studies in India, as cited by the authors, suggested a 10 to 50% prevalence of dust-induced illness among active workers. The authors interpreted this to mean two to three million active workers may be suffering from exposure to asbestos and other dusts or fibers.
  • From ATSDR's separate Libby, Montana medical testing program (cited as ATSDR 2002, not this article's own study), chest x-ray readers reported pleural abnormalities in 1,186 of 6,668 participants (18% of those x-rayed).
  • From ATSDR's review of Libby-area mortality for 1979 to 1998 (cited from ATSDR reports, not this article's own study), mortality attributed to asbestosis was 40 to 80 times higher than expected.
• The authors' conclusion: The authors noted ATSDR's conclusion that more research is needed on the risks of low-level exposure to asbestos, particularly fibers like Libby asbestos. They wrote that such research would improve understanding of asbestos exposures in India as well as the U.S.
• Limitations the authors state:
  • The authors stated that the paper could not discuss each focus area in depth, so it covered only arsenicosis and asbestosis.

Topics

Medical terms in this study, explained in our Lexicon: Bilateral.

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