The Brazilian System for Monitoring Workers and General Population Exposed to Asbestos: Development, Challenges, and Opportunities for Workers' Health Surveillance

Our plain-English summary of The Brazilian System for Monitoring Workers and General Population Exposed to Asbestos: Development, Challenges, and Opportunities for Workers' Health Surveillance, by R.J. Buralli, R.D.C. Pinheiro, L.L. Susviela, et al (International Journal of Environmental Research and Public Health, 2023).

The study

• Authors: R.J. Buralli, R.D.C. Pinheiro, L.L. Susviela, S.R.C. Duracenko, E.M. De Capitani, A. Savaris, E. Algranti
• Journal: International Journal of Environmental Research and Public Health
• Published: 2023;20(5)
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Unlabelled: The lack of safe levels of asbestos exposure and the long latency of asbestos-related disease (ARD) makes workers' health surveillance challenging, especially in lower-income countries. This paper aims to present the recently developed Brazilian system for monitoring workers and general population exposed to asbestos (Datamianto), and to discuss the main challenges and opportunities for workers' health surveillance.

Methods: a descriptive study of the Datamianto development process, examining all the stages of system planning, development, improvement, validation, availability, and training of health services for its use, in addition to presenting the main challenges and opportunities for its implementation.

Results: The system was developed by a group of software developers, workers' health specialists, and practitioners, and it was recently incorporated by the Ministry of Health to be used for workers' health surveillance. It can facilitate the monitoring of exposed individuals, epidemiological data analysis, promote cooperation between health services, and ensure periodical medical screening guaranteed to workers by labor legislation. Moreover, the system has a Business Intelligence (BI) platform to analyze epidemiologic data and produce near real-time reports.

Conclusions: Datamianto can support and qualify the healthcare and surveillance of asbestos-exposed workers and ARD, promoting a better quality of life for workers and improving companies' compliance with legislation. Even so, the system's significance, applicability, and longevity will depend on the efforts aimed at its implementation and improvement.

In plain English

This was a descriptive report, not a study of disease risk. The authors described how Datamianto, a Brazilian system for monitoring people exposed to asbestos, was built from 2019 to 2022. It has a patient-care module, a module for checking companies' legal duties, and a reporting tool. Training reached 321 participants from 15 of Brazil's 27 states. By December 2022, 27 health services had recorded 20,368 exposed individuals and 4405 notifications of asbestos-related disease (485 confirmed, 3043 under investigation). They also recorded 853 deaths of previously exposed workers, most with the asbestos link still under investigation. In Santa Catarina State, 1422 exposed workers still required periodic evaluation by companies: 131 due annually, 182 every two years and 1109 every three years. The authors reported that companies were late with these reassessments: 95.4% for the annual group, 69.2% for the two-year group and 75.9% for the three-year group. The authors noted that some data are self-reported and may contain recall bias. They concluded that Datamianto can support care and surveillance of exposed workers, but that its value depends on efforts to implement and improve it.

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 article on the development and operation of a national asbestos-exposure monitoring information system, with preliminary data from its use
• Who was studied: The Datamianto system and its users in Brazil. It was developed from 2019 to 2022. As of December 2022, 27 health services in 9 of 27 states had used it to record 20,368 individuals exposed to asbestos. The worked example covers 3528 workers and former workers of one asbestos-related company in Santa Catarina State.
• Exposure: Occupational (and some non-occupational) asbestos exposure. The Santa Catarina example concerns workers in the asbestos-cement industries.
• Main results:
  • Starting from the existing Datatox system, 173 changes were made to the database, 173 to the reporting (BI) tool and 382 to the system's interfaces.
  • 321 participants from 15 of the 27 Brazilian states were trained to use the system.
  • Nationwide, health services registered 4405 notifications of asbestos-related disease, of which 3043 were under investigation and 485 were confirmed.
  • Nationwide, 853 deaths of workers previously exposed to asbestos were recorded, most with the causal relation still under investigation.
  • In Santa Catarina, 4581 health monitoring actions were recorded. Companies carried out 90.9% of them and Cerest/SC carried out 9.1%.
  • In Santa Catarina, 413 death records were registered. 76.0% had not yet been investigated. Of those investigated, 12.1% were not asbestos-related, 7.3% were due to asbestos exposure and 4.6% were still under investigation.
  • In Santa Catarina, 1693 workers (48.0%) had ended exposure more than 30 years earlier.
  • In Santa Catarina, 1422 exposed workers required periodic evaluation by companies: 131 (9.2%) to be assessed annually, 182 (12.8%) every 2 years and 1109 (78.0%) every 3 years.
  • Among these Santa Catarina workers requiring periodic evaluation, companies were late with reassessments that should be carried out annually (95.4%), every two years (69.2%) and every three years (75.9%).
• The authors' conclusion: The authors concluded that Datamianto can support and qualify healthcare and surveillance of exposed workers and asbestos-related disease in Brazil. They added that its significance, applicability and longevity will depend on efforts aimed at its implementation and improvement.
• Limitations the authors state:
  • Some clinical and exposure data are self-reported and may have recall and information bias.
  • Biases, misinformation and classification errors by the health workers entering data cannot be ruled out.
  • The system needs human resources and technology (computers and internet) that public health services do not always have.
  • There is currently no implementation plan for the system.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Latency, Quality of Life.

Related studies

• Brazilian Thoracic Society recommendations for the diagnosis and monitoring of asbestos-exposed individuals — U.P. Santos, E. Algranti, et al. (2024)
• Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues — A. Marinaccio, A. Binazzi, et al. (2015)
• Local Cancer Recurrence: The Realities, Challenges, and Opportunities for New Therapies — D.A. Mahvi, R. Liu, et al. (2018)
• Mesothelioma incidence surveillance systems and claims for workers' compensation. Epidemiological evidence and prospects for an integrated framework — A. Marinaccio, A. Scarselli, et al. (2012)
• Non-malignant asbestos-related diseases in Brazilian asbestos-cement workers — E. Algranti, E.M. Mendonça, et al. (2001)
• Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance — F. Barbiero, T. Zanin, et al. (2018)

Browse more research in International Journal of Environmental Research and Public Health, or return to medical research.