Asian Ban Asbestos Network (A BAN) Conference Report

Transcription

1 Asian Ban Asbestos Network (A BAN) Conference Report Hanoi, Vietnam September 6 7,

2 Table of Contents Opening speeches... 3 Philip Hazelton ILO, Hanoi Office... 3 Dr. Gabit Ismailov WHO, Hanoi Office... 4 Sharan Kumar APHEDA... 5 Presentations... 6 Prof. Ken Takahashi, University of Occupational and Environmental Health (UOEH), Japan... 6 Mr. Sugio Furuya, Coordinator, Asian Ban Asbestos Network (A BAN)... 8 Comments and Discussions:...11 Victims testimonies...13 Presentations...14 Mr. Ram Charitra Sah, Center for Public Health and Environmental Development (CEPHED)...14 Mr. Kam Hong CHAN and Ms. Sin Man SU, Association of the Rights of Industrial Accident Victims (ARIAV), Hong Kong...16 Mr. Peter Tighe, CEO of the Asbestos Safety and Eradication Agency, Australia...17 Dr. Luong Mai Anh, Health Environment Management Agency, Ministry of Health, Vietnam...18 Mr. Paul Bastian, National Secretary of Australian Manufacturing Workers Union (AMWU)...20 Comments and Discussions:...20 Group discussions...22 South East Asia group:...22 East Asian group:...22 Vietnam group...24 South Asia group:...22 Asbestos Monitoring Project Mr. Yeyong CHOI...25 Solution of substitution to asbestos in roofing sheet manufacturing in Vietnam Presentation by Dr. Do Quoc Quang, Former vice Director, Institute of Technology, Ministry of Industry and Trade...28 Comments and Questions...30 Dr. Barry Castleman, Environmental Consultant, USA Discussions:...32 WHO s film on asbestos...34 Feedback from the Rotterdam Convention Mr. Sanjiv Pandita...34 A BAN2015 Discussions on Future cooperation to advocate for chrysotile s ban in the region

3 A BAN Conference 2015 The A BAN conference was held on September 6 7, 2015 in Hanoi, Vietnam. The A BAN Coordinators welcomed all delegates and thanked VN BAN for hosting the conference. Opening speeches Philip Hazelton ILO, Hanoi Office Mr. Hazelton expressed great pleasure to be present at an important moment in the long campaign to eradicate chrysotile asbestos from the region. He stated that the ILO applauds all those present who have campaigned, often over a very long time, and against powerful industry interests, for the health, safety and protection of communities and workers across Asia from exposure to this deadly fiber and extended special congratulations to the newly established Vietnam Ban Asbestos Network (VN BAN) in which few individual Vietnamese voices have been able to come together and through strategic and determined efforts advocate, inform and promote a safer healthier non asbestos future for Vietnam. The collaboration of a range of NGOs to form VN BAN over the last 18 months is a fantastic further step in that process. 2

4 He mentioned that Vietnam has taken some significant steps in revising its position towards chrysotile, for example the recent change with regards to the position on chrysotile in Annex 3 of the Rotterdam Convention and support from the government in relation to seriously looking at a ban of chrysotile in the coming years. Now is the time however to push through and seek a firm commitment and date for such a ban. Industry will need time to adjust. Industry needs that signal from government to set a timetable for a complete ban. He laid out the different range of international instruments (Conventions and Recommendations, ILO Resolutions and Codes of Practice) which ILO and WHO has been promoting with the Vietnamese Government. These international instruments provide solid legal bases as well as practical guidance for comprehensive preventive measures at the national and enterprise level in order to protect workers and prevent asbestos related diseases. 1. These include the ILO Asbestos Convention, 1986 (No. 162), provides for the measures to be taken for the prevention and protection of workers against, health hazards due to occupational exposure to asbestos. 2. The Occupational Cancer Convention, 1974 (No. 139), provides for the measures to be taken for the control and prevention of occupational hazards caused by carcinogenic substances and agents. 3. A Resolution concerning asbestos was adopted by the International Labour Conference at its 95th Session in Noting that all forms of asbestos, including chrysotile, are classified as human carcinogens by the International Agency for Research on Cancer (IARC), and expressing its concern that workers continue to face serious risks from asbestos exposure, particularly in asbestos removal, demolition, building maintenance, ship breaking and waste handling activities. The Resolution underlined that the ILO Convention on Safety in the Use of Asbestos, No. 162, should not be used to provide a justification for, or endorsement of, the continued use of asbestos. Mr. Hazelton also shared that in recent times technical advice to the first stand alone National OSH Law was given leading to the passing in June this year by the National Assembly, support to the ratification of ILO Convention 187 in 2014, promoting a ban on chrysotile and taking the unusual step of directly writing to the Vietnam PM jointly with WHO, urging such a ban by He wished the conference a big success and move Asia forward to implementing a ban on Chrysotile Dr. Gabit Ismailov WHO, Hanoi Office Dr. Ismailov expressed great pleasure to speak on behalf of the World Health Organization at the A BAN Annual Conference in Hanoi and was very pleased to learn that VN BAN has now joined forces with the asbestos ban movement in Asia aiming to protect people s health from this hazardous substance. He stated that the conference is a very important event bringing together scientists and activists particularly around Asia a region with the highest asbestos consumption in the world. This Conference is an excellent opportunity for countries to share effective measures for banning the use of asbestos as well as putting forward options for asbestos alternatives. He reiterated that Asbestos has long been recognized as a carcinogen causing one third of occupational cancer deaths and that the best way to prevent asbestos related diseases is to stop using asbestos completely. However, in reality the answer is more complex than that. International experience shows that even the most irrefutable public health arguments are often insufficient for making right policy choices. Economic argument, low cost of asbestos containing products, is often cited as an argument for continuing use of asbestos, particularly in the context of care for the poor by providing cheap roofing. He however stated that the low cost should be considered not only against compensation costs for asbestos industry workers with ARDs but also costs of healthcare for people living in houses with toxic 3

5 roofing. Future costs of removing asbestos containing materials have proven to be very substantial in many other countries that delayed banning asbestos. He mentioned that unlike tobacco, asbestos is an old toxic technology being abandoned throughout the developed world at a great cost, has safe substitutes that are already being produced in industrial quantities in Viet Nam, ironically mostly used for export. The non asbestos roof sheet technology developed in Viet Nam provides opportunity for local jobs and for Viet Nam to position itself in green industry in the region. He commended the Government of Viet Nam for issuing Decision 7307 in September 2014 that outlined clear pathway towards phasing out the use of asbestos in Viet Nam and the changed position on inclusion of chrysotile in Annex 3 of the Rotterdam Convention. He stated that now is a critical time for relevant Ministries to take actions in implementing this important decision to protect the health of the people and believed that the UN and the civil societies have an important role in providing technical assistance as well as monitoring the implementation of this process. Sharan Kumar APHEDA Mr. Sharan stated that this meeting is another important step in a challenging journey to bring an end to asbestos related diseases suffered by workers, members of their families and the general community. For the Australian trade union movement, this journey began many years ago when workers began to fall sick from asbestos related diseases. Australian workers also realized that they have to help workers in the region and so it started its asbestos solidarity work in 2000/01 when we began work to help rebuild Timor Leste or East Timor. Here in Vietnam, APHEDA started its asbestos initiative in February 2010 in partnership with National Institute of Labour Protection (NILP) and the Australian Manufacturing Workers Union. Within NILP, National Resource Centre on Asbestos was set up to conduct health monitoring of the asbestos exposed workforce, investigate non asbestos roofing material and produce training material to help at risk workers to minimize their exposure. He added that since then, there has been a sea change in the asbestos discussions and we are now at the stage when we can see the light at the end of the tunnel the possible banning of asbestos in the near future in Vietnam. He acknowledged the tireless work and dedication of the many individuals who have given their time, resources, and skills to the goal of banning asbestos and elimination of asbestosrelated diseases in Vietnam and added that they have gone beyond the call of duty in their efforts to bring greater awareness of how destructive asbestos is. These individuals include the previous APHEDA regional manager, Phillip Hazelton, APHEDA s Program manager, Hoang Thi Le Hang and APHEDA s Project Officer Dr. Vinh Thuan Pham. He also acknowledges the support of Professor Le Van Trinh, the previous NILP executive director, Ms. Mai Anh, HEMA deputy director, Madam An, National Assembly member and Dr. Thuan and Madam Van from VN BAN whose leadership and contribution in this journey will always be appreciated. He said that they are not only the organization working on asbestos in Vietnam. There are equally enthusiastic individuals and organizations around the table here, such as WHO, BWI, AMRC, CDI, A BAN, as well as sisters and brothers from other countries who bring different and necessary strengths to this effort to ban asbestos in Vietnam. Looking at the deadly and devastating impact which asbestos has on the health of workers, their families and members of the community, there is a need to work together to achieve the ban. A ban on asbestos in Vietnam will also impact the other nations in the region. It will be the model for others working in the other countries to aspire to. Therefore, the results of our work will extend beyond Vietnam. 4

6 The journey ahead is challenging. It is not helped by the fact that there are vested interest groups who are trying to deliberately confuse the issues so that the banning process can be postponed. We need to learn lessons from countries like Japan, Korea, and Australia etc who have gone through this journey and gained experience in dealing with the entire process. Hopefully Vietnam and countries in the region will not have to repeat the same mistakes to learn the lessons here. The onus is on us to work cooperatively together. We have to be strategic, smart and stay focused on our goal the banning of asbestos in Vietnam first, and the rest of the countries in the region next. This calls for real cooperation. Although Australia has banned asbestos in 2003, the number of mesothelioma cases is rising. We are now witnessing the third wave of asbestos related diseases. The first were the miners who contracted deadly mesothelioma and lung cancer; the second wave was the people who worked directly with asbestos in factories, unloading it at the docks, or as builders, plumbers, electricians and carpenters. Now, we see the third or bystander wave. These are women who washed their husband s asbestos laden clothes; as well as children who inhaled asbestos from their father s work clothes. Increasingly, home renovators are also having asbestos related diseases. This is the challenge for Vietnam and other countries in this region the impact of asbestos will live on for long after it is banned; and our efforts must continue to bring greater awareness of how we can prevent asbestos related diseases in the future. There are over 3,000 products which are manufactured using asbestos. Without a ban, workers and their families will continue to die a painful death. This meeting will move us closer to that goal. Presentations Prof. Ken Takahashi, University of Occupational and Environmental Health (UOEH), Japan Thank you for this invitation and I am very pleased to share my thoughts. The title of my talk is Asbestos and ARDs a Global Health Issue. So the single message that I want to convey is, Asbestos and ARDs is a global health issue. I want to start off by asking a question to the audience on what global health is and how many of you think asbestos and ARDs is a global health issue. OK. My core message today is to make the case that Asbestos and ARD is a global health issue and I hope I can convince as many people as I can. My presentation today will only reflect my personal belief and experiences. But I can say with confidence that I have long standing respect for and also adhered to WHO declarations and recommendations on Asbestos and ARD. Here I use the definition released this year by PubMed a database of scientific articles in the field of medical and health fields. They now officially use it as a keyword to characterize articles. I am not going to read out the entire definition but the few keywords are, multi and inter disciplinary field, equity and health, transcends national boundaries and it combines population disease prevention with patient care. To prepare my talk I have two bases. One is the seminal key paper by Kaplan that defines what global health is, a paper published in Lancet in The second one is the statement that came from the Collegium Ramazzini on June 30th this year entitled, Global Health Dimensions of Asbestos and ARD. What is global health? It actually is a combination of two important concepts; the first concept is prevention in populations. In that sense there is huge overlap with public health. The other concept is, it also embraces the clinical care of individuals. Now at this point many people get confused, including me; we know the term public health and international health, so what s the difference? Well public health mostly concentrates on prevention in populations; in that sense it is very close to global health. But the other thing that global health also embraces is the clinical aspects as well as the basic sciences. But all these concepts, global health, international health and public health aspire to promote social and economic equity. The other way of saying this is to reduce disparities. 5

7 If there is one take home message that I would ask you to remember is how global health is uniquely different. What I am saying is that asbestos is a global health issue and it comes down to these concepts. 1. Geographical reach: What it means is that it reaches out crossing many boundaries, and transcends national boundaries. 2. Inter disciplinarity: It involves a range of disciplinaries. We often used multi disciplinary but now the buzz word seems to be inter disciplinary. This means we just don t engage many disciplines but connect different disciplines. 3. Level of cooperation: this requires cooperation at the global level. I looked up the PubMed database of medical literature for the word global health. When we say keyword, it is not the author writing the articles who gives it. There is a profession called the indexers at the National Library of Medicine of USA who objectively reads and attaches the keyword, so it is an objective keyword. As I said this keyword or descriptor started only in 2015 but there are more than 13,000 articles on global health. Indexers read articles and if they find global health as the main theme they attach the keyword to that article. This is done also retrospectively for earlier articles. The typical themes that come to mind about global health is climate change, globalization, HIV, tobacco control, smoking, obesity, injury prevention and so forth. But we never see asbestos considered as a global health issue. And that s the point I want to make and we want to change this. Now on the other hand if we look at articles on asbestos as the main theme of papers we have more than 16,000 of them. My impression is that 16,000 articles written on asbestos aren t that many. Now I look into the dissecting idea, there are 74 articles that had both global health and asbestos as the keyword attached by the indexers. Of the 74 articles, 42 articles dealt with the field or discipline of occupational health. The other keywords were world, global, universal and ban asbestos; it was the most frequent keyword that was attached/or could be attached. The authors, the first one were the Collegium Ramazzini, and there is a reason for that. This academic association published many articles since 1993 on the need to globally ban asbestos. In this slide we show few of the famous articles on the issue. The 3rd statement in 1993 by the Collegium Ramazzini was the first to say about the need for a global ban on asbestos. The paper by Julian Peto was the first to use the word epidemic for the European mesothelioma situation. And of course WHO has a very important declaration on the need to eliminate asbestos related diseases. We all know ILO and WHO jointly published the outline for the National Development Program for the Elimination of Asbestos Diseases (NPEAD). The next is Joseph LaDou, The Case for a Global Ban on Asbestos. When a theme is considered a global health issue, one important criterion is evaluating the burden of disease. The declaration made by WHO in 2006 said the most efficient way to eliminate ARD is to stop using all types of asbestos. My team tried to faithfully follow this statement and we compiled data which supported this very important claim. Recently WHO acknowledged such work by saying that the national burdens of asbestos diseases are directly proportional to the national consumption of asbestos. And for WHO to say that, it justifies the call on ban of asbestos usage. The most important aspect of the recent IARC monograph is the addition of cancers of the larynx and ovary to the already included lung cancer and mesothelioma which are related to asbestos. The monograph is a huge review of the scientific literature. IARC also inserted in this issue the global health aspect showing regional disparities in terms of the per capita asbestos use. We were fortunate to have our paper referenced in it. The Collegium Ramazzini Statement is a 7 page paper. And I already mentioned the three aspects, namely geographical area, inter disciplinarity and level of cooperation at the global level. 6

8 Typically when we think of global health diseases, we think of Ebola; no one would disagree that Ebola is a global health issue similar to HIV/AIDS. But if you think about Ebola, Africa has many patients and the work is still in progress but these epidemics affect populations for fairly limited periods. Many of the diseases eventually diminish but asbestos affect populations over sustained periods of time. Even after countries stop the usage of asbestos, the effects of asbestos will continue and linger for decades. So asbestos and ARDs are a lasting global health issue. One unique aspect of global health issue is its diversity of concerned parties like we have here today. People from many different backgrounds such as researchers, administrators and activists are here. So we need a diverse global partnership. As I mentioned earlier, the issue is not a matter of only developing or only developed countries but it s a problem of both. So we have to involve social and behavioral sciences, and some with a background in law and economics, some coming from engineering and bio, and so forth. Although I started off my talk by referring to public health which may have alienated a few of you, but in the end, global health is truly about inter disciplinary and multi disciplinary approach. Lastly, I take this slide directly from the Collegium Ramazzini, Industrial countries that have already gone through asbestos ban have learned their lessons and acquired know how and capacity. This is called soft technologies that can be of great value if they are deployed in industrializing countries who are embarking on this transition, that is from a using status to a non using status. So this collaboration between industrialized and industrializing countries can and should be led by industrial organizations, the scientific community and all grass roots NGOs and should involve practitioners, administrators, researchers and civil society. This is very much in line with the criteria for global health. Mr. Sugio Furuya, Coordinator, Asian Ban Asbestos Network (A BAN) Mr. Sugio Furuya updated the gathering on the current asbestos situation in Asia and the world. This slide shows the total consumption of asbestos in the world. The total consumption of asbestos peaked to about 5 million tones in the late 70 s then rapidly decreased until 2000 but since then it has remained at around 2 million tones. The rapid decrease in consumption of asbestos during the 80 s and 90 s was due to the stopping of usage in Europe and North America. But in contrast even after 2000 asbestos consumption in Asia is still increasing. This shall result in asbestos epidemic in Asia in the future. There was an increase in consumption in Europe in 2013 & 2014 because of increase in consumption in Russia (Russia & Central Asia included in European figures). The next slide shows the proportion of continent consumption to the global consumption, asbestos consumption proportion is more than 70% in Asia and Middle East in 2012 compared to the global consumption. In other words Asia is becoming the main target for the asbestos industry. This slide shows the biggest exporting countries of asbestos. Historically Canada and Russia are the biggest producers and exporters of asbestos. Canada has finally stopped to produce and export asbestos in 2012, and Russia has continued to increase its production of asbestos. China consumes nearly all of its domestically produced asbestos and it imports asbestos from Russia but now China s exports are slowly increasing. As some of you may remember the recent A BAN campaign delegation to Canada in the end of 2010 to Stop New Asbestos Mine Development Projects and Stop Asbestos Exports to Asia. So Canada s stopping production and exporting of asbestos is a victory of our campaign. This slide shows the situation of asbestos in Russia. Russia s production of asbestos is increasing but the consumption is decreasing hence the export of asbestos is increasing. Thus Russia is becoming the new Merchant of Death. In Russia export of asbestos has decreased mainly due to the global economic depression so Russia is trying to increase its exports again. Real situation in Russia is still unknown; however actions by grass root groups have started. One of such groups Volgograd Ecopress Information Center organized a workshop in I was invited to this meeting by the leader of this 7

9 group Ms. Elena Vasilieva, she wanted to be part of this conference but unfortunately she had trouble arranging her travel here. This slide show the top 10 asbestos consuming countries in recent years, you can see countries China, India, Indonesia, Vietnam and Thailand featuring in the list. This slide is by International Ban Asbestos Secretariat, a comparison of National Asbestos Ban from 2000 to years ago there were only 20 countries which introduced Ban on consumption of asbestos now as many of 50 countries have introduced a ban on asbestos. This slide shows chronology of asbestos bans. Japan introduced Ban in 2004, Korea introduced ban in 2007; Singapore prohibited the use of asbestos in construction in 1988 and import of raw asbestos in In Brunei Ministry of Development has introduced administrative rules and prohibitions on use of asbestos in 1994 but I still think peer review is required to ascertain this for Brunei. In April last year Hong Kong finally implemented ban on asbestos. Hong Kong Pneumoconiosis Compensation Fund Board held a conference Joining Hands to Eliminate Asbestos Hazards in November Hong Kong government had said banning asbestos to reduce the risks to its exposure has become an international trend. Amended Air Pollution Control Ordinance will further reduce the risks to public exposure and environment by imposing a total ban on asbestos. Except for goods in transit and few registered Chinese medicine, imports and trans shipments of asbestos in all forms are banned to prevent asbestos from entering Hong Kong. This is Asbestos abatement charter in Honk Kong s statement, we are committed to discontinuing completely use of asbestos in construction material in Hong Kong. In Hong Kong trade unions and civil societies organized No More Asbestos in Hong Kong Alliance and advocated for eliminating asbestos hazards for many years. In the end of last year we received good news from Nepal. The Ministry of Science and Technology and Environment had released a notice in the Nepal Gazette on December 22nd, to ban import, sale distribution and use of asbestos. This also covers corrugated/non corrugated sheets, tiles, insulation and other asbestos containing material except for lining in brake shoe and clutch plate. The decision based on Environmental Protection Act 1997 and has automatically come into force in June this year. So Nepal has become the first country in South Asia to introduce ban on asbestos. Along the way there have been several joint delegations with trade unions which submitted a memorandum to the Nepal Prime Minister. Center for Public Health and Environmental Development has campaigned for ban on asbestos for two years. These pictures show destruction of asbestos sheets in Kathmandu courtesy of Mr. Ram. We have one more good news from Sri Lanka, the country s President assured to take steps to ban the import of asbestos by the year This is only on imports, but the President made clear of his intentions for total ban on asbestos last month. 8

10 The previous A BAN meeting was held in Dhaka, Bangladesh in At that time Bangladesh Ban Asbestos Networks (B BAN) was established since then there were various efforts from various parties. An international asbestos conference was held in Bangkok, Thailand in last November. Asbestos conference was held in Karachi, Pakistan last year and again this year. International Commission on Occupational Health (ICOH) conference was held in Seoul, Korea in June this year and a special session on Asbestos Program in Asia was organized by Professor Domyung Paek In particular there has been substantial development in Vietnam which we will hear later today. I visited Vietnam in 2004 for the first time to attend a meeting by National Institute of Labour Protection & AMRC and made a presentation on asbestos. VN BAN launch meeting was held last November. In addition we are seeing big developments in Laos and Cambodia. It is very meaningful that we have this meeting in Hanoi. I ve tried to classify Asian countries for seeking our strategy to achieve ban on asbestos. Type A countries: Japan, Korea, Singapore, Hong Kong and Taiwan will join by Legal ban on import and use of asbestos has been introduced in these countries but it is still needed to monitor its enforcement. Asbestos victims are increasing. Improvements in diagnosis, treatment, register compensation and empowerment is needed. Public awareness is relatively high but still not enough and as time passes it may decrease. Huge amount of asbestos still remain in our environment. In order to eliminate asbestos related diseases national strategic plan with a road map and implementation structure for making our society free from asbestos is required. Type B countries: Malaysia, Vietnam, Thailand, Philippines. There has been asbestos debate for more than 10 years and voluntary phase out plans have been established. Asbestos import has been decreasing but pro asbestos lobbying by international industry is really increasing. How to get political decision to introduce legal ban on asbestos as early as possible? Asbestos victims are becoming visible, mesothelioma cases have been detected and reported but compensative cases are very few. Voices of real victims should give great impetus for tackling asbestos issue in those countries in the future. Public awareness is still not enough. Existing regulations against asbestos are insufficient and lack of strategic approach for making our environment free from asbestos. Type C countries: Nepal, Cambodia, Bhutan, Myanmar, Laos, Bangladesh. Asbestos import and use in these countries is relatively small and there is no official data. How to make asbestos a national agenda and how to make political decisions a main subject? Asbestos victims don t exist or invisible. Public awareness is very limited almost no rendition on asbestos. Even if legal ban was introduced its enforcement, raising awareness, establishing basic structure to tackle various aspects of asbestos are needed. Type D: India, Indonesia, China, Pakistan. Asbestos consumption is the largest in the world and is still increasing. Power of local asbestos industries is strong. How to attract attention of major politicians and how to strengthen local initiatives against and national networking is subject to discussion? In these countries asbestos victims already exist but invisible. I would like to emphasize the importance of mesothelioma cases. Public awareness is very limited, lack or limited rendition and/or lack of limited enforcement. All the countries can start from international instruments to consider practical actions against asbestos and I guess those are enough for decision making. National Asbestos Profiles have been developed for 5 countries: Vietnam, Mongolia, Japan, Philippines and Germany. Laos will develop within this year followed by Nepal, Cambodia and so on. Banning asbestos is the first step but there are various issues to be tackled and national programs are required not only for countries who have not introduced ban on asbestos yet but also for countries who had introduced the ban. European Parliament adopted a new resolution on asbestos in 2013, this resolution asked EU for an Action Plan to achieve asbestos free society by Australia has 9

11 established New National Agency to implement a strategic plan. In order to achieve the elimination of asbestos related disease, the first step is immediate ban on asbestos; the next step is setting target timeline for achieving asbestos free society and environment. This slide show the current situation which I d already explained earlier. I m expecting Malaysia, Department of Occupational Safety and Health shall conduct public consultations on banning asbestos very soon. There have been substantial developments in Vietnam and Thailand. Unfortunately Thai cabinet was unable to make a decision in the end of last year but efforts are continuing. In the Philippines, the Government, academicians, trade Unions are working together towards the ban on asbestos. I also hope any other Type C country can introduce a ban on asbestos following the lead of Nepal. Anyway Asia is moving towards the ban of asbestos, also Australia and EU are showing the next stage of eliminating the asbestos related diseases. We strongly recommend you to learn experience lessons from Hong Kong, Nepal also learning about coalition building in Thailand T BAN, Bangladesh B BAN. I hope this conference shall become a landmark event for the effort in your country, Asia and the World for banning asbestos and eliminating asbestos related diseases. Thank you very much. Comments and Discussions: 1. Dr. Nguyen An Luong from Vietnam: In Vietnam there are an interest group, represented by the Vietnamese Association of Roofing Sheets. They argue that there is still inconclusive proof that asbestos is carcinogenic. They invited Vietnam scholars from countries like Canada, Brazil and Switzerland (a Swiss scholar received 1 million dollars from Chrysotile Institute to conduct research to prove that asbestos is harm free). These three scholars announced to the Vietnamese media that asbestos is not carcinogenic and that WHO and other international research institutions are wrong about asbestos. Therefore, I urge that scientists in this A BAN conference can state clearly and firmly to all Vietnamese media and participants that asbestos is carcinogenic, that there is no safety level in asbestos exposure. Your restatements are important as it will clear away all doubts shrouding the current discussion on asbestos in Vietnam. The pro asbestos group also argues that there are now only about 50 countries in the world which prohibit asbestos use and by subtracting; they say there are more than 140 countries which still use asbestos. This is completely wrong. There are only 30 countries where asbestos is still in use, of which Vietnam is among the top ten biggest consumers. Countries like Russia, China, and Brazil are big exporters so they evidently cannot ban asbestos. Few countries have ban on domestic use of asbestos and if the local businesses use asbestos they need to pay penalties and compensations but 10

12 they still export asbestos overseas. America does not outlaw asbestos use but their consumption is so minimal (a reduction from 350 million tons to nearly 900 tons, which is also not used to produce any consumer goods). We also need to reaffirm these facts to avoid misleading and manipulating arguments from pro asbestos side. 2. Mr. Sugio Furuya: Ken s presentation and reports from ILO, WHO and other international organizations are the most comprehensive review on scientific evidence regarding asbestos. And they conclude that the scientific consensus is that asbestos is carcinogenic. So if someone claims that there is no scientific evidence for these reports, that there is no consensus on asbestos harm, they should prove it by writing English papers available to international community for review. Western countries or Japan have failed in avoiding ARDs. But ARDs are avoidable diseases so there is no need for Vietnam and other countries to repeat these same mistakes. We need to act before the epidemic begins. There is a similar discussion in many other countries as they try to phase out asbestos. For example in Japan, we introduced a ban in principle in 2004 and we have achieved a full ban by The same process might be more time consuming in other contexts, other countries. However, the number of asbestos banning countries must be over 50, nearly 60 as of now. 3. Prof. Ken Takahashi: there are several reasons for lack of scientific evidence in Vietnam. First, the period of exposure to asbestos since you started using asbestos in Vietnam is relatively short. Vietnam only started using asbestos as a building material since 1960s. So there is insufficient time for ARDs especially mesothelioma which need at least 30 years, sometimes 40 years or more, to develop. Another reason is the relative poor infrastructure in Vietnam to conduct valid scientific studies. It is difficult to diagnose ARDs which require pathological confirmation, which is only introduced to Vietnam very recently. We need to identify mesothelioma which is evidence that ARDs exist. But conditions to diagnose, confirm, report, record these cases is at very early stage of development in Vietnam. Another reason is lack of not only medical expertise to diagnose ARDs but also lack of exposure confirmation, which is easier said than done. It remains difficult to pinpoint exposure several decades ago and to link exposure with diseases. However, scientific evidence, not local but international evidence is already abundant and sufficient to confirm asbestos harms. So the lack of evidence in Vietnam does not have to be a problem. Many international organizations and scientific bodies have published extensive review documents on asbestos. I think Vietnam and other countries need to give weight to the evidence of asbestosrelated diseases. There might be opposing arguments or sporadic papers which try to refute these widely acknowledged views but they are only minority views expressed by authors with interest conflicts. Increasingly, with practices requiring researchers to disclosure their interest conflicts, we will know more about dubious motivations behind pro asbestos research. So we reconfirm that there is no scientific evidence that asbestos can be used safely. 4. In Vietnam, there is research which claims that white asbestos is harmful but as it is mixed with cement in roofing sheets, the roofing material structure is stable enough to ensure no remittance of asbestos into the environment, which makes it harmless. And in India, when taken to the Supreme Court in 2011, a factory submitted a report from International Chrysotile Association which stated that roofing sheets are safe with just 0.6% of chrysotile mixed with cement. In response to these arguments, we can look at Japanese experience. In Japan there is literally an asbestos ban with no exception. This covers products for military purpose, and naturally occurring asbestos containing products. It is strictly prohibited to import and use any products containing more than 0.1% of asbestos. Japanese government also confirms that there are safer materials, that there is no asbestos containing products for which no safer material exists. However we need to increase public awareness on this issue. 11

13 5. In India, there are some recent positive changes. The first change is the huge number of workers exposed to asbestos that have been identified and compensated. Secondly, Indian Railway Company has changed the roofing sheets on their platforms to non asbestos material without making any public announcements. One of the biggest asbestos manufacturers also announced that they are going to replace the asbestos products with non asbestos ones. 6. To identify workers who are exposed to asbestos in the past is very important. The logical step would be to start with those who are currently exposed as it is easier and you can establish a system to follow up with them for the next years. But later we should begin with the people exposed in the past. Of course there is logistics difficulty in identifying those workers. In Japan, there is a system called health system diary for workers exposed to asbestos. Once they are issued these diaries, as long as they present these diaries to clinics, they are entitled to periodical health checkups and this has been going on for 40 years now. As ARDs require long time to manifest, we need long time follow up. Victims testimonies 1. Mr. Rajendra Pevekar from India: My father used to work for a Hindustan Ferro Dye Asbestos company. On May 28th, 1970s, he joined the company as a sweeper and was exposed to dust, fiber, chemicals and asbestos dusk during his work. When he came home, we would wash his clothes and breathed in asbestos dust. As a child I would ask him: papa, what is this on your clothes. He would say it 12

14 was nothing, only factory dust. My father was very fond of me, I would play with him, laid down on his chair, sleep with him during the nights. He did not have habit to change his garments at the end of his shift, only changed his clothes in the morning after the shower. So during the nights, when I played with him, laid on his chair, his garments were laden with asbestos dust. My mother used to look after his clothes, washed these clothes thus she was also exposed to asbestos dust. In July 1992, when my father was at his work, he had a heart attack and later died at the hospital. In 2010, we were approached by the Occupation Health & Safety Center in Bombay and were offered health check. Our x ray results were found with scars in the lungs. I had to admit my mother to hospital 10 times. Due to treatment cost, I am in heavy debt. We both experienced a lot of health problems. Mr. Rob Moore has made a documentary movie on our problem and shown it all over the world. So that people came to know about our problem. Joining this network, we are empowered and get opportunities to meet doctors, activists, and people attending this meeting. We get so many benefits attending these meetings. I m thankful to all for giving me this opportunity to attend this meeting. 2. Mr. Ji Yol JUNG from Korea: We are living close to asbestos mine explored during Japanese colonialism. Among 71 family members living nearby the mine, 26 people (37%) get ARDs; of which 10 people (38%) die and the other 16 (62%) are still alive. 14 people are occupation exposed and 12 suffer from environmental exposure. 8 people died before relief system advent and only 18 people get relief. Of which 4 people get lung cancer; 10 people asbestosis and 4 others are monitoring cases. I am now chair of Ban Asbestos Network of Korea (BANKO) and Victim Organization. In Korea, there has been BANKO since The relief system for environment exposure cases was established since Since then, about 600 ARDs victims and their families have got relief. At this moment, a total of 739 people get monthly relief supports from relief system. Every month, a dozen of new ARD cases are accepted into the system. In Asia, many countries still use asbestos and they do not have proper compensation system for their victims. We have to work closely and collaboratively with victims initiatives and campaigns and share experience from countries like Japan, Korea. These efforts can eventually lead to A BAN on asbestos in the world. 3. Mr. Dong Wook HWANG from South Korea: My father is a mesothelioma patient. My father s case symptoms were displayed in Sep 2011 and exactly one year later, he passed away. When he got first symptoms, during the first 3 months, they think it is tuberculosis, not mesothelioma, so my father s case was not easily diagnosed. I heard about the Global Health in the plenary session, I believe family global health is relevant in addition to the personal global health. This is my first time to attend A BAN meeting. My experience from the last 2 days is that most people are experts & activists so they focus on social issues & their dynamics. I m social welfare workers in Korea. My concern is that the sickness situation should not give the burden to the families and I want to contribute to making a support system so that the personal tragedies will not result in the breakdown of families. Presentations Dr. Ram Charitra Sah, Center for Public Health and Environmental Development (CEPHED), Nepal Thank you gentlemen and I am pleased to share a small success story. We are an NGO and our goal is to preach science and technology to the people. We are working on several environmental and public health issues. Through our work we have become partner with numerous organizations working on health and environment issues. Our work at the ground level has been recognized at both national and international level. In 2011 our center was awarded with PCB elimination award while working on the PCB pumps issue. UNCOP s convention secretary gave us an award and it was also recognized by the Government of Nepal and the Ministry of Environment bestowed us with the Environmental 13

15 Conservation Award. In 2012 our success story was a part of UN publications. We are working with mercury related health concerns by providing free dentistry care to the people affected by this issue. We have also been serving in some of the technical committees like the Chemical Safety Committee, Environmental Standard Formation Committee of the Nepal Government. Nepal is a small landlocked country, we don t have any mining of asbestos so we import all of the asbestos and roofing industry is the biggest consumer of asbestos products. Due to this there is prevalence of mesothelioma and the number of cancer related cases is on the rise. There is no official record of cancer cases due to asbestos but there are 40,000 reported cases of cancer which might include cases related to asbestos as well. Customs Department shows that in 2012 more than 21,000 tones of asbestos have been imported by Nepal. Most of the asbestos related products by and large are imported from India. I take this opportunity to request the Indian delegation to highlight this fact with the concerned authorities in India and stop the export of toxic asbestos to Nepal. Asbestos is widely used in the roofing industry including roofs of schools. So children are being exposed to asbestos from their time in Kindergarten. Recently in Tarai region there is a massive increase in the use of asbestos for the roofing of the houses. I m here to share the strategies used in advocacy against the use of asbestos, I am of opinion that the learning s gained through our work might be relevant elsewhere in the rest of Asia. We have done pioneering studies in the use of lead in paints, use of chemicals in cosmetics and children s tools and write a letter of advocacy to the concerned government agencies. A sample letter of Advocacy has the following components. Magnitude of the Problem Research/Study finding Existing Law Recommendations We have also highlighted that dumping of asbestos is being taking place just 150 meters from the Ministry of Health premises, within 300 meters of Ministry of Environment and within 1,000 meters from the Prime Minister s office. Department of Environment has taken swift measures to remove the asbestos waste being dumped illegally. The unfortunate thing was that the Department of Environment collected the asbestos waste and dumped the whole thing in a different place, again unattended. This is the picture of a business community advertising with their own jingle broadcasting on FM radio stations that asbestos is a good material. On December 22nd our government took a decision to ban the sale, purchase, import, distribution of all kind of asbestos and the ruling has been in effect from June 20th, We are running media campaigns to spread awareness about the decision throughout the country. 14

16 There is no specific legislation regarding asbestos in Nepal although we have many laws on environment and health aspects. Our country is also a party to the three most important chemical conventions. This ban is the result of persistent campaign based on evidence and research based findings has helped us to sway the government decision in banning asbestos. There is an urgent need for massive awareness and information dissemination. The asbestos industry has filed petitions in the Nepal courts against the government. Lastly we need to keep the workers from exposure to the asbestos. Mr. Kam Hong CHAN and Ms. Sin Man SU, Association of the Rights of Industrial Accident Victims (ARIAV), Hong Kong From 2004 to 2013 there has been about 104 patients suffering from ARDs including Mesothelioma. Even though situation in our country is not as critical as other countries but we have a lot of work ahead of us. Asbestos was totally banned in April of last year, so there is no import, transshipment or use of asbestos in Hong Kong. We do keep monitoring the situation and closely work with the government on public awareness campaigns. Before the legislation of banning asbestos we submitted a petition to the government asking for a ban on asbestos. There was a situation last year where trains imported by Australia and New Zealand from China had asbestos contents while the contract for the trains clearly stated that the trains shouldn t contain any asbestos. And this worries us because the MTR Company also imported trains from the same manufacturer in China. We submitted a petition to the MTR Company in this regard, as this is a public health issue. This action has increased the public awareness on the hazards of asbestos. In May MTR conducted a study to find if there was any asbestos related material in the train and fortunately the results came out negative. We believe that proper reporting and labeling is very important as we are not sure which products contain asbestos. So we are asking the government to enforce this system of labeling the products containing asbestos. We also encourage the citizens to report asbestos related products to the Environment Protection Department and request the concerned officers to remove the products immediately. We have also discussed with various government departments on how we can raise the awareness amongst them. We also believe the need to conduct road shows to educate the public. Many construction workers migrate to Hong Kong especially from Pakistan and Nepal and they are seldom aware of asbestos related hazards and we educate them. We also gave them materials to take home so as to educate their families as well. We conducted a survey of the workers and most of them aren t aware of asbestos issue, its symptoms and cause, they didn t understand the prevention methods, they also didn t know about the compensation that they are entitled to. We have begun educating the workers about all the relevant issue of asbestos. We also conduct talks with the old buildings association, 15

17 the buildings constructed in the 50 s and 60 s have many asbestos containing materials. The residents living in these buildings are always at risk. But many of them choose to ignore. Mr. Peter Tighe, CEO of the Asbestos Safety and Eradication Agency, Australia We have been mining asbestos back in the 1970 s and in the 1980 s they have been phased out. A total ban on asbestos has been placed in 2003 which included imports and over the intervening years there was a sporadic attempt to deal with the legacy issues associated with asbestos. 2 years ago my agency was put in place to monitor the legacy issues of the asbestos. The first step is to stop direct exposure to asbestos and the second step is dealing with the legacy issues of asbestos. The deaths caused by mesothelioma are one of the main reasons why my agency was created and it averages about 700 deaths a year. The deaths related to asbestos are well over 1,000 now; Australia is relatively a small country in terms of population at 24 million people. The deaths due to ARD are equal to number of deaths in road accidents. The trend is growing and it is supposed to peak around the year What we are seeing is the phase out of deaths of people associated with the manufacturing and mining of asbestos but we now have a new issue of non occupational exposure to asbestos which is creating the peak in mesothelioma. The job of my agency is to reverse the trend curve and get the deaths to zero. The agency was created in July Prior to being appointment as a statutory officer I was a long term union official who worked largely on health and safety including asbestos. We have political bipartisan support and the agency has developed a National Strategic Plan which allows us to deal with legacy issues. Fundamentally what we do is to coordinate with the government activities at commonwealth and state level among variety of players who have role in asbestos issues like environment, health, work place regulator, local councils which are responsible for building approvals and other departments who have responsibility in generating awareness, removing, transporting, dealing with illegal dumping and a number of other issues. The agency has a council made up of government officials, players from industry, unions and victims groups. I report directly to the minister and main role is to implement the strategic plan and ensure we work towards zero in relation to deaths. Our goal is to completely remove asbestos from our environment by 2030 and we have also introduced a national exposure registry 18 months back and we have 1,500 to 1,600 people who claim to be exposed to asbestos because of asbestos in our building environment. We have a mesothelioma register which has been operating for a number of years. One of my first jobs was to negotiate with all areas of the government in 2014 to get a common focus right through commonwealth of Australia and to ensure dissemination of all the information that is generated in relation to asbestos to all the government agencies. We had a phased approach. 16