1. Tsuyoshi Kawakami, MD, PhD Senior OSH Specialist ILO Subregional Office for East Asia Towards the elimination of asbestos-related diseases - Common challenges in Asia -

2. Asbestos ILO Resolution concerning Asbestos, June 2006, aiming at elimination of use of asbestos - Asian Asbestos Conference, July 2006 - National Asbestos Workshop, Vietnam, November 2006 - National Asbestos Workshop, Thailand, March 2007 Asbestos as a CSR (Corporate Social Responsibility) issue as well as a workers’ health issue

3. What are the practical steps to eliminate the use of asbestos ? 1.Promoting public awareness 2.Strengthening health surveillance 3.Responding to business needs (asbestos-free alternatives) 4.Providing special support to small businesses 5. Establishing concerted national policies

4. Case: A joint-venture construction company. -Around 400 workers in the construction site. -Good OSH system at the workplace. -Employers attended an asbestos seminar organized by the Ministry of Industry in March 2006 and knows asbestos hazards. -They use asbestos-contained materials, and ensure workers to use personal protective equipment. -They use asbestos-free materials depending on customers’ preferences. Though asbestos-free materials are more expensive, some customers demand asbestos-free materials.

5. Pilot survey on asbestos in Thailand - Questionnaires distributed to 350 companies - Questioned about current use, control measures taken, future plan, government support. - 61 companies (27 Thai, 34 Joint-venture) responded. - 13 companies used asbestos at present (6 companies) or in the past (7 companies). - No company reported asbestos-related disease.

6. Knowledge on health hazards of asbestos - Causes lung cancer 47 (77.0%) - Causes mesothelioma 23 (37.7%) - 30 – 40 year latency period 20 (32.8%) - Countries banning asbestos 17 (27.9%) - Asbestos-free materials 21 (34.4%) - Global companies replacing asbestos 23 (37.7%) - Asbestos-free materials sold in Thailand 20 (32.8%)

7. Information sources on asbestos hazards - MSDS from sellers 15 (24.6%) - Health professionals 12 (19.7%) - Labels on materials containers 10 (16.4%) - Technical institutions 9 (14.8%) - Government inspectors 7 (11.5%) - Mother companies 7 (11.5%) - Other companies 5 (8.2%) - Customers 3 (4.9%) - Others (internet, journals, chemical engineers, safety officer training etc) 23 (37.7%)

8. Reasons why stopped asbestos (N=7) - Technically no more needed 5 - Worrying about employee health 3 - Worrying about pollution 3 - Asbestos-free alternatives available 3 - Worrying about customer health 2 - Customers’ demand 1

9. Asbestos as a business risk (N=13) Cannot judge now 5 Yes 4 Yes, but a small risk 2 Don’t know 2

10. Companies’ support needs from government(N=13) 10 companies; Information on asbestos-free materials 9 companies; Labour inspector advice, National campaign 8 companies; Workers health surveillance, Information on global business trends 7 companies; Laws to clarify company duties, Technical guidelines 6 companies; Employee training, Employer training, Technical support to control, Employee medical treatment, Employee compensation, Recognize companies’ efforts 5 companies; Experience exchange between companies 4 companies; Financial support for replacement

11. Recommendations Information dissemination to the public concerning hazards of asbestos, global business trends and asbestos-free materials. Strengthening health surveillance including cohort studies. National campaigns about health hazards of asbestos. Strengthening policy-legislative frameworks on the duties of employers to protect their employees from asbestos.

12. Independent consultation committee on asbestos diseases - What medical professional can do - 1.Advise and train doctors and health practitioners to diagnose asbestos-related diseases including patients’ work history taking. 2.Doctors should have easy access to the committee for consultation about their patients. 3.The committee should comprise lung disease specialists, radiologists, occupational disease experts and public health officers and be independent from other authorities.

13. Conclusion 1.To establish a consultation committee on asbestos diseases from public health viewpoints. 2.To study available asbestos-free materials and disseminate the information to companies. 3.To learn from best practice companies that have stopped use of asbestos. 4.To provide correct knowledge of asbestos health hazards to the public. 5. To strengthen inter-ministerial cooperation to set concerted national policy.