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© 2010 Government of Singapore
A Great Workforce A Great Workplace
1
Asbestos – Trends and Action Globally
and in Singapor...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
2
© 2010 Government of Singapore
A Great Workforce A Great Workplace
3
Past World Estimates, asbestos deaths:
112,000 every ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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© 2010 Government of Singapore
A Great Workforce A Great Workplace
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5
Asbestos consumption in Asia and in the World
© 2010 Government of Singapore
A Great Workforce A Great Workplace
6
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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Work-related Annual Deaths – EU-27
Sources: WSH Insti...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
8
Work-related Annual Deaths – World
Sources: Hämäläine...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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Source: Rushton a.o.
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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10
Consumption of Asbestos and Mesothelioma Deaths i...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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11
Today
© 2010 Government of Singapore
A Great Workforce A Great Workplace
12
Year
Source: R. Virta, United States Geological Surv...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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Year
Data Source: United States Geological Survey , ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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Year
Source: United States Geological Survey , U.S. ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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ProblemSources:
Eun-Kee Park , Ken Takahashi (UOEH),...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
16
*
* *
Thailand
deaths, estimate
U.K.
Exposure
U.K.
D...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
17
Selected data from various
sources, refs included
26...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
18
Asbestos mortality estimates based on consumed
asbes...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
19
Asbestos mortality estimates based on consumed
asbes...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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26-Nov-14 Visiting Expert Week20
© 2010 Government of Singapore
A Great Workforce A Great Workplace
21
Work-related Asbestos Mortality estimates based
on c...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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26-Nov-14
© 2010 Government of Singapore
A Great Workforce A Great Workplace
23
Work-related Asbestos mortality estimates based
on U...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
24
Work-related Asbestos Mortality estimates based
THAI...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
25
Work-related Asbestos Mortality estimates based
SING...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
26
Why Mesothelioma Mortality is low in Asia as
compare...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
27
Why Asbestos-related Lung Cancer is poorly
identifie...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
28
Asbestos and smoking - synergistic effect
Increased ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
29
Asbestos and smoking - synergistic effect
Increased ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
30
Background or “non-exposed” reference mortality
1. R...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
31
Slide of Sugio Furuya
© 2010 Government of Singapore
A Great Workforce A Great Workplace
32
Slide of Sugio Furuya, modified by JT:
Singapore, ot...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
33
Year & Area/
Deaths
Finland
2001
(Nurminen et al.)
F...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
34
Conclusions borrowed from Kurt Straif:
© 2010 Government of Singapore
A Great Workforce A Great Workplace
35
Conclusion
© 2010 Government of Singapore
A Great Workforce A Great Workplace
36
A Great Workforce A Great Workplace
Singapore’s Expe...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
37
1950 1980 1990 2000 2014
Use of asbestos
building
ma...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
38
National Asbestos Control Programme
Targeted interve...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
39
WSH (Asbestos) Regulations 2014
Effective from 30 Ma...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
40
WSH (Asbestos) Regulations 2014
1. Asbestos Survey t...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
41
Are there building
works carried out for
building bu...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
42
Illegal removal of asbestos-containing materials
© 2010 Government of Singapore
A Great Workforce A Great Workplace
43
Illegal removal of asbestos-containing materials
Any...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
44
Other Relevant Regulations
1. WSH (Medical Examinati...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
45
Corrugated asbestos sheets
Common ACMs found in Sing...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
46
Common ACMs found in Singapore (Buildings)
Asbestos
...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
47
Common ACMs found in Singapore (Plants /vessels)
Pip...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
48
• Notification of asbestos-removal work
•
2011 2012 ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
49
“Not-so-common” ACMs
Rubbish
chute
insulation
lining...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
50
Technical requirements on asbestos work
Designated
w...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
51
Designated work area
Decontamination facilities
Indu...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
52
Compliance Assistance
WSH Guidelines
Management and
...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
53
Compliance Assistance
WSH Guidelines
Management and
...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
54
Conclusion
• Asbestos-related diseases have killed a...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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THANK YOU
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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© 2010 Government of Singapore
A Great Workforce A Great Workplace
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Additional selected data from
various sources, refs ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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© 2010 Government of Singapore
A Great Workforce A Great Workplace
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© 2010 Government of Singapore
A Great Workforce A Great Workplace
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© 2010 Government of Singapore
A Great Workforce A Great Workplace
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EUROSTAT numbers referred by the Health and Safety E...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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Cancer site: Attributable Fraction(%) Attrib Deaths ...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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Cancer Site Asbestos Shift
work
Min.
oils
Solar
rad
...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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10 leading causes of Deaths in East Asia
Murray et a...
© 2010 Government of Singapore
A Great Workforce A Great Workplace
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10 leading causes of Deaths in East Asia
Murray et a...
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"Asbestos – Trends and Action Globally and in Singapore" by Dr Jukka Takala and Ms.Lynnette Goh

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Presentation in the "Expedite Asia Free from Asbestos Hazard" Conference in Bangkok" on 24-25 Nov 2014

"Asbestos – Trends and Action Globally
and in Singapore" by Dr Jukka Takala and Ms.Lynnette Goh
Workplace Safety and Health Institute, Ministry of Manpower
17 November 2014

Published in: Government & Nonprofit
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"Asbestos – Trends and Action Globally and in Singapore" by Dr Jukka Takala and Ms.Lynnette Goh

  1. 1. © 2010 Government of Singapore A Great Workforce A Great Workplace 1 Asbestos – Trends and Action Globally and in Singapore Dr Jukka Takala, Ms.Lynnette Goh Workplace Safety and Health Institute, Ministry of Manpower 17 November 2014
  2. 2. © 2010 Government of Singapore A Great Workforce A Great Workplace 2
  3. 3. © 2010 Government of Singapore A Great Workforce A Great Workplace 3 Past World Estimates, asbestos deaths: 112,000 every year (ILO estimate) 107,000 every year (WHO estimate)
  4. 4. © 2010 Government of Singapore A Great Workforce A Great Workplace 4
  5. 5. © 2010 Government of Singapore A Great Workforce A Great Workplace 5 5 Asbestos consumption in Asia and in the World
  6. 6. © 2010 Government of Singapore A Great Workforce A Great Workplace 6
  7. 7. © 2010 Government of Singapore A Great Workforce A Great Workplace 7 Work-related Annual Deaths – EU-27 Sources: WSH Institute Singapore 2014, Hämäläinen P, Takala J, Saarela KL; TUT, ILO, WHO, EU-OSHA, WSH Institute Singapore, JOEH May 2014, ref. data: MOH/MOM and WHO WPRO A region Work-related Annual Deaths – Singapore and EU distribution of fatal injuries and illnesses, EU in brackets
  8. 8. © 2010 Government of Singapore A Great Workforce A Great Workplace 8 Work-related Annual Deaths – World Sources: Hämäläinen P, Takala J, Saarela KL; TUT, ILO, EU-OSHA, Asbestos: 25-50% of all work- related cancers New 102 500
  9. 9. © 2010 Government of Singapore A Great Workforce A Great Workplace 9 Source: Rushton a.o.
  10. 10. © 2010 Government of Singapore A Great Workforce A Great Workplace 10 10 Consumption of Asbestos and Mesothelioma Deaths in the U.K. 2003
  11. 11. © 2010 Government of Singapore A Great Workforce A Great Workplace 11 11 Today
  12. 12. © 2010 Government of Singapore A Great Workforce A Great Workplace 12 Year Source: R. Virta, United States Geological Survey , U.S. Department of Interior * Exports bigger than imports in 1985 etc. * Singapore:total estimated consumption 1960 -2012 was 136,209 metric tons * * Finland: total estimated consumption 1960 -2012 was 311,904 metric tons
  13. 13. © 2010 Government of Singapore A Great Workforce A Great Workplace 13 Year Data Source: United States Geological Survey , U.S. Department of Interior * Exports bigger than imports ** IntJOEH2004;10:22-25 & BJC(2012),106,575-584 * •Total consumption in Taiwan 480,000, Singapore 136,000, and Malaysia 750,000 metric tons in Every 170 tons causes 1 mesothelioma case, and 2-10 lung cancers ** *
  14. 14. © 2010 Government of Singapore A Great Workforce A Great Workplace 14 Year Source: United States Geological Survey , U.S. Department of Interior * SingaporeNumberofDeaths 50 100 Singaporeindex:2x104 * Exports bigger than imports in 1985 * U.K 2005 Singapore expected Singapore scale * * Today U.KMesothelioma deaths
  15. 15. © 2010 Government of Singapore A Great Workforce A Great Workplace 15 ProblemSources: Eun-Kee Park , Ken Takahashi (UOEH), Jukka Takala, ILO
  16. 16. © 2010 Government of Singapore A Great Workforce A Great Workplace 16 * * * Thailand deaths, estimate U.K. Exposure U.K. Deaths Thailand exposure, moving average U.K 2005 Mesothelioma deaths= 200,000 tons used/year 1500 Today U.K
  17. 17. © 2010 Government of Singapore A Great Workforce A Great Workplace 17 Selected data from various sources, refs included 26-Nov-14 Visiting Expert Week17
  18. 18. © 2010 Government of Singapore A Great Workforce A Great Workplace 18 Asbestos mortality estimates based on consumed asbestos, FINLAND Estimates made in 2001 based on 1996 data (Nurminen ) 1. 59 mesothelioma deaths, 42 at work, 208 asbestos related lung cancer deaths estimated, RR = 2.3, AF= 14% (males) for asbestos and synergistic smoking, related to average asbestos consumption 10 041 tons/year, 1950-70 2. 170 tons of asbestos use causes 1 mesothelioma death, data calculated also for global estimates (Tossavainen) 3. 48 tons of asbestos consumption caused 1 asbestos related lung cancer, totalling 250 deaths, 312 - 335 deaths at peak level in the year around 2020 of which an expected 62, in reality 85, mesothelioma deaths, see point 7. below. 4. Other cancers known to have been caused by asbestos: stomach, colon, larynx, ovary, rectum, and asbestosis deaths need to be added 5. Asbestos epidemic will cause 8 785 deaths of which 1 757 mesothelioma deaths. 6. Year 2013: average 85 mesothelioma cases recorded annually in Finland. Sources: Nurminen, Karjalainen: Scand J Work Environ Health, Vol 27, no.3 Tossavainen A.: IntJOEH 2004; 10:22-25
  19. 19. © 2010 Government of Singapore A Great Workforce A Great Workplace 19 Asbestos mortality estimates based on consumed asbestos, UNITED KINGDOM Estimates made in 2005 (Rushton ) 1. 8 010 occupational cancer deaths in 2005, 1 937 mesothelioma deaths at work, 2 223 asbestos related lung cancer deaths, total 4160 deaths estimated, related to annual average asbestos consumption: 140 173 tons in 1950-70, resulting to 33.7 tons of asbestos causing 1 death either by mesothelioma or lung cancer 2. Year 2013: 2 535 recorded mesothelioma deaths, with corresponding rate estimated to have 2 909 lung cancer deaths, totalling 5 444 deaths, (HSE) 3. Maximum recorded consumption in 1960: 163 019 tons of asbestos, this consumption would produce an expected 4 837 maximum estimate of expected deaths: the reality is close to above 5 444 deaths/year between 2015-2020 Sources: BJC Rushton: BJC(2012),106,575-584 and HSE: http://www.hse.gov.uk/statistics/causdis/mesothelioma/mesothelioma.pdf
  20. 20. © 2010 Government of Singapore A Great Workforce A Great Workplace 20 26-Nov-14 Visiting Expert Week20
  21. 21. © 2010 Government of Singapore A Great Workforce A Great Workplace 21 Work-related Asbestos Mortality estimates based on consumed asbestos, WORLD (1 of 2) Estimates made in Nov 2014 (Takala ) 1. Based on RR = 2.3 and AF = 14 % (males), 0.6% (females), 10 041 tons of asbestos exposure cause 208 asbestos related lung cancer, ARLC (Nurminen), or every used 48 tons cause one lung cancer, and every 170 tons cause one mesothelioma, every 35.5 tons cause 1 death (Tossavainen). 2. World consumption was 3.5 million tons in 1970 and peak consumption was 4.7 million tons in 1980. 3. Corresponding ARLC in around 2015-20 will be: 73 200 deaths, and peak mortality in 2025-30: 97 800 deaths. Mesothelioma deaths, peak 27 600 (under reporting expected here) in 2025-2030. 4. Asbestos caused other cancer deaths ( colon,stomach, larynx, ovary) come to approx. 1.8 % of mesothelioma and lung cancers (1760), and asbestosis deaths to 3.8% of these cancers (4765), adding all together at peak period 132 000 deaths Sources: 1.Rushton L: BJC(2012), 107,53-57 2. HSE: http://www.hse.gov.uk/statistics/causdis/mesothelioma/mesothelioma.pdf 3. Nurminen M, Karjalainen A: Scand J Work Environ Health, Vol 27, no.3 4. Tossavainen A.: Int JOEH 2004; 10:22-25 5. Virta Robert, United States Geol. Survey: Worldwide Asbestos Supply and Consumption 1900-2003, http://pubs.usgs.gov/circ/2006/1298/c1298.pdf 6. Straif K: The Burden of occupational cancer, editorial, DOI: 10.1136/oem.2007.038224 http://oem.bmj.com/
  22. 22. © 2010 Government of Singapore A Great Workforce A Great Workplace 22 26-Nov-14
  23. 23. © 2010 Government of Singapore A Great Workforce A Great Workplace 23 Work-related Asbestos mortality estimates based on U.K. consumed asbestos, WORLD cont. (2 of 2) Estimates made in Nov 2014, (Takala ) 1. Based on U.K. Data (Rushton) in 2005 there were 8 010 occupational cancer deaths of which 1 937 mesothelioma deaths and 2 223 ALRC deaths. In 2013 the number of mesothelioma cases was 2 535 and corresponding ARLC deaths 2 909, totalling 5 444 deaths. 2. U.K. Peak consumption was 163 019 tons of asbestos in 1960. Average annual consumption in 1950-70 was 140 173 tons. 3. The average consumption between 1950-70 would be equal to 1 death for every 33.7 tons covering both ARLC and mesothelioma. For peak consumption and present 2013 deaths, 1 death would be caused by 29.9 tons. Global peak consumption 4.7 million tons in 1980, outcome in 2025-2030. 4. Corresponding global ARLC and mesothelioma deaths would be 139 500 based on average consumption 1950-70, and 157 000 based on latest 2013 death numbers and peak consumption in the U.K. Other asbestos caused cancers and asbestosis deaths need to be added. Sources: 1.Rushton L: BJC(2012), 107,53-57 2. HSE: http://www.hse.gov.uk/statistics/causdis/mesothelioma/mesothelioma.pdf 3. Nurminen M, Karjalainen A: Scand J Work Environ Health, Vol 27, no.3 4. Tossavainen A.: Int JOEH 2004; 10:22-25 5. Virta Robert, United States Geol. Survey: Worldwide Asbestos Supply and Consumption 1900-2003, http://pubs.usgs.gov/circ/2006/1298/c1298.pdf
  24. 24. © 2010 Government of Singapore A Great Workforce A Great Workplace 24 Work-related Asbestos Mortality estimates based THAILAND Estimates made in Nov 2014 (Takala ) 1. Based on estimate of exposure-outcome relation (RR=2.3), and the Thai consumption of asbestos in 1970, which was 21 272 metric tons, Thai ARLC number would be 441 deaths and mesothelioma 125 deaths totalling 566 and adding other asbestos caused deaths 599 in 2015- 20. 2. Average annual consumption around 2006 was 135 000 tons which would produce 3 800 (3802) peak annual deaths of all asbestos related causes around the year 2050. 3. Peak consumption of 190 205 tons of asbestos in 1996 in Thailand would produce a figure of 5 400 (5 357) in around the year 2040-50 (less reliable). Sources: 1.Rushton L: BJC(2012),107,53-5 2. HSE: http://www.hse.gov.uk/statistics/causdis/mesothelioma/mesothelioma.pdf 3. Nurminen M, Karjalainen A: Scand J Work Environ Health, Vol 27, no.3 4. Tossavainen A.: Int JOEH 2004; 10:22-25 5. Virta Robert, United States Geol. Survey: Worldwide Asbestos Supply and Consumption 1900-2003, http://pubs.usgs.gov/circ/2006/1298/c1298.pdf
  25. 25. © 2010 Government of Singapore A Great Workforce A Great Workplace 25 Work-related Asbestos Mortality estimates based SINGAPORE Estimates made in Nov 2014 (Takala ) 1. Based on estimate of exposure-outcome relation (RR=2.3), and the Singapore peak consumption of asbestos in 1975 which was 8 671 metric tons the number of total peak annual asbestos related number would be 244 deaths in 2025-30. Mesothelioma may be around 10-25 % of this number depending on the type of asbestos used. 2. Total consumption until 2006 was 136 209 tons which would produce an asbestos epidemic of 3 800 (3836) deaths of all asbestos related causes during some 50 years. 3. Peak of deaths is expected at 2025-30 Sources: 1.Rushton L: BJC(2012),107,53-57 2. HSE: http://www.hse.gov.uk/statistics/causdis/mesothelioma/mesothelioma.pdf 3. Nurminen M, Karjalainen A: Scand J Work Environ Health, Vol 27, no.3 4. Tossavainen A.: Int JOEH 2004; 10:22-25 5. Virta Robert, United States Geol. Survey: Worldwide Asbestos Supply and Consumption 1900-2003, http://pubs.usgs.gov/circ/2006/1298/c1298.pdf 6. McCormack, Peto et al: BJC(2012),106,575-584
  26. 26. © 2010 Government of Singapore A Great Workforce A Great Workplace 26 Why Mesothelioma Mortality is low in Asia as compared to Europe, USA, Australia/NZ, Japan 1. Asbestos use was started slower in Asian countries and generally later than in industrialised countries. The peak for Singapore is expected to be 10 years later than in the U.K. at 2025-30. In Thailand the peak is expected to be 30-35 later in 2040-50. Latency time from the high country consumption is also longer than earlier thought: not all imported/produced asbestos is used immediately on the year imported rather with some delays, also disease latency period is very long - up to 50 years. 2. Diagnosing, recording, reporting and compensating mesothelioma is considerably low and lower in Asian and other developing countries than in best reporting developed countries. 3. The type of asbestos used e.g. in the U.K. has earlier contained a significant amount of crocidolite and other amphibole fibers that are causing more mesothelioma and proportionally less ARLC (McCormack et al.) Sources: 1.Rushton L: BJC(2012),107,53-57 2. HSE: http://www.hse.gov.uk/statistics/causdis/mesothelioma/mesothelioma.pdf 3. Nurminen M, Karjalainen A: Scand J Work Environ Health, Vol 27, no.3 4. Tossavainen A.: Int JOEH 2004; 10:22-25 5. Virta Robert, United States Geol. Survey: Worldwide Asbestos Supply and Consumption 1900-2003, http://pubs.usgs.gov/circ/2006/1298/c1298.pdf 6. McCormack, Peto et al: BJC(2012),106,575-584
  27. 27. © 2010 Government of Singapore A Great Workforce A Great Workplace 27 Why Asbestos-related Lung Cancer is poorly identified 1. Lung cancer is caused by many factors and smoking may cover up to 85% of all lung cancers. The outcome is not readily identified as been caused by asbestos and easily dismissed as many workers exposed to asbestos are also smokers, and most lung cancer victims are exposed to asbestos and actively smoking. 2. The attributable fraction or the number of “lung cancers eliminated by reducing just asbestos“ is high but, in particular, caused by the multiplicative or super-additive synergistic effects of both asbestos exposure and smoking (see next slide). 3. Diagnosing, recording, reporting and compensating asbestos related lung cancer is weak everywhere due to difficulty of individualising the asbestos exposure effect. This effect is seen in a population but evidence individually is challenging to proof. Many jurisdiction expect asbestos being as the main cause i.e. the magnitude of causal effect is more than 50% to record them as compensable. 4. Life expectancy is relatively low in many Asian countries. Lung cancer and mesothelioma appear late in life. Sources: 1.Rushton L: BJC(2012),107,53-57 2. HSE: http://www.hse.gov.uk/statistics/causdis/mesothelioma/mesothelioma.pdf 3. Nurminen M, Karjalainen A: Scand J Work Environ Health, Vol 27, no.3 4. Tossavainen A.: Int JOEH 2004; 10:22-25 5. Virta Robert, United States Geol. Survey: Worldwide Asbestos Supply and Consumption 1900-2003, http://pubs.usgs.gov/circ/2006/1298/c1298.pdf 6. McCormack, Peto et al: BJC(2012),106,575-584 7. Memorandum from the Occupational Cancer Working Group, FIOH www.ttl.fi/en/publications/Electronic_publications/Documents/Memorandum_Cancer_2013.pdf
  28. 28. © 2010 Government of Singapore A Great Workforce A Great Workplace 28 Asbestos and smoking - synergistic effect Increased risk of lung cancer when exposed to: 1. Asbestos alone RR = 2 - 5, 2. Smoking alone RR = 8-10 3. Combined RR = 50-80
  29. 29. © 2010 Government of Singapore A Great Workforce A Great Workplace 29 Asbestos and smoking - synergistic effect Increased risk of lung cancer when exposed to: 1. Asbestos alone RR = 2 - 5, 2. Smoking alone RR = 8-10 3. Combined RR = 50-80 Source: T. Driscoll
  30. 30. © 2010 Government of Singapore A Great Workforce A Great Workplace 30 Background or “non-exposed” reference mortality 1. Relative risk and attributable fractions are calculated against the background mortality for “non-exposed“ population. Exposure limit today for airborne asbestos vary from 0.1 fiber/ml to 0.01 f/ml (or 100 000 to 10 000 fibres/m3) 2. In countryside Europe background is about 100-500 fibres/m3. In cities – e.g. in Geneva in between the ILO and WHO buildings: 900 fibres/m3 and inside the office buildings 600 fibres/m3. 3. 25 fibres/ml – years is considered as a criteria for ARLC/mesothelioma for workers‘ compensation base on daily 8 hours exposure. This may be easily reached in a population of 1 000 people if exposure is continuous for 24h/day: 900 fibres/m3 * 3 * 1000 = 2.7 f/ml – yrs and in 10 years 27 f/ml – yrs. 1 death for every 10 years for “non exposed“ - acceptable? 4. Passive smoking and, in particular, active smoking radically increase the risk of ARLC. 5. Health-based OEL should be 0.001 f/ml, and for general population life-time risk (24/7 exposure) limit should be 0.0000001 f/ml or 0.1 fibres/m3 (Cherrie) . Sources: Cherrie John http://venus.unive.it/fall/presentazioni/Cherrie_op.pdf
  31. 31. © 2010 Government of Singapore A Great Workforce A Great Workplace 31 Slide of Sugio Furuya
  32. 32. © 2010 Government of Singapore A Great Workforce A Great Workplace 32 Slide of Sugio Furuya, modified by JT: Singapore, other Asia U.K.: ̴ 2909 a-r lung cancers, 48.5/mill. 2535 meso.,42.2 in 2013, HSE Source:Fazzo et.al Finland 42/mill.a-r lung cancer Finland 11.8/mill.meso. Finland 16/mill
  33. 33. © 2010 Government of Singapore A Great Workforce A Great Workplace 33 Year & Area/ Deaths Finland 2001 (Nurminen et al.) Finland 2014 est. U.K. 2005 (Rushton et al.) U.K . 2013 est. Thailand 2015 Thailand 2050 est. World Peak value Asbestos related lung cancer, ARLC 208 243 2223 2909 441 6 3093 6 97800 3 Mesothelioma 42 - 59 68–85 5 1937 2535 125 6 507 6 27600 3 ARLC + Mesothelioma 250 311 4160 5444 566 3600 125400 3 Other asbestos cancers and asbestosis added 264 328 4234 4 5541 4 598 3800 132000 3 All cancer deaths at work 839 1135 1 8010 13300 1 4825 1 n/a 666 000 2 1. Based on a proportional value derived from ILO estimate for High income economies and SEARO countries (WHO data 2011) 2. Based on ILO Estimate 2014 (WHO data from 2011): https://www.wsh-institute.sg/files/wshi/upload/cms/file/Global%20Estimates%20of%20Occupational%20Accidents%20and%20Work-related%20Illness%202014.pdf 3. Around the years 2025-2030 4. Without asbestosis 5. Estimated at 68 but recorded annual average at 2010 was 85 6. Rate between ARLC and Mesothelioma considered 4:1 , in 2050 used McCormack et.al ratio 2-10 : 1 , average 6.1:1 Table 1. Asbestos-Related Disease and Cancer Deaths at Work (selected countries)
  34. 34. © 2010 Government of Singapore A Great Workforce A Great Workplace 34 Conclusions borrowed from Kurt Straif:
  35. 35. © 2010 Government of Singapore A Great Workforce A Great Workplace 35 Conclusion
  36. 36. © 2010 Government of Singapore A Great Workforce A Great Workplace 36 A Great Workforce A Great Workplace Singapore’s Experience in Asbestos Management and Control
  37. 37. © 2010 Government of Singapore A Great Workforce A Great Workplace 37 1950 1980 1990 2000 2014 Use of asbestos building materials banned in 1988 Licensing of all raw asbestos and ACM (excluding chrysotile) imports in 1989 Banning of asbestos brake pads and clutch linings in 1995 Inclusion of chrysotile containing ACM for licensing control in 2008 Decreasing use of ACM Wide usage of asbestos as building materials, fireproofing and heat insulators Enactment of Factories (Asbestos) Regulations in 1980 History of Asbestos Control in Singapore Gazette of WSH (Asbestos) Regulations in 2014
  38. 38. © 2010 Government of Singapore A Great Workforce A Great Workplace 38 National Asbestos Control Programme Targeted intervention Standard setting Compliance assistance Capability building Engagement
  39. 39. © 2010 Government of Singapore A Great Workforce A Great Workplace 39 WSH (Asbestos) Regulations 2014 Effective from 30 May 2014 To enhance protection of workers against asbestos exposure
  40. 40. © 2010 Government of Singapore A Great Workforce A Great Workplace 40 WSH (Asbestos) Regulations 2014 1. Asbestos Survey to be carried out by a competent person to ascertain the presence of asbestos 2. Licensing of contractors carrying out asbestos removal work 3. Written plan of work to ensure asbestos removal work is carried out safely 4. Removal of ACMs before demolition of building 5. Technical requirements on asbestos work 6. Training for persons carrying out work involving asbestos Key changes: Source: http://www.mom.gov.sg/legislation/occupational-safety-health/Pages/default.aspx
  41. 41. © 2010 Government of Singapore A Great Workforce A Great Workplace 41 Are there building works carried out for building built before 1 Jan 1991? Is there any work, operation or process involving a specified material? Conduct an asbestos survey to ascertain the presence of asbestos Engage an approved asbestos –removal contractor Submit asbestos work notification to Ministry of Manpower Conduct asbestos- removal work with measures taken to minimise the release or spread of asbestos during work Engage a licensed waste disposal to dispose asbestos waste YES YES Presence of asbestos 14 AARC licensed by MOM 68 Competent persons trained Cable penetration insulation, fire protection board, panel, wall and door, gasket, refractory lining, sprayed insulation, thermal insulation of pipe, boiler, pressure vessel and process vessel 2 licensed companies by NEA 200 Notifications per year
  42. 42. © 2010 Government of Singapore A Great Workforce A Great Workplace 42 Illegal removal of asbestos-containing materials
  43. 43. © 2010 Government of Singapore A Great Workforce A Great Workplace 43 Illegal removal of asbestos-containing materials Any person who contravenes the WSH(Asbestos) Regulations shall be liable on conviction to a fine not exceeding $20,000 or to imprisonment for a term not exceeding 2 years or to both Any person guilty of an offence under the WSH Act shall be liable on conviction to a fine not exceeding $200,000 or to imprisonment for a term not exceeding 2 years or to both for persons Any person guilty of an offence under the WSH Act shall be liable on conviction to a fine not exceeding $500, 000 to companies
  44. 44. © 2010 Government of Singapore A Great Workforce A Great Workplace 44 Other Relevant Regulations 1. WSH (Medical Examinations) Regulations 2014 Persons who carry out work involving asbestos to undergo pre-employment and periodic medical examinations to screen for symptoms of asbestos-related diseases. 2. Work Injury Compensation Act Asbestosis and Mesothelioma are reportable occupational diseases and workers who have contracted these diseases arising out of their work can claim compensation.
  45. 45. © 2010 Government of Singapore A Great Workforce A Great Workplace 45 Corrugated asbestos sheets Common ACMs found in Singapore (Buildings) Roof Wall Cladding
  46. 46. © 2010 Government of Singapore A Great Workforce A Great Workplace 46 Common ACMs found in Singapore (Buildings) Asbestos cemented wall panels Asbestos ceiling board Asbestos ceiling board Asbestos Vinyl Sheet
  47. 47. © 2010 Government of Singapore A Great Workforce A Great Workplace 47 Common ACMs found in Singapore (Plants /vessels) Pipe lagging Gasket Pipe insulation Cable Penetration
  48. 48. © 2010 Government of Singapore A Great Workforce A Great Workplace 48 • Notification of asbestos-removal work • 2011 2012 2013 2014 (till date) 194 205 251 202 Total Permits Demolition work Structural work Average (Jun-Oct 2014) 519 79 440
  49. 49. © 2010 Government of Singapore A Great Workforce A Great Workplace 49 “Not-so-common” ACMs Rubbish chute insulation lining Ventilation panels
  50. 50. © 2010 Government of Singapore A Great Workforce A Great Workplace 50 Technical requirements on asbestos work Designated work area Negative pressure units Proper decontamination facilities Industrial vacuum cleaner Measures to minimise the release or spread of asbestos during work
  51. 51. © 2010 Government of Singapore A Great Workforce A Great Workplace 51 Designated work area Decontamination facilities Industrial vacuum cleaner DirtyShowerClean
  52. 52. © 2010 Government of Singapore A Great Workforce A Great Workplace 52 Compliance Assistance WSH Guidelines Management and Removal of Asbestos -Good practices in managing exposure to ACM -Removal of ACM •Plan of work •Site preparation •Decontamination facilities •PPE •Air monitoring etc.
  53. 53. © 2010 Government of Singapore A Great Workforce A Great Workplace 53 Compliance Assistance WSH Guidelines Management and Removal of Asbestos Video Working Safely with Asbestos WSHC Website Asbestos www.wshc.sg
  54. 54. © 2010 Government of Singapore A Great Workforce A Great Workplace 54 Conclusion • Asbestos-related diseases have killed a large number of people worldwide • Most effective way to prevent asbestos-related diseases is to eliminate or prohibit the use of asbestos • A multi-pronged approach involving legislation, enforcement and engagement is necessary • Joint effort by regulators and stakeholders is needed to prevent exposure to asbestos and manage asbestos at workplaces
  55. 55. © 2010 Government of Singapore A Great Workforce A Great Workplace 55 THANK YOU
  56. 56. © 2010 Government of Singapore A Great Workforce A Great Workplace 57
  57. 57. © 2010 Government of Singapore A Great Workforce A Great Workplace 58 Additional selected data from various sources, refs included
  58. 58. © 2010 Government of Singapore A Great Workforce A Great Workplace 59
  59. 59. © 2010 Government of Singapore A Great Workforce A Great Workplace 60
  60. 60. © 2010 Government of Singapore A Great Workforce A Great Workplace 61
  61. 61. © 2010 Government of Singapore A Great Workforce A Great Workplace 62 EUROSTAT numbers referred by the Health and Safety Executive, U.K. web page: http://www.hse.gov.uk/statistics/pdf/fatalinjuries.pdf (accessed 2014 09 11) Takala J, Hämäläinen P, Saarela KL, Loke YY, Manickam K, Tan WJ, Heng P, Tjong C, Lim GK, Lim S, Gan SL: Global Estimates of the Burden of Injury and Illness at Work in 2012. JOEH 11: 326-337, May/2014, Taylor & Francis, open access, http://www.tandfonline.com/doi/pdf/10.1080/15459624.2013.863131 ILO Report Contribution by Nenonen N, Hämäläinen P, Takala J, Saarela KL, Lim SL, Lim GK, Manickam K: GLOBAL ESTIMATES OF OCCUPATIONAL ACCIDENTS AND FATAL WORK-RELATED DISEASES IN 2014, based on 2010 and 2011 DATA, Report to the ILO, Tampere, Singapore, Geneva 2014, DOI: 10.13140/2.1.2864.0647, web page: http://www.wshi.gov.sg/files/Global%20Estimates%20of%20Occupational%20Accidents%20and%20Work-related%20Illness%202014.pdf Stephen S Lim, Theo Vos, Abraham D Flaxman, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters I 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2224-60, Institute of Health Metrics and Evaluation web site: http://vizhub.healthdata.org/gbd-cause-patterns/ Hämäläinen P. Global Estimates of Occupational Accidents and Fatal Work-Related Diseases. Doctoral dissertation, Publication 917, Tampere University of Technology, Finland, 2010. Accessed on 11 Sep 2014 and available at http://dspace.cc.tut.fi/dpub/bitstream/handle/123456789/6818/hamalainen.pdf?sequence=1 Nurminen M & Karjalainen A (2001). Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland. Scandinavian Journal of Work, Environment & Health 27, 161–213. http://www.sjweh.fi/show_abstract.php?abstract_id=605(accessed 26 March 2014) Steenland K, Rollins School Public Health, Emory University, Atlanta, Ga. USA. 2004 http://www.occupationalcancer.ca/wp-content/uploads/2011/03/Steenland.pdf (Accessed on 2014 09 14) Ana M García, Rafael Gadena Merino, Vicente López Martínez: Estimación de la mortalidad atribuible a enfermedades laborales en España, 2004. Rev Esp Salud Pública 2007; 81 :261-270, N.°3 Mayo-Junio 2007. Accessible from: http://scielo.isciii.es/scielo.php?pid=S1135-57272007000300003&script=sci_arttext (accessed 2014 09 15) Andrea ‘t Mannetje, Neil Pearce: Quantitative estimates of work-related deaths, diseases and injury in New Zealand. Scand J Work Environ Health 2005;31(4):266-276; doi:10.5271/sjweh.882. Accessible from www.sjweh.fi/download.php?abstract_id=882&file_nro=1 (accessed 2014 0915) Murray CJL, Lopez AD (ed.) The Global Burden of Disease – A comprehensive assessment of mortality and disability from diseases, injuries, and risk fraction in 1990 and projected to 2020. Volume I. The Harvard School of Public Health, World Health Organisation, and World Bank. 990 p., 1996. Santonen T, Oksa P. (eds.): Memorandum from the Occupational Cancer Working Group. Finnish Institute of Occupational Health. ISBN 978-952-261-369-1. See: http://www.ttl.fi/en/publications/Electronic_publications/Documents/Memorandum_Cancer_2013.pdf (accessed 2014 09 15) V McCormack, J Peto, G Byrnes, K Straif, P Boffetta. Estimating the asbestos-related lung cancer burden from mesothelioma mortality. Accessed on 16 May 2013 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273352/ (accessed 17 March 2014) WHO: Asbestos: elimination of asbestos related diseases. See: http://www.who.int/mediacentre/factsheets/fs343/en/ (accessed 2014 09 15) Singapore WSH Statistics, WSH Institute, available at http://www.wshi-institute.sg/Observatory-WSH-Landscape/WSH-Statistics.html Labour Force Survey 2013, Ministry of Manpower available at http://stats.mom.gov.sg/Pages/Employment-Tables2013.aspx Lesley Rushton, Sally J Hutchings, Lea Fortunato, Charlotte Young, Gareth S Evans, Terry Brown, Ruth Bevan, Rebecca Slack, Phillip Holmes, Sanjeev Bagga, John W Cherrie and Martie Van Tongeren. Occupational cancer burden in Great Britain Br J Cancer 107: S3-S7; doi:10.1038/bjc.2012.112. Accessed on 16 May 2013 and available at http://www.nature.com/bjc/journal/v107/n1s/index.html Communicable Disease Report 2012, MOH: accessed on 16.09.2014 http://www.moh.gov.sg/content/moh_web/home/Publications/Reports/2013/Communicable_Diseases_Surveillance_in_Singapore_2012.html
  62. 62. © 2010 Government of Singapore A Great Workforce A Great Workplace 63 Cancer site: Attributable Fraction(%) Attrib Deaths (2005) Attrib. Registrations (2004) Male Female Total Male Female Total Male Female Total Bladder 7.1 1.9 5.3 215 30 245 496 54 550 Bone 0.0 0.0 0.0 0 0 0 0 0 0 Brain 0.5 0.1 0.3 10 1 11 12 2 14 Breast 4.6 4.6 555 555 1,969 1,969 Cervix 0.7 0.7 7 7 18 18 Kidney 0.04 0.04 0.04 1 1 1 2 1 3 Larynx 2.9 1.6 2.6 17 3 20 50 6 56 Leukaemia 0.9 0.5 0.7 18 5 23 30 9 38 Liver 0.2 0.1 0.2 4 2 5 4 1 5 Lung 21.1 5.3 14.5 4,020 725 4,745 4,627 815 5,442 Lympho-haematopoietic 0.004 0.002 0.003 0 0 0 0 0 0 Melanoma (eye) 2.9 0.4 1.6 1 0 1 6 1 6 Mesothelioma 97.0 82.5 94.9 1,699 238 1,937 1,699 238 1,937 Multiple Myeloma 0.4 0.1 0.3 5 1 6 8 2 10 Nasopharynx 10.8 2.4 8.0 7 1 8 14 1 15 NHL 2.1 1.1 1.7 43 14 57 102 39 140 NMSC 6.9 1.1 4.5 20 2 23 2,513 349 2,862 Oesophagus 3.3 1.1 2.5 156 28 184 159 29 188 Ovary 0.5 0.5 23 23 33 33 Pancreas 0.02 0.01 0.01 1 0 1 1 0 1 Sinonasal 43.3 19.8 32.7 27 10 38 95 31 126 Soft Tissue Sarcoma 3.4 1.1 2.4 11 3 13 22 4 27 Stomach 3.0 0.3 1.9 101 6 108 149 9 157 Thyroid 0.12 0.02 0.05 0 0 0 1 0 1 Total 8.2 2.3 5.3 6,355 1,655 8,010 9,988 3,611 13,598 Total GB cancers 15+yrs 77,912 72,212 150,124 175,399 168,184 343,583 Source: Rushton a.o.
  63. 63. © 2010 Government of Singapore A Great Workforce A Great Workplace 64 Cancer Site Asbestos Shift work Min. oils Solar rad n Silica DEE PAHs (Tars) Painters Dioxins ETS Radon Welders All Bladder 296 106 71 550 Brain 14 Breast 1,957 1,969 Cervix 18 Kidney 3 Larynx 8 56 Leukaemia 38 Liver 5 Lung 2,223 470 907 695 282 215 284 209 175 5,442 LH cancers 1 Melanoma eye 6 Mesothelioma 1,937 1,937 Multiple Myeloma 10 Nasopharynx 15 NHL 74 140 NMSC 902 1,541 475 2,862 Oesophagus 188 Ovary 33 Pancreas 1 Sinonasal 55 126 STS 27 27 Stomach 47 83 157 Thyroid 1 Total Attrib. Registrations 4,216 1,957 1,722 1,541 907 801 475 437 316 284 209 175 13,598 Source: Rushton a.o.
  64. 64. © 2010 Government of Singapore A Great Workforce A Great Workplace 65 10 leading causes of Deaths in East Asia Murray et al. Lancet 2012, http://www.healthmetricsandevaluation.org/gbd/visualizations/regional
  65. 65. © 2010 Government of Singapore A Great Workforce A Great Workplace 66 10 leading causes of Deaths in East Asia Murray et al. Lancet 2012, http://www.healthmetricsandevaluation.org/gbd/visualizations/regional WORK-related

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