1. Current Situation of Asbestos in Thailand Dr. Somkiat Siriruttanapruk Bureau of Occupational and Environmental Diseases, Ministry of Public Health, Thailand

2. Asbestos  It has been imported for more than 30 years  It is used in several industries:-roof tile, cement pipe, etc.  Asbestosis is one of the occupational diseases under national disease surveillance scheme. Introducti on

3.  No asbestos mine in the country  Only import for manufacturing  Only chrysotile is allowed to use  (crocidolite was banned in 1992 and amosite was banned recently) Production and use

4. 90 % cement manufacture, roof tile, cement pipe 8 % brake and crutch 2 % vinyl floor tile, gasket, heat insulating material The proportion of asbestos use in manufacturing industry

5. Amount of imported asbestos in Thailand (1988-2002) Tons

6. Top 10 countries of imported asbestos in Thailand, 2002 1. Russian Federation 46,132Tons 2. Canada42,091 Tons 3. Brazil33,740 Tons 4. Kazakhstan28,500 Tons 5. Zimbabwe22,759 Tons 6. Czech Republic1,914 Tons 7. Belize1,656 Tons 8. Swaziland1,638 Tons 9. South Africa1,476 Tons 10. Botswana1,080 Tons

7. Top 5 countries of imported asbestos in Thailand during 1997-2002 To ns

8. Number of asbestos factories and workers by type in each region of the country in 2004

10. Occupational Exposure Limits (OELs) of asbestos in some Asian countries Takahashi et al. (2003)

11.  Never been reported to the surveillance scheme or the Workmen’s Compensation Fund Asbestos related diseases

12. Why? 1. This maybe the real situation, or 2. Under-report of cases:  Long latency period of the disease  High turn-over rate among workers  Lack of awareness and knowledge in diagnosing the disease among physicians  No follow-up or registration system

13. Estimation of cases of asbestos- related diseases in Thailand  Tossavainen indicated a significant linear correlation between consumption of asbestos and the number of mesothelioma cases.  Calculating as follows: Y= 6.82x amount of consumption (25-30 years ago)+0.43 Y= No. of cases/million/year Amount of consumption= No. of Kg/capita/year (2.5 Kg/cap/y) Y=(6.82x2.5)+0.43=17.5 cases/million/year Total new cases/year=17.5x63= 1,103 cases

14. Results of the survey YearNo. of Facto ries No. of work ers No. of abnor mal CXR No. of pleur al thicke ning No. of suspe cted asbes tosis 19872470113 - 20006669?-- 20036140415- 200481063191

15. Do we need to prevent and control asbestos-related diseases?

16. If we don ’ t do anything, what will happen?  Health status of exposed workers  Cost of medical service and compensation  Public alarming  Economic problem  Company and country reputation

17. Can we prevent and control asbestos-related diseases in Thailand?

18. SWOT Analysis Strength:  well-established responsible organizations  Existing relevant legislation system  Good health service system

19. SWOT Analysis Weakness:  No data for convincing policy makers and public  Lack of awareness among government officers, employers, employees, and occupational health professionals  Poor agreement among relevant government agencies  Lack of knowledge for health screening and diagnosis of the disease among physicians  No effective surveillance system

20. SWOT Analysis Opportunity:  Global concern  Strong supportive network  Low number of target population  Alternative materials and other technical preventive measures are available

21. SWOT Analysis Threat:  Lack of policy support?  Being against by pro-asbestos local and international industries  Economic burden  No public awareness

22. Conclusions  Consumption of asbestos in Thailand is very high and the trend shows its increasing  Asbestos-related diseases will become more important public health issue  Several measures need to be implemented urgently  Strategy of asbestos ban is the best policy but an achievement of this goal is still a long way

23. Thank you very much!