Brazilian Success: Pioneering Medical Program to Expand! 

by Laurie Kazan-Allen



An injection of funds this year, most recently on October 8, 2020, is enabling a ground-breaking asbestos surveillance and treatment collaboration created in 2018 by medical experts at the Heart Institute of the University of São Paulo and the Brazilian Association of the Asbestos-Exposed (ABREA) to expand its support network to patients in three more Brazilian cities. During the global coronavirus pandemic, which has hit Brazilians particularly hard, this program is a literal life-saver as people whose lungs have been scarred by asbestos are more vulnerable to the virus than others.

Under the leadership of pneumonologist Dr. Ubiratan de Paula Santos, the pilot project provided care for asbestos-exposed individuals at a medical outpatient clinic (the clinic) located at the renowned Heart Institute of the University of São Paulo (InCor).1 The clinic – which is a public sector facility and therefore provided free healthcare – had the capacity to perform medical tests, diagnose, treat and monitor asbestos patients. Unfortunately, the patient population eligible for treatment at the clinic was restricted to those living locally. Efforts to proactively search for high-risk workers exposed to asbestos in other São Paulo cities and regions where asbestos-using companies were located, especially those that made intensive use of asbestos fiber, had been constrained by a lack of resources. As a result of these limitations, the needs of affected cohorts in other São Paulo cities remained unmet; until now. With the 2020 grants, first class medical training is being provided to doctors in urban centers in order to build capacity to diagnose and care for asbestos patients, most of whom are unskilled workers without resources to pay healthcare or treatment costs.

The financial support secured this year from a generous donor is being used to provide supplemental services, such as treatment follow-ups for existing patients to ensure the completion of all diagnostic procedures and the identification and assessments of new patients, such as asbestos factory workers, insulators, builders, plumbers and others at high-risk of occupational asbestos exposures, and relatives (exposed to asbestos on contaminated work clothes) in the São Paulo City cohort. Work is simultaneously being progressed to build medical capacity, in collaboration with regional and local units of the Workers' Health Centers of the Unified Public Health System, to treat at-risk populations in the cities and surrounding areas of Campinas, Piracicaba and Rio Claro. Doctors from collaborating centers are being trained by staff from the Pulmonology Division of the Heart Institute in São Paulo to provide state-of-the-art care for asbestos-exposed patients using online and virtual portals for one-to-one tutorials as well as group sessions. According to Dr. Ubiratan:

“The impact of Covid-19 has highlighted the vulnerability of people with asbestos-related diseases. This knowledge has incentivized medical professionals to prioritize outreach work such as regular contact, at short intervals, with patients with diseases related to asbestos to assess those with possible symptoms of Covid-19, as well as provide guidance on vaccination against influenza and pneumonia.”

As per the schedule of the expanded asbestos project, training and implementation of the program will be completed by the middle of 2024.

Welcoming the expansion of the medical care for asbestos-exposed Brazilians, ABREA President Eliezer João de Souza said:

“Brazilian law requires companies to perform medical check-ups on former employees post-retirement or post-occupational asbestos exposures for up to thirty years after their last occupational exposure. ABREA members and others lack confidence in the reliability and accuracy of the examinations carried out by asbestos company doctors or doctors hired by these companies. The treatment provided by the InCor clinic and the results of its tests, however, are fully trusted by ABREA members who are extremely pleased about the expansion of this program to other public health centers in São Paulo State and hope that, in due course, people in other States will also have access to these high levels of medical care. ABREA’s aim is to make the impact of asbestos exposures visible by ensuring that each victim is counted. The InCor clinic not only provides first-rate treatment but also registers each case with the relevant authorities in order to build up an accurate picture of the number of Brazilian asbestos victims.”

October 21, 2020


1 It is noteworthy to point out that the funds for the pilot project were sourced from a court fine imposed on Brazil’s former asbestos giant Eternit S.A. for non-compliance with a legal agreement made with the Federal Public Ministry of Labor (2nd Region). The company had failed to inform the relevant authorities about asbestos victims who had waived their legal rights after receiving small amounts of compensation via extrajudicial agreements from the company.



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