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ASBESTOS RELATED
DISEASES IN SLOVENIA
M. Dodič Fikfak, A. Franko
UMC Lj, Clinical Institute of
Occupational Medicine
Ljubljana, SI
Important dates
1860
1922
1947
1996
1998
1999
Important dates
1860
1922
1947
1996
1998
1999
Nova/stara izpostavljenost
Important dates
1860
1922
1947
1996
1998
1999
National directives for asbestos
Aims
1. Legislation
2. Collect the data about:
– asbestos consumption,
– production of asbestos and asbestos-cement products,
– use of asbestos products
3. Collect the data about exposed workers
4. Collect the information about asbestos caused
morbidity and mortality
National directives for asbestos
Aims
4. Collect available air measurements
5. Collect the information about the location
of asbestos dump sides and assess the
quantities of asbestos waste material
National directives for asbestos
Getting information “Snow ball” princip
• Companies: » Salonit Anhovo
» Donit Tesniti
» Donit Filter
» Donit Laminati
» Fenolit
» Fragmat
» Izolirka
» TIT Velika Loka
» TVT Maribor
» TMT Velika Loka
» Slovenske železnice
National directives for asbestos
Getting information
Slovenian customs: • permit for import of asbestos in 1997
Ministry of Health: • Information about companies that demanded import-
export permit for asbestos products in 1998
Slovenian Cancer Registry: • Cluster analysis of mesotheliomas from 1959-1994
National directives for asbestos
Getting information
Questionnaire:
• Production • Quantities of asbestos use
• Quantities of products made
• Quantities of products sold at home market and
abroad
• Quantities and locations of products built in
different buildings (objects)
• “Lifetime” of produced products
National directives for asbestos
Getting information Questionnaire:
• Workers • Quantity of yearly employed workers in asbestos factory
• Quantity of yearly exposed workers
• Names of exposed workers, birth dates, gender…
• Asbestos related diseases
• Exposure limits for different time periods
• Health and safety education
• Asbestos air measurements, methods used, locations, plans of plants…
• Asbestos waste material (quantities, location: legal-illegal..)
• Do they want to educate workers
National directives for asbestos
Getting information
Information about asb buildings: • Schools (451+136) and kindergartens
• Cement-asbestos roofing and water pipes
National directives for asbestos
Results
Yearly consumption of asbestos from
1965 to 1997
0
5000
10000
15000
20000
25000
30000
1965 1970 1975 1980 1985 1990 1995 1999
asbesto
s in t
ons
Slovenia
Salonit Anhovo
Quantities of Amphiboles and Chrysotile (in
tons) Used in the Manufacture of Asbestos-
cement Pipes, 1963 to 1994
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
19
63
19
64
19
65
19
66
19
67
19
68
19
69
19
70
19
71
19
72
19
73
19
74
19
75
19
76
19
77
19
78
19
79
19
80
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
year
ton
s
amphibole chrysotile
Quantities of Amphiboles and Chrysotile (in tons)
Used in the Manufacture of
Asbestos-cement Sheets, 1963 to 1994
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
19
63
19
64
19
65
19
66
19
67
19
68
19
69
1970
19
71
19
72
19
73
19
74
19
75
19
76
19
77
19
78
19
79
1980
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
1990
19
91
19
92
19
93
1994
year
tons
amphibole chrysotile
The diagnosis
State Board for the Recognition of
Occupational Asbestos Diseases:
• occupational physician
• pulmonologist
• radiologist
PLEURAL DISEASES
• plevralni plaki
• difuzne zadebelitve
plevre
• plevralni izliv
AZBESTOSIS
• brazgotinjenje pljučnega
tkiva
• bolezen napreduje tudi po
prenehanju
izpostavljenosti
• povečano tveganje za
razvoj pljučnega raka
LUNG CANCER
Date of hire, date of diagnosis and quantity of
asbestos used by fibre type and by year
0
10
20
30
40
50
60
70
1923 1928 1933 1938 1943 1948 1953 1958 1963 1968 1973 1978 1983 1988 1993
n. o
f w
ork
.
0
5000
10000
15000
20000
25000
t o
f a
sb
./year
date of hire date of diagnosis
amphibole
chrysotile
MESOTHELIOMA MLG.
• The most agresive mlg. disease
• Avr. survival time: 17 months
• Latency period: up to 65 years
• Also at low eposure
Expeced number of new cases of
mesothelioma
2 3 1224
4158 58
103
149
y = 2,3766x2 - 6,8662x + 9,0714
R2 = 0,9704
0
50
100
150
200
250
300
61-65 66-70 71-75 76-80 81-85 86-90 91-95 96-00 01-05 06-10 11-15 16-20
Year
Nu
mb
er
of
cases
Kanal
OTHER CANCERS
• Laryngeal ca
• Ovarian ca • Buccal mucus ca
• Esophageal ca
• Kidney ca
• Intestinal ca
NUBER OF ASBESTOS RELATED
DSEASES IN SI, 1998 – 2013/2016 Dseases Number Salonit Number Sl Difference
No diseases 553 715 162
Asbestosis 404 448/559 44
Pleural plaques 1070 1189/1866 119
Mesothelima 93 127/189 34
Lung cancer 49 52/74 2
Intestinal ca 10 10 /
Laryngeal ca 1 2 1
Other ca 30 30 /
Mesothelioma&Lung ca 1 2 1
Intestinal ca & ca uteri 1 1 /
All 2212 2586 374
Results
DISEASE # AGE
years
Gender M
%
Gender F
%
CumA
Exp A
asbestosis 448 62.5 28.6-93.9
71.5 28.5 31.8
pleural dis. 1188 58.3 31.1-93.6
71.5 28.5 15.5
mesothelioma 127 61.9 36.5-84.7
64.5 35.5 19.6
Lung cancer 52 62.6 41.6-84.8
87.8 12.2 19.2
GIT cancer 10 60.5 55.2-65.7
80.0 20.0 25.2
Results, disease/no disease
DISEASE CumAsbE
xp A
T p
asbestosis 31.8 7.3 0.000
pleural dis. 15.5 5.1 0.000
mesothelioma 19.6 3.3 0.001
lung cancer 19.2 3.5 0.000
GIT cancer 25.2 2.6 0.009
Compensation
• Pleural diseases
• Asbestosis
• Mesothelima
• Lung cancer
• Environmental mesothelioma
• Others: gastrointestinal, laringeal (court)
ASBESTOS RELATED DISESES,
COMPENSATION – 2014 (Bechibani)
DISEASE MAX. COMPENSATION, EURO
PLEURAL DISEASES 13.394,74
PLEURAL EFL. 14.573,47
CHR. PLEURAL EFL 17.393,41
ASBESTOSIS 23.507,07
MESOTHELIOMA, LUNG CANCER… 46.991,55
60% RS – 40% EMPLOYER
100% RS
EMPLOYER DOES NOT EXIST + ENVIRONMENTAL
MESOTHELIOMA
THE STORM 2008
THE STORM 2008
“Cleaning actions”
i.e Clean Slovenia in one day
Vinaz
Ministry of health
2nd National directives for asbetos
Thank you for your attention
Univerztetni klinični center ljubljana Klinični inštitut za medicino dela, prometa in
športa
