Finnish Institute of Occupational Health Asbestos Program 1987-1992

Our plain-English summary of Finnish Institute of Occupational Health Asbestos Program 1987-1992, by M.S. Huuskonen, K. Koskinen, A. Tossavainen, et al (American Journal of Industrial Medicine, 1995).

The study

• Authors: M.S. Huuskonen, K. Koskinen, A. Tossavainen, A. Karjalainen, J.P. Rinne, J. Rantanen
• Journal: American Journal of Industrial Medicine
• Published: 1995;28(1):123-42
• Cited by: 28 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In 1987-1992, the Finnish Institute of Occupational Health (FIOH) implemented a nationwide asbestos program aimed at preventing asbestos-related risks in good cooperation with governmental authorities, industry, trade unions, the health care and insurance systems, and mass media. The goals were to minimize all exposure to asbestos, identify people exposed at work, and improve the diagnostics of asbestos diseases, especially cancers. The program entailed several concrete actions and extensive dissemination of information, training, services, and scientific research. As proposed by the State Asbestos Committee, new use of asbestos products was banned and strict regulations were applied to renovation and inspection of old buildings. The screening study of asbestos-induced diseases included 18,943 current and retired workers from house building, shipyard, and asbestos industries. Pleural and parenchymal changes were found in 4,133 persons (22%), who were referred to further clinical examinations as suspected cases of an occupational disease. It was estimated that past exposure of asbestos among the Finnish population of 5 million causes > 150 mesotheliomas and lung cancers annually, totalling > 2,000 asbestos-induced cancer deaths by the year 2010. Although several major control actions were made or started during the program, the bulk of the preventive work still lies ahead.

In plain English

This article is a commentary from the Finnish Institute of Occupational Health describing its national Asbestos Program of 1987-1992. The program aimed to minimize asbestos exposure, identify exposed workers and improve diagnosis of asbestos diseases. During the program, asbestos use in Finland fell from 2,500 tons to under 300 tons a year. Manufacture and import of asbestos products were banned from January 1, 1993, with some exceptions. In a screening study in 1990-92, 18,943 current and retired workers from house building, shipyards and the asbestos product industry were interviewed and had chest X-rays. Of these, 4,133 (22%) had lung or pleural findings meeting the screening criteria and were referred for further examination. About three-quarters of those referred were diagnosed with an occupational disease: 96% had pleural changes and 4% asbestosis. The authors reported an estimate that past exposure causes more than 150 cancer deaths a year in Finland. They stated it would take 20 to 40 years to judge the program's effect on disease. They concluded that most of the practical work still lay ahead.

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: Commentary (program report) describing a national asbestos prevention program, including a screening study of workers and smaller examination surveys
• Who was studied: Finland. 18,943 current and retired workers were examined in 1990-92: 17,937 in house building, 550 in the asbestos product industry and 456 in shipyards. Smaller groups were also examined: 57 asbestos sprayers in 1987 and 453 construction workers in the Tampere area in 1988.
• Exposure: Occupational asbestos exposure in house building (at least 10 years, starting before 1980), and in shipyards or the asbestos product industry (at least 1 year, starting before 1976). The authors note that chrysotile was the most common type used in Finland, but patients' work histories almost always included other asbestos types.
• Main results:
  • In the screening study, 4,133 of the 18,943 examined workers (22%) had chest X-ray findings meeting the criteria (lung fibrosis, pleural plaques or pleural thickening) and were referred for further examination.
  • About three-quarters of those referred were diagnosed with an occupational disease; 96% had pleural changes and 4% asbestosis.
  • The percentage of positive screening findings was 29% in the Helsinki area and 18% elsewhere in the country.
  • Of 57 asbestos sprayers who came to examination in 1987, 16 (28%) had a previously undetected asbestos disease.
  • In the 1988 Tampere-area survey, 116 of 453 examined construction workers (25%) had a distinct lung fibrosis or pleural change that could have been caused by asbestos.
  • During the program, asbestos use in Finland fell from 2,500 tons to under 300 tons per year.
  • Asbestos-induced cancers entered in the Register of Occupational Diseases rose from an average of four or five per year in 1982-86 to 83 in 1992.
  • The authors reported an estimate that asbestos exposure causes more than 150 cancer deaths a year in Finland.
• The authors' conclusion: The authors concluded that legislative measures and regulations were mostly implemented during the program, but the bulk of the practical work to solve the asbestos problem still lies ahead.
• Limitations the authors state:
  • The authors state it will take 20 to 40 years to see whether the program reduced asbestos-related disease.
  • The authors state that the true number of mesotheliomas is probably higher than register figures.
  • The authors state that most asbestos-induced occupational diseases are still not recognized as such.

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 Disease, Mesothelioma, Lung Cancer.

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