Finnish Institute of Occupational Health (FIOH): prevention and detection of asbestos-related diseases, 1987-2005

Our plain-English summary of Finnish Institute of Occupational Health (FIOH): prevention and detection of asbestos-related diseases, 1987-2005, by M.S. Huuskonen, J. Rantanen (American Journal of Industrial Medicine, 2006).

The study

• Authors: M.S. Huuskonen, J. Rantanen
• Journal: American Journal of Industrial Medicine
• Published: 2006;49(3):215-20
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Between 1987 and 1992, the Finnish Institute of Occupational Health (FIOH) initiated and implemented the Asbestos Program that aimed at reducing asbestos-related risks. It was a cooperative effort between government authorities, labor market organizations, and health care and labor protection personnel.

Methods: During the Program and its follow-up since 1993 several preventive actions were taken, and considerable new legislation and official instructions were issued.

Results: Approximately 200,000 people in Finland have been exposed to asbestos in their work. Through the cooperative efforts of government, labor, health care and worker protection programs, the import of asbestos was ceased in 1993 with a few exceptions. Almost all imports ceased in 2005 following European Union directives. Regulation of asbestos abatement companies has been greatly increased. The occupational exposure limit has been reduced from 2.0 fibers/cm(3) to the present 0.1 fibers/cm(3). Asbestos-related diseases are closely monitored and education of health care providers regarding the occupational source of these conditions is now emphasized.

Conclusions: The success of the primary goal of the Program, a reduction in asbestos-related morbidity, will not be fully realized for many decades.

(c) 2006 Wiley-Liss, Inc.

In plain English

This was a commentary, not a new study. The authors, from the Finnish Institute of Occupational Health (FIOH), described its Asbestos Program of 1987–1992 and follow-up since 1993. The program worked with government, labor organizations and health and safety staff to reduce asbestos-related risks in Finland, where about 200,000 people had been exposed at work. They reported that yearly asbestos consumption fell from 2,500 tons in 1986 to 10 tons in 2005. The occupational exposure limit fell from 2.0 to 0.1 fibers per cubic centimeter. Registered asbestos-induced cancers rose from an average of four or five per year in 1982–1986 to 83 in 1992 and 132 in 2002. A national screening of 18,943 construction, shipyard and asbestos industry workers in 1990–1992, published separately, found pleural or parenchymal changes in 22% (4,133) of those X-rayed. The authors estimated about 150 asbestos-related premature deaths a year. They concluded that asbestos-induced diseases would peak by 2010–2015, and that physicians had paid little attention to exposures. They also said that judging whether the program reduced disease would take many years.

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 describing a national asbestos prevention program and its follow-up (not an original study)
• Who was studied: Workers in Finland exposed to asbestos at work (about 200,000 people), described at the national level for 1987–2005
• Exposure: Occupational asbestos exposure in Finland: high exposures in insulation work and asbestos product manufacture (over 10,000 workers), and considerable exposures at construction sites and shipyards (some 50,000 workers) and among car mechanics and maintenance and repair men. A total of 300,000 tons of asbestos was used in Finland in 1918–1988.
• Main results:
  • Total consumption of asbestos in Finland was 2,500 tons/year in 1986, 300 tons/year in 1992 and 10 tons/year in 2005. Import of raw asbestos fell from 2,200 tons/year to 0.
  • The occupational exposure limit was 2.0 fibers/cm3 in 1986, 0.5 fibers/cm3 in 1992 and 0.1 fibers/cm3 in 2005.
  • Asbestos-induced cancer cases entered in the register of work-related diseases rose from an average of four or five per year in 1982–1986 to 83 in 1992 and 132 in 2002.
  • All asbestos-induced diseases reported in Finland rose from 35 cases in 1986 to over 1,000 cases in 1992 and over 500 cases in 2002.
  • In a national screening study in 1990–1992 (Koskinen et al., 1998), 18,943 construction, shipyard and asbestos industry workers took part. Of those X-rayed (the article does not give how many were X-rayed), 22% (4,133) showed pleural or parenchymal changes, and 75% of these were occupational diseases when examined clinically.
  • The average annual number of lung cancers registered as occupational diseases was 80 in 1997–2002, compared with 1.8 in 1982–1986.
  • The average annual number of mesotheliomas registered as occupational diseases was 33 in 1997–2002, compared with 2.8 in 1982–1986.
  • The annual risk of mesothelioma was about 400/million among the 50,000 people with the highest exposure, and about 70/million among the 150,000 people with moderate occupational exposure.
  • From cited studies: among 999 anthophyllite miners and millers, 553 had died before 1991. Four of them died from mesothelioma (three pleural, one peritoneal), and all four had high concentrations of anthophyllite fibers in their lung tissue.
  • The annual number of asbestos-related premature deaths in Finland was estimated at about 150, which exceeds the annual number of fatal work accidents.
• The authors' conclusion: The authors concluded that the peak of asbestos-induced diseases would be reached by 2010–2015. They also concluded that, because physicians had paid little attention to exposures, asbestos-related cancers were not adequately registered and compensated as occupational diseases. They expected asbestos-related cancers to keep increasing before slowly decreasing over future decades.
• Limitations the authors state:
  • The authors stated that assessing whether the program's primary goal, a reduction in asbestos-related morbidity, has been reached will take many years.

Topics

Medical terms in this study, explained in our Lexicon: Abatement, Occupational Exposure.

Related studies

• Finnish Institute of Occupational Health Asbestos Program 1987-1992 — M.S. Huuskonen, K. Koskinen, et al. (1995)
• Programmed health surveillance and detection of emerging diseases in occupational health: contribution of the French national occupational disease surveillance and prevention network (RNV3P) — V. Bonneterre, L. Faisandier, et al. (2010)
• A camel through the eye of a needle: expertise and the late recognition of asbestos-related diseases — A. Menéndez-Navarro (2011)
• FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe — J.C. Bailar, S.G. Ballal, et al. (2006)
• Incidence of cancer among Finnish patients with asbestos-related pulmonary or pleural fibrosis — A. Karjalainen, E. Pukkala, et al. (1999)
• Occupational lung diseases and global occupational health on the Net — K. Takahashi, A. Sekikawa, et al. (1998)

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