Document x2mezE4Z6wyjM0MgrOnQ5d0g

02/12/98 01:03 FAI 14104482388 Letters @001 Working with Asbestos in Brazil To die Editor:--As President of the Brazilian Asbestos Association (ABRA). an organization which is concerned with scientific and med ical research on asbestos, I would like to comment about the article '`Occupational Exposures to Asbeaos in Brazil," by Fernanda Giannasi and Annie Thebaud-Mony, published in the April/June 1997 edition (lntj Occup Environ Health 1997-3:150-157). Some of the state ments in the article must be clarified so diat a perfect understanding of the circumstances of asbestos use in Brazil can be reach? - Chrysotile ashestn* .. been used in Brazil for more than 60 yean, pri marily in fiber cement production (92% cement and 8% asbestos). The use of asbestos in the form of chrysotile asbestos takes Brazil out of the list of countries where the in appropriate use of asbestos has caused serious problems to workers' health, especially in Europe and in the United States. Until die 1970s, these countries made extensive use of atnphibole asbestos in the con struction and naval industries, to coat metal structures. The highpressure spraying of asbestos ex posed workers to extremely bad con ditions. Nowadays this process is prohibited nearly all over the world. In Brazil, asbestos was never used in this way. It has been proved that chtysotile asbestos may pose a risk to human health solely in the work environ ment. Only when large quantities of asbestos fibers have been inhaled omer many years is there the possi bility of lung disease. ABRA has been monitoring the development of companies that mine chrysotile and manufacture asbestos products in Brazil- It also provides them with technical support and carries out systematic measurements to check the adequacy of environmental con trols. Wc can guarantee that in the fiber cement industry, which is re sponsible for 92% of use of chryso tile asbestos in Brazil, working con ditions are far superior to those mandated by international regula tory requirements. As an example, the data from our latest research confirm that 73.2% of fiber cement companies operate within the regulatory standard of 0.1 fiber/cc, the same level adopted in the United States. In other sec tors, including brake manufactur ers, they operate with dust levels below that suggested by the World Health Organization (WHO), which recommends a maximum of2 fibers/ cc in the work environment. This level is also mandated by Federal Law 9055/95, which applies to as bestos utilization all over Brazil. This level is stricter than that set up by the tripartite agreement be tween Brazilian workers, industry, -- ------ - " tgree- mum .iron- * 1lsare fiber cord- ducc :Heve JPRor, 7u*gp*t non- . xnAtnnm companies are well equipped to safely mine and manufacture chrysotile as bestos. Only with a thorough knowl edge of the technology offiber pro cessing is it possible to obtain such a high level of environmental control. Moreover, the tripartite agree ment that regulates asbesios.mining and manufacturing has in its struc ture a component that ensures its ef fective implementation, the As bestos Control Commissions. These commissions are made up exclu sively of stable workers (they may not be dismissed) whose function is to check the safety conditions of the companies- The commissions' rep resentatives have the authority to stop a plant's operation if they find any change in the level of dust emis sion. This procedure shows the matu rity of the relationships between the workers, industry, and the govern ment In the mining and manufac turing of asbestos. The position of the Syndicate ofWorkers in the Min ing Industry of Non Metallic Miner als of Minacu, an organization that represents the workers of the only asbestos mine in Brazil, and of the Federation of Workers of Mines, both affiliated with CUT (Brazil's national workers' confederation), is to extend the control procedures for asbestos to the whole mining sec tor. The idea is to use this successful experience with asbestos to encour age other mining companies to start investing in technology and envi ronmental controls to benefit all workers. Control measures with asbestos are absolutely necessary in the work environment. In this respect, the Brazilian companies have been pio neers in the introduction of control procedures. Documents show that since 1978, before the introduction of the first regulatory standards in Brazil, there have been investments for this purpose. Both in the mining area and in the asbestos manufac turing industry, all workers undergo periodic medical examinations. The medical flies of the workers and ex workers are concrete proofofthe ef ficiency of the control measures im- 56 12-FEB-98 THU 5:53 14104482368 P.01 02/12/98 01:03 FAI 14104482368 @002 plemenied at the companies. All mining workers' files, x-rays, spirom etry, and medical examinations have been used by the Medical Sci ences College of the University of Campinas (UNICAMP), one of the most important universities in Brazil, as the basis for studies of oc cupational health. Since 1980, the asbestos manufac turing industry has maintained good operational conditions, with no occurrence of illness caused by asbestos. There are 27 cementfactories in Brazil, with about 8,000 work ers, operating under the strictest safety standards. In countries such as Brazil, where the housing deficit is a challenge to be met by the whole society, fiber ccmen t products are of vital importance. Because of their durability, weather resistance, and low price, they are essential to the construction of new buildings, par ticularly for the low-income popula tion. Moreover, the last study pub lished by the WHO, which gathered experts from ten countries to re evaluate all the studies related to chrysoiik asbestos, confirmed its safety and showed progressive re ductions in the levels of dust occur ring in asbestos mining and in the manufacture of asbestos products. This re-evaluation was part ofthe In ternational Program on Chemical Safety (IPCS) developed by the WHO in cooperation with the Inter national Work Organization of the United Nations Environment Pro gram (UNEP). This analysis was car ried oul at the request of many countries interested in studies of chrysoiik asbestos. In view of these facts, we consider that the measures to ban asbestos taken in some European countries may not be appropriate in a differ ent context such as Brazil The Brazilian condition does not allow the occurrence ofany epidemic as it appears in the article published in the journal. Brazil has a modem chrysotile asbestos industry and one of the most advanced regulatory standards in the world. Finally, we would like to point out that the use of chrysotile asbestos in the United States was approved by die U.S. Environmental Protection Agency (EPA). T hope that the ahove is enough to dismiss any possible doubts about the subject. Feel free to coniacr us for any further clarification you might need. Jacques Rang President Brazilian Asbestos Association Sdo Paulo, Brazil In reply*.--The President of the Brazilian Asbestos Association (ABRA) takes issue with our article 'Occupational Exposures to As bestos in Brazil* while defending the production and use of asbestos in Brazil. He primarily uses three ar guments to support the asbestos in dustry position, to each of which we give our response: 1. Exposure to asbestos is under control in Brazil. The exposure data given by ABRA are produced by the asbestos indus try, without participation by the Brazilian government and worker organizations. ABRA states that `As an example, the data from our latest research confirm that 78.2% offiber cement companies operate within the regulatory standard of 0.1 fiber/cc, the same level adopted in the United States." An internal document from the Capivari asbestos-cement plant, the largest and most modem of all the Saint Gobain operations in Brazil, spelled out the extent of deplorable working conditions at the plant The company referred to several work place settings where they admitted that it was "impossible to keep as bestos dust under control." The President of ABRA asserts that good industrial hygiene is prac ticed widely in Brazil's asbestos plants. In actual fact, even in the newest of the plants, control mea sures are far from adequate. He does not mention that most asbestosmanufaemring enterprises are small and entirely unregulated. Many thousands of workers in Brazil work with asbestos in plants where they have absolutely no exposure con trols. Even something as simple as a particle mask is rarely found in these workplace settings. The asbestos mining operations are also dangerous. An interna tional environmental audit done by CEMSO of Costa Rica, which stud ied the SAMA mine in Brazil, found 35% of the work areas analyzed had inadequate dust control. One year later, a report by the Instituio de Pesquisas Tecnologicas de Sao Paulo (UT) confirmed that the asbestosdust-control measures at SAMA were effective only part of the time in protecting workers and the in habitants of a nearby village. 2. There arc no cases of asbestosrelated disease in Brazil, and there wiE not be in the future. ABRA states thatinvestmeals in dust control began in 1978, and suggests that there has been no occurrence of asbestos-related disease since then. But even if all the asbestos mines and plants in Brazil were made completely safe in 1978, there would still be disease from previous years. The denial of any asbestos-re lated disease among the thousands of workers employed in the first 40 years of the asbestos industry in Brazil says more about the industry's neglect than it says about the true occurrence of asbestos-related dis ease. Diagnosis and treatment of can cer are available to few Brazilians. Most workers would not be likely to receive such advanced medical care. It is a rarity that a cancer caused by workplace exposure is diagnosed as such and seldom if ever is it treated. Moreover, the Cancer Registry in Brazil covers less than 5% of the country's population. There arc a few Brazilian studies of asbestos-related disease. One VOL mo 1, JAN-MAR 1998 12-FEB-98 THU 5:54 14104482368 Letters 87 P. 02 02/12/98 01:03 FAX 14104482368 @003 early study initiated by the Medical Sciences College ofthe University of Campinas (UNICAMP) reported cases of mesothelioma in a journal ankle.' Later studies pointed out as bestos-related diseases in various ar eas in Brazil. The most recent study was conducted by Fundacentro/Labor Ministry, UNICAMP, the Heart Institute of die University of Sio Paulo (INCOR), and Centro de Ref erenda etn Saude do Trabalhador de Sio Paulo (CRST), a public oc cupational health center. A study is currently under tvav at Osasco, a large industrial area near Sio Paulo. Here, Gtom 1940 to 1992, the Swiss Eternit group operated one of the oldest of the asbestos-ccmenc facto ries in Brazil. Preliminary data from ibis study demonstrate that of 645 ex-workers examined to date, many have asbestos-related diseases or evi dence of high levels of chronic as bestos exposure. There are 57 continned cases of asbestosis, 130 cases with pleural plaques, and 82 cases of impaired respiratory function. There are at least four cases of pleural mesothelioma, and many suspected cases are under invesrigatiaa. Eight cancer fatalities (four pulmonary and four gastrointesti nal), and another 20 cancer deaths under investigation, are of particu lar concern to (lie researchers. 3. Brazil needs inexpensive housing materials. Many inexpensive alternative build ing materials are available in Brad! The asbestos industry knows very well how to deal with alternative ma terials and technologies, as Saint Gobain and Elex did in France and other European countries after the ban of asbestos. For the low-income people of Brazil, an abundance of tropical fibers is already widely used for housing material, and galva nized metal roofs, as well as Parrytype lightweight concrete roofing tiles, prestresseed concrete pipe, clay pipe for sewerage, anti highdensity polyethylene pipe arc avail able. Interior building walls can be made with many things other than asbestos-cement. Potential alterna tive natural resources are almost un limited, yet liule research is pro vided. by industry and government. The President of AJBRA expresses his concent for the housing needs of low-income families in Brazil. Yet his company refuses to provide housing and medical care for the many thou sands of former employees who have lost their health to the asbestos industry in Brazil. LetABRA demon strate its compassion first to the vic tims of the Eternit asbestos plant in Osasco. Then ABRA can begin to demonstrate its concern for Brazil's dozens by protecting diem from further asbestos exposure. I-ast, it is preposterous for ABRA to say that the U.S. EPA has "ap proved' the use of chrysotile as bestos. The EPA tried to ban as bestos in the United States, but the industry challenge in court over turned the ban. It remains the EPA's position that chrysotile and ocher forms of asbestos should be re placed in all uses with safer materi als, and U-S. asbestos use has steadily dropped to very low levels even since the ban was overturned. ANNIE THtBAUD-MONY, PhD National Institute for Health and Medical Research (TNSERM) Ved de Marne, France tfiebavd@trjf.instrm.Jr FERNANDA GlANNAST, BE Occupational Health and Safety Administration Brazilian Labor Ministry Sdo Paolo State, Brazil giannasi@telnet. eom.br I. Diffuse malignant mesothelioma of the pleura ctiologically related ro asbestos expo sure: discussion of throe clinical cases. ia~ 58 Letters lrfEB-98 THU 5:54 14104482368 !NT J OCCUP ENVIRON HEALTH P. 03 a