Medical monitoring of asbestos-exposed workers: experience from Poland

Our plain-English summary of Medical monitoring of asbestos-exposed workers: experience from Poland, by B. Świątkowska, N. Szeszenia-Dąbrowska, U. Wilczyńska (Bulletin of the World Health Organization, 2016).

The study

• Authors: B. Świątkowska, N. Szeszenia-Dąbrowska, U. Wilczyńska
• Journal: Bulletin of the World Health Organization
• Published: 2016;94(8):599-604
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

In Poland, the use of asbestos was banned in 1997 and asbestos plants have been closed since then. Despite their closure, cases of asbestos-related occupational diseases among former asbestos workers are still being recorded in the Central Register of Occupational Diseases. Between 2001 and 2014, there were 2726 asbestos-related illnesses, classified and reported as diseases associated with occupational exposure to asbestos. In 2000, Poland introduced a programme called Amiantus, targeted at former asbestos-processing plant workers. The programme provided periodic medical examinations to workers and free access to medications for treatment of asbestos-related illnesses. Introduction of the programme provided additional data to generate a reliable estimation of the number of asbestos-related occupational diseases, including cancer. The average latency period for asbestosis, lung cancer and mesothelioma is about 40 years so there may still be some health impact to former workers necessitating follow-up. We present the Polish experience of implementing a medical examination programme for asbestos-exposed workers and provide a list of activities to consider when planning for such a programme.

In plain English

This article is a descriptive policy-and-practice report on Poland's Amiantus programme. It drew on data from Poland's Central Register of Occupational Diseases. The Polish Ministry of Health introduced the programme in 2000. It offered former workers of 28 asbestos-processing plants a yearly medical examination, including a chest X-ray and spirometry, and free medications for asbestos-related illnesses. Construction and shipyard workers were not included. The authors reported that about 90% of the asbestos used by Polish plants after World War II was chrysotile and about 10% crocidolite. About 1700 former employees were examined each year from 2001 to 2014, but only about 20% of eligible workers were examined over the programme's 14 years. Of 2726 asbestos-related occupational diseases registered from 2001 to 2014, 1453 (53.3%) were asbestosis, 398 (14.6%) lung cancer and 289 (10.6%) pleural or peritoneal mesothelioma. Compared with 1991 to 2000, recorded diseases in 2001 to 2010 rose almost twofold, and mesothelioma almost threefold. The authors said this could reflect long latency and increased surveillance. They concluded that all asbestos-exposed workers need follow-up, even after they stop working.

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: Descriptive policy and practice report of a national medical examination programme, drawing on data from Poland's Central Register of Occupational Diseases
• Who was studied: Former workers of 28 asbestos-processing plants in Poland eligible for the Amiantus programme. About 1700 were examined each year between 2001 and 2014, about 10% of them for the first time. Construction and shipyard industries were not included.
• Exposure: Occupational exposure to asbestos dust in asbestos-processing plants (textile, insulation, asbestos-cement and friction products). Of about 2 million tonnes used after World War II, 90% was chrysotile and about 10% crocidolite. Until the mid-eighties, crocidolite and small amounts of amosite were used to make pressure pipes.
• Main results:
  • Of the 2726 asbestos-related illnesses recorded in the Central Register of Occupational Diseases between 2001 and 2014: asbestosis 53.3% (1453), lung cancer 14.6% (398), pleural or peritoneal mesothelioma 10.6% (289). Diseases of the pleura or pericardium, added to the list in 2002, accounted for 20.5% (559).
  • Compared with 1991 to 2000, the number of recorded asbestos-related diseases in 2001 to 2010 increased almost twofold, and mesothelioma almost threefold. Average cases per year: total 217.9 vs 107.9; mesothelioma 19.5 vs 6.8. The authors said this could be due to the long latency period and increased surveillance by the programme.
  • Asbestos-processing plant workers made up less than 70% of diagnosed asbestosis cases before the programme was introduced, and 80% by 2014.
  • Between 2001 and 2013, work-related mesotheliomas made up about 9% (260 of 2808) of mesothelioma cases diagnosed nationally.
  • According to register data, the average latency period for asbestosis, lung cancer and mesothelioma was about 40 years.
• The authors' conclusion: The authors concluded that the programme allowed periodic examinations, free medications and a reliable estimate of asbestos-related occupational diseases. They concluded that follow-up of all asbestos-exposed workers, even after they stop working, is needed to ensure complete reporting.
• Limitations the authors state:
  • Only about 20% of eligible former asbestos workers were examined during the programme's 14 years.
  • Construction and shipyard industries were not included because of a lack of accurate information on exposure.
  • Occupational mesothelioma may be underestimated, mainly because patients were not interviewed in depth about their occupational history.

Topics

Medical terms in this study, explained in our Lexicon: Medical Monitoring, Occupational Disease, Occupational Exposure, Latency, Lung Cancer, Mesothelioma.

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• Occupational diseases in Poland--an overview of current trends — N. Szeszenia-Dąbrowska, U. Wilczyńska (2013)
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