Environmental health centers for asbestos and their health impact surveys and activities

Our plain-English summary of Environmental health centers for asbestos and their health impact surveys and activities, by D.M. Kang, J.E. Kim, Y.J. Lee, et al (Annals of Occupational and Environmental Medicine, 2016).

The study

• Authors: D.M. Kang, J.E. Kim, Y.J. Lee, H.H. Lee, C.Y. Lee, S.J. Moon, M.S. Kang
• Journal: Annals of Occupational and Environmental Medicine
• Published: 2016;28:68
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

In 2009, Korea banned the import, transport, and use of asbestos, and the Asbestos Injury Relief Act (AIRA) was promulgated in 2011. Two environmental health centers for asbestos (EHCA), including Pusan National University Yangsan Hospital (PNUYH) and SoonChunHyang University Cheonan Hospital (SCHUCH), were adapted to find environmental asbestos-related diseases (ARDs) and to support the purposes of AIRA. EHCA conducted a health impact survey (HIS) on persons who resided or reside near asbestos factories or mines. A total of 13,433 persons have taken screening examinations in PNUYH EHCA, and 623 persons (4.6%) have had secondary examinations. Of the 21,014 persons who had screening examinations in SCHUCH EHCA, 2490 persons (11.8%) had secondary examinations. Some of those who tested positive for ARDs through HISs filed applications for the asbestos victims' medical pocketbook (AVMP). Approximately 116 and 612 persons received AVMPs as a result of PNUYH and SCHUCH examinees, respectively. EHCAs have conducted HISs, public relations, and education for asbestos victims, ordinary citizens, and physicians. As HISs are based on voluntary participation, they does not monitor high-risk groups. Active surveillance focusing on high-risk groups has been blocked by the personal information protection act. Although important work has been performed in finding environmental asbestos victims and increasing public awareness on asbestos, it is necessary to improve the current system and registration.

In plain English

This short communication described the work of Korea's two Environmental Health Centers for Asbestos. Based at Pusan National University Yangsan Hospital (PNUYH) and SoonChunHyang University Cheonan Hospital (SCHUCH), they were set up to find environmental asbestos-related diseases and support the Asbestos Injury Relief Act. The centers offered health surveys to people who had lived within 2 km of asbestos mines, factories or similar sites for over 5 years. Volunteers had a screening examination, and those with abnormal findings had a second examination with a chest CT scan and lung function test. At PNUYH, 13,433 people were screened and 623 (4.6%) had a second examination. At SCHUCH, 21,014 were screened and 2490 (11.8%) had a second examination. About 116 PNUYH and 612 SCHUCH examinees received asbestos victims' medical pocketbooks, mostly for asbestosis. Lung cancer was very rare among these pocketbook holders, which the authors suggested strict recognition criteria might explain. The authors noted that recognition rates could not be calculated and that a privacy law blocked active surveillance of high-risk groups. The authors concluded that the system and registration need improving.

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: Short communication describing the activities and results of two government-designated asbestos health centers (descriptive program report)
• Who was studied: Residents in Korea who had lived within 2 km of asbestos mines, asbestos factories or other designated areas for over 5 years and who took part voluntarily. They were examined by the PNUYH center (southern and eastern Korea) or the SCHUCH center (northern and western Korea), 2009 to August 2016.
• Exposure: Environmental (residential) asbestos exposure near asbestos mines, asbestos factories (including asbestos textile factories), asbestos loading docks, asbestos cement slate concentrated areas, a quarry and repair shipyards. Fiber types were not reported.
• Main results:
  • PNUYH center: 13,433 persons had screening examinations and 623 (4.6%) had secondary examinations
  • SCHUCH center: of 21,014 persons screened, 2490 (11.8%) had secondary examinations
  • About 116 PNUYH examinees and 612 SCHUCH examinees received asbestos victims' medical pocketbooks (recognition as asbestos victims)
  • Diseases among SCHUCH pocketbook holders (2011 to 2015; 2016 not available): 4 malignant mesothelioma, 47 lung cancer, 560 asbestosis, 1 pleural thickening. Diseases among PNUYH holders: 1 lung cancer and 66 asbestosis (Ministry of Environment funded), plus 2 lung cancer and 47 asbestosis (Busan city funded).
  • Among asbestos victims' medical pocketbook holders, asbestosis predominated and lung cancer was very rare. The authors suggested that strict criteria for recognizing lung cancer might explain this.
  • According to the authors (data not shown), most pocketbook holders were former asbestos miners and people who had worked high-risk jobs in construction
• The authors' conclusion: The authors concluded that the current voluntary survey system has disadvantages. They said the system and registration process should be improved, including creating and using an asbestos-victims database to reach highly exposed people.
• Limitations the authors state:
  • There was no data on how many examinees applied for recognition, so rates of application and recognition could not be calculated
  • The surveys relied on voluntary participation. People with severe disease may have died or been unable to travel to the examinations.
  • Few victims were recognized through the surveys, so their efficiency appeared low
  • Active surveillance of high-risk groups was blocked by the personal information protection act

Topics

Medical terms in this study, explained in our Lexicon: Active Surveillance.

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