1. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok 05-06 th Aug 2008

2. Summary of Presentation Why estimates? Data sources and approach Methods used in Estimation. Limitations of the methods used Conclusions and recommendations National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

3. Asbestos Consumption in World and SEARO (Thousand – MT) National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

4. Why Future Projections Policy makers need evidence for decision making Long latent period of Asbestos-related disease (asbestosis and malignances) Complaisance in developing countries due to non-availability of information on existing cases due to – Inadequate maintenance of records – Lack of awareness amongst affected population and physicians – Scarcity of experts to diagnose asbestos-related diseases – Misinformation National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

5. Why Future Projections Significant linear correlation exists between asbestos used and cases of mesothelioma and asbestosis after 3 decades (Ro-Ting Len et al Lancet 2007; 369: 844–49; Dtechn, Int J Occ Env Hlth, 2004, 10:22 -25) The quantity of asbestos consumed can be as predictor of estimates cases of asbestos-related disease after the latent period. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

6. Available methods for estimates Ro-Ting Len et al Lancet 2007; 369: 844–49 – All mesothelioma in male = 0.382 x ACKCP - 0.135 – All mesothelioma in female = 0.208 x ACKCP - 0.326 – Asbestosis in male = 0.439 x ACKCP - 1.255 – Asbestosis in female = 0.050 x ACKCP - 1.513 Dtechn, Int J Occ Env Hlth, 2004, 10:22 -25 – Y (cases/million/year) = 6.82 X kg/capita/year) + 0.43 or 1 death from mesotheolima per 170 tons of asbestos use. Global Trade Unions on Occupational Health and Safety profiling of countries http://old.global-unions.org/pdf/ohsewpG_1b.EN.pdf http://old.global-unions.org/pdf/ohsewpG_1b.EN.pdf – 170 tons of asbestos use = 1.6 lung cancer, 1 case of mesothelioma and 0.7 cases of asbestosis ACKCP = Annual consumption of asbestos in Kg/per capita per year National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

7. Production, imports and exports of asbestos (MT) in SEAR countries in 2006 SEAR CountryProductionImportsExports Apparent Consumption India 20,000306,427377326,050 Indonesia --36,337--36,337 Sri Lanka --7,954--7,954 Thailand --98,280--98,280 Total20,000452,893377472,516 National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

8. Estimated Annual burden of Asbestos-related Diseases in SEAR countries MesotheliomaLung CancerAsbestosisTotal India1918306914066393 Indonesia214342157712 Sri Lanka477534156 Thailand5789254241927 All countries2780444720389265 National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

9. Limitations Assumption of – Similarity in exposures and precautions. – Similarity in susceptibility – Exposure to other modulating factors e.g. age of first exposure, life expectancy, exposure to other carcinogens e.g. tobacco smoke and/or other environmental carcinogens. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.

10. Conclusions and recommendations In recent years there is significant increase in consumption of asbestos in SEAR countries Extrapolation of results of results of well accepted eco- epidemiological studies indicate possible epidemic of asbestos-related diseases including cancer in near future. Asbestos can not be handled safely and safer substitutes are available There is urgent need to take adequate steps to avert the future catastrophe. National workshop on ”Strategies of Elimination of Asbestos-Related Disease“ Richmond Hotel, Bangkok, 5-6 th Aug 08.