Pleural mesothelioma in Asturias (1982-2001)

Pleural mesothelioma in Asturias (1982-2001)

The association between occupational exposure to asbestos and certain lung and pleural diseases is well documented scientifically in a just a few decades but has its origins in antiquity.

In Spain asbestosis and lung cancers and associated with occupational exposure to asbestos contained in the pleura schedule of occupational diseases included in Royal Decree 1995/1978 of May 12.

The Occupational Health Service of the Ministry of Health and Health Services in 1999 created a registry of workers exposed to asbestos(RTEA) from the data of the companies contained in the RERA at that time and the information from a Record on post-employment benefit that asbestos workers had remained active Health Institute until 1998.

This registry currently (August 2002) consists of 49 369 workers who are active with asbestos, asbestos 140 active, 6 unemployed, 20 killed, 71 retirees, 38 not want to collaborate, lost 41 and 4 unknown situation.

In cases where the history of exposure of these workers is unknown, a telephone or personal interview is performed to reconstruct the employment history and then are sent to trial the service of Occupational Pneumology, National Institute of Silicosis. A copy of the results of tests carried out and the date of the next review is sent to the Occupational Health Service to update employee data, monitor the health surveillance is being done in the right conditions and conduct surveillance epidemiology of cancer and respiratory morbidity and mortality from all causes, of the people included in the registry.

When any asbestos related disease, classified as an occupational disease (PD) suitable channels for legal recognition are still detected.

This study is justified because despite being known association between Pleural Mesothelioma (MP) and occupational exposure to asbestos, recently there has been an increased incidence in most countries, the expected number of cases increase sharply in the coming years as a long latency period required for the disease becomes clinically visible is possible.

In this connection, the demands of workers for a MP is recognized them as EP are growing, finding most of the time with lack of reliable information from the defendant companies, trade union organizations, teams assessment of disabilities, pulmonologists charge of diagnosis and the judges themselves, for various reasons. A constant factor of dispute between the parties is the percentage of pleural mesotheliomas that may be attributable to occupational exposure.

Finally, the information requirements and doubts are raised by Occupational Health Service of the Ministry of Health, which is why it has chosen to undertake a descriptive study of pleural mesothelioma in Asturias with the main objective to know the reality in our Community Autonomous.

Objectives

1. To determine the incidence of pleural mesothelioma in Asturias and estimate its trend.

Two. To establish the distribution of cases by age, sex, health area and type of diagnosis

Three. Meet disease indicators: survival, diagnostic delay, and the relationship with other pleural and pulmonary lesions, particularly asbestosis and pleural plaques

April. Test whether the consumption of snuff or not influence the occurrence of disease

May. Rebuilding work history of all cases identified

6. To determine the percentage of clinical stories that consist work history, especially asbestos exposure data

7. Estimate the proportion of pleural mesothelioma associated with occupational exposure to asbestos

8. To verify the employment status at the time of diagnosis (gainfully employed, unemployed, retired)

9. Meet a few of the cases worked in companies registered in the Register of Companies at Risk of Asbestos (RERA)

10. Determine the number of cases that have applied for disability due to occupational disease and few of them have obtained

11. Promoting Professional recognition as pleural mesotheliomas disease associated with exposure to asbestos.

Conclusions

1. It is necessary to have a simple method of screening, such as a questionnaire to detect people who are or have been exposed to asbestos. This questionnaire should be offered in the workplace for prevention, but also for primary care health professionals due to the preventive potential of early detection of exposure.

Two. Since the diagnostic delay has not improved in the past 20 years, and since a plausible cause of it may be the fact that health professionals do not think about mesothelioma as a likely diagnosis would be useful training workshops on this pathology alert and raise awareness in healthcare that is paid to workers.

Three. When a health professional, whatever the field in which you work, detects a person with probable occupational exposure to asbestos, you should notify the registry of workers exposed to asbestos from the Ministry of Health to ensure proper health surveillance to entitled, even after completion of any contractual relationship.

April. Conducting a labor history specialist pulmonology is also important. When the worker is treated at a pulmonology department disease has already been developed, but to show the relationship between pleural mesothelioma and asbestos exposure will facilitate take preventive measures in workers who develop occupational or similar tasks would enhance legal recognition as occupational disease.

May. It would be desirable to centralize the diagnosis of pleural mesothelioma and other asbestos-related diseases in a single department or unit to ensure better and faster diagnosis, as well as be a support for disability assessment units responsible for issuing a report on the professional nature of the disease.

6. Due to the relatively high number of cases in the activities of agriculture and home care, it would be interesting to investigate this relationship in order to alert other people with the same dedication. However, because the asbestos is now banned in Spain, not a research priority.