European Asbestos Conference: Policy, Health and Human Rights

The European Parliament in Brussels was the venue for a conference, hosted by the European United Left/Nordic Green Left (GUE/NGL) Party's European Parliamentary Group, that examined the effects of decades of European asbestos use, with an emphasis on the impact in new European Union (EU) Member States. The provision of English, Spanish, Italian, French, Dutch, German, Portuguese, Greek and Czech interpreters facilitated the participation of one hundred and fifty delegates from more than twenty countries; amongst the delegates were asbestos victims, campaigners, public health activists, doctors, researchers, engineers, social scientists, civil servants, lawyers, asbestos removal experts and journalists. Presentations made during the conference highlighted the failure of current EU policies to protect the public and the environment from hazardous exposures to asbestos. The lack of EU funding for medical research and treatment of asbestos-related diseases and the export of European ships riddled with asbestos to Asian ship-breakers were soundly criticized.

Opening Session

Opening the conference, MEP¹ Francis Wurtz, President of the GUE/NGL, welcomed delegates. Wurtz categorized Europe's tragic asbestos legacy as a missed opportunity. Despite the fact that asbestos had been recognized as a hazardous material for a hundred years, dangerous practices had persisted which had endangered the health and lives of workers and the public. The same industry groups that prevented Europe from banning asbestos until January 1, 2005, are still advocating that it can be used “safely” under controlled conditions; a report in 2004 by the International Social Security Association documented a dramatic increase in asbestos consumption in the developing world. Wurtz called for coordinated action on asbestos in Europe; the loopholes in EU asbestos legislation need to be exposed and solutions found to protect future generations. Sustainable cooperation between like-minded individuals throughout the world is essential. Hazardous situations, such as “exceedingly dangerous conditions” experienced by untrained immigrants working for asbestos removal companies and the export of Le Clemenceau and other asbestos-laden ships to ship-breaking yards in India, cannot be tolerated.

The next speaker was the Co-Chair of the conference, MEP Kartika Liotard, who told delegates that:

“Asbestos remains the primary carcinogenic toxin affecting European workers. Outside the workplace, asbestos is second only to tobacco as an environmental source of cancer. Asbestos products in European homes and commercial buildings, as well as asbestos waste in our environment continue to cause unprecedented levels of disease and death in Member States of the European Union.”

The widespread use of asbestos in the Netherlands, Liotard's home country, has had dire consequences; thousands have died from asbestos-related diseases after working with asbestos or asbestos-containing products, sharing a home with relatives who had been occupationally exposed to asbestos, or living in the vicinity of asbestos-consuming factories. In the town of Goor, where the Eternit asbestos factory was the major employer, many local people have contracted asbestos diseases. There was a conspiracy of silence and the victims received no assistance or recognition. The formation of the Dutch Asbestos Victims' Committee in the 1990s and the commitment of its members have transformed the plight of asbestos victims in the Netherlands. Liotard said:

“Nowadays, many of the asbestos injured in the Netherlands receive appropriate medical treatment and financial compensation. Unfortunately, others do not. Neighbourhoods remain contaminated and workers continue to be exposed to asbestos products hidden within our infrastructure…

How can we improve the situation for all asbestos victims is one of the main questions to be answered at this conference; how can we prevent future generations from contracting these deadly diseases is another. During the conference, we will examine the EU asbestos policy; we will pinpoint its successes and expose its failures. Delegates will describe national asbestos experiences in new EU Member States and highlight the main problems they face.”

The fact that Vladimir Spidla, European Commissioner for Employment, Social Affairs and Equal Opportunities, and Stavros Dimas, European Commissioner for the Environment, declined to participate in the conference illustrated the low priority placed on asbestos issues by the EU. Liotard hoped that the adoption of a conference declaration would place asbestos firmly on the social and political agenda.

Xavier Jonckheere, Conference Co-Chair and President of ABEVA, the Belgian Asbestos Victims' Group, believed that the presence of delegates from so many countries at the conference illustrated the widespread nature of a problem which:

“affects all the countries on the planet. (It is) like an octopus spreading out its tentacles. What is prohibited in our countries is now being done elsewhere – where labor laws are not so stringent, where levels of protection are non-existent, where asbestos lobbying is still powerful.”

Describing, the celebrations which had recently taken place to commemorate the hundred year anniversary of Eternit, a Belgian multinational whose vast global operations were founded on asbestos, Jonckheere contrasted the pomp and circumstance of a visit from Belgian royalty, widespread media coverage, the launch of new products and the publication of an official history of the company with the total silence on the “hundreds of thousands of people who had died and will die because of direct or indirect contact with (Eternit) asbestos.” The conspiracy of silence which prevails in combination with a hostile legal system has resulted in few Belgian victims gaining compensation. The Belgian State, which did not ban asbestos until 1998, refuses to acknowledge the harm it has done and political leaders hide behind a multitude of clichés to explain away the government's inaction. In truth, profits and budgets were continually put before occupational and public health. ABEVA is calling for stricter enforcement of EU asbestos legislation and further action by EU Parliamentarians.

Panel 1: Occupational Asbestos Exposure

Angel Carcoba, Chair of the panel discussion Occupational Asbestos Exposure represents the Confederación Sindical de Comisiones Obreras (CCOO), one of Spain's largest trade unions. In the decades preceding the asbestos ban in Spain (2001),² more than 2 million tons³ of chrysotile (white asbestos) were imported; during this time 140,000 workers were exposed to a mixture of crocidolite, amosite and chrysotile. According to the (Spanish) National Center of Epidemiology, the asbestos mortality rate has risen by 90% from 419 in 1992 to 795 in 2002.⁴ The debate on asbestos which took place in Spain from 1980 onwards considered the scientific, social and political implications of hazardous occupational exposure; nowadays, the asbestos hazard is perceived as a public and environmental health hazard. Photographs exhibited by Mr. Carcoba showed piles of asbestos debris littering the countryside.

The CCOO is working with other stakeholders, including the EU's Senior Labor Inspectors' Group (SLIC), to bring to fruition the following projects in Spain:

the setting up of a health surveillance program for at-risk workers;
the establishment of a national mesothelioma register and a program for the psychological and social support of asbestos victims;
epidemiological research in asbestos hot-spots;
legislation to allow the early retirement of asbestos-exposed workers;
the creation of a national compensation fund and procedures which recognize asbestos injuries as occupational;
the adoption of a national protocol to protect the public from hidden asbestos in the Spanish infrastructure; mandatory asbestos audits of buildings and structures.

Acknowledging that the Spanish asbestos experience replicates that in other countries, the speaker stressed that much of the progress which had been made in Spain flowed from the coordination of activities mounted by victims and trade unions. Carcoba added that the SLIC will be engaged in intensive activity on asbestos in 2006-2008 to address shortcomings in current EU directives; he urged delegates to work with the SLIC.

According to Svetla Karova, from the Confederation of Independent Trade Unions (Bulgaria),⁵ between the 1970s and 1990s, 40,000 tons of chrysotile and anthophyllite were produced or processed in Bulgaria. In addition, thousands of tons of asbestos-containing products were imported for use in construction, energy production, transport and other industries. The incidence of asbestos-related disease, which has been reported for the period 1980-2000, totals 887 cases including 45 of malignant pleural mesothelioma. Although the number of mesotheliomas nearly trebled from 6 in 1991 to 16 in 1997, many cases remain uncounted due to ineffective data collection procedures. There is no systematic monitoring of asbestos-exposed workers.

Despite steps taken by the Government to reduce hazardous asbestos exposures, a survey conducted five years ago established that 4,400 workers were still being occupationally exposed to asbestos and that awareness of asbestos hazards was low amongst employers and employees. Government initiatives to minimize hazardous exposures are being implemented but assistance from EU sources would be welcomed in:

setting up programs for the collection and analysis of data and systematic medical monitoring of asbestos-exposed workers;
exchanging information on techniques for minimizing hazardous exposures to asbestos at work-sites and managing asbestos waste;
establishing guidelines for the implementation of EU asbestos directives.

The next speaker, Italian trade unionist Riccardo Ferretti, said that until the 1980s asbestos was considered as just another raw material used in the manufacture of Eternit asbestos-cement products. Thanks to the efforts of two Italian trade unions, workers became aware of the hazards of occupational asbestos exposures and the extent of asbestos use in Italy. Official figures show that as of March 2005, the State had recognized 128,000 claims for occupational asbestos-related diseases amongst claimants whose exposures dated back more than a decade.

Even after the Italian asbestos ban in 1992, asbestos continues to cause problems in Italy; asbestos regulations are only partially enforced and worker protection remains inadequate. The management of asbestos products, which are in many public buildings including schools and hospitals, is inadequate. Asbestos removal procedures and decontamination prior to demolition are not conducted to acceptable standards. There has been little compliance with a national law which mandated that local authorities conduct asbestos audits of public buildings. Ferretti cited research which estimates that there are 32 million tons of asbestos-containing products in Italy. If EU Member States cannot “get our act together” on asbestos, what hope is there for other countries, the speaker asked. This is an international problem which needs to be tackled on an international level.

According to Armando Farias of the General Confederation of Portuguese Workers (Confederaão Geral dos Trabalhadores Portugueses, CGTP), although there are small deposits of asbestos in the north of Portugal, virtually all the asbestos consumed in Portugal was imported from Canada and South Africa; the majority was used for the manufacture of asbestos-cement building materials. By the end of the 1980s, 3,000 people were directly or indirectly working in the asbestos and associated sectors. Asbestos factories in Portugal employed 800 people and asbestos-cement was big business. To protect their interests, asbestos stakeholders formed a trade association, the Association of Chrysotile Product Producers, which lobbied the government to forestall the introduction of asbestos restrictions, with producers claiming that chrysotile asbestos could be used safely under “controlled conditions.” Since the implementation of the EU asbestos directives, industry has been replacing asbestos with safer alternatives such as PVA and cellulose.

Data on the incidence of occupational asbestos-related disease in Portugal is only available for the period 1985-1993; during this time, 71 cases of asbestos-related diseases were recorded. In 1992, 6 deaths from asbestos-related disease were registered. In 2003, the Social Affairs Ministry said there were 161 cases of asbestos-related disease as well as many more cases of pulmonary complications due to the inhalation of asbestos dust. The system for collecting and collating data on the incidence of asbestos disease is inadequate and it is unlikely that official figures are accurate. Many asbestos-related illnesses go undiagnosed. Prior to the EU deadline of January 1, 2005, the CGTP had been lobbying for an asbestos ban and had also raised concerns about the presence of asbestos in public buildings. Two years ago, the Portuguese Parliament passed a law which made asbestos audits for public buildings mandatory; in addition, the law said that people working in these buildings should undergo regular health monitoring. More needs to be done to ensure that the laws designed to protect the public and the workers from hazardous exposures are enforced.

Socialist MP Remi Poppe from the Netherlands has been investigating hazardous asbestos exposures for over forty years. “Aside from gunpowder,” he said, “asbestos is the most scandalous substance people have had to work with.” According to Poppe, “the dark forces” which profit from asbestos think little of using blackmail, deceit and unscrupulous practices to protect the bottom line; they willingly sacrifice workers' health for corporate profits. Before asbestos had been banned in Holland, there were strict environmental restrictions on working with chrysotile asbestos; these were routinely neglected. At the end of the 1980s, Poppe got in touch with people from Goor, the location of an Eternit asbestos-cement factory; they enabled him to gain entrance, through the back door, to the factory. Here he observed people working in horrendous conditions:

the factory floor was covered with asbestos debris;
asbestos was falling off the conveyor belt;
people were dry sweeping asbestos debris off the floor;
the finished product was supposed to be vacuum packed in plastic bags but was just dropped into the plastic packing and afterwards manually compressed and tied;
the heat inside the factory (it was August) ensured that none of the workers wore protective clothing.

When Poppe published a report detailing these findings, the company threatened to sue. The scandal which was generated by this incident led to the asbestos ban in the Netherlands. If this type of corporate malfeasance is possible in a country with strict health and safety regulations, what is going on elsewhere, Poppe asked. It is, he concluded, time that asbestos was banned worldwide. The United Nations should adopt a resolution calling for the global shut-down of the asbestos industry.

Summing up the discussion which took place during this panel, Chair Angel Carcoba suggested that to make a reliable diagnosis of the EU's asbestos problem, more research was needed to:

establish the amount and location of asbestos remaining in each EU Member State;
learn how Member States control and monitor installed asbestos-containing products;
compare the monitoring and health surveillance programs in the EU and investigate the possibility of harmonizing health surveillance at an EU level;
establish the level of social assistance and the economic programs which exist for asbestos victims and families in Member States;
understand the role played in each State by judges, prosecutors, experts, and others.

Panel 2: Environmental Asbestos Exposure

The paper Environmental Asbestos Exposure in Poland by Dr. Neonila Szeszenia-Dabrowska, Chair of the Panel and an asbestos expert from the Nofer Institute of Occupational Health in Poland, began the next session. The specific characteristics of environmental asbestos pollution, the speaker said, are:

unlimited life – asbestos fibers are practically indestructible;
on-going risk – lethal fibers are continually liberated during the degradation of asbestos-containing materials such as asbestos-cement and insulation products;
the multitude of sources of asbestos and the variable concentration of asbestos fibers in the ambient air.

Environmental exposure to asbestos dust increases the risk of lung cancer and may also cause mesothelioma and non-malignant lesions in the pleura. To quantify the health hazard to the population it is essential to consider the:

accumulation in the lungs of respirable asbestos fibers from the ambient air over an individual's lifetime;
long latency periods of asbestos-related diseases (20-40 years) and the fact that disease may develop long after hazardous exposure had ceased;
fact that short-term environmental exposures to high concentrations of asbestos or prolonged contact with low concentrations of asbestos can cause mesothelioma.

Szeszenia-Dabrowska explained that to make an accurate risk assessment it was necessary to determine retrospectively the levels of hazardous exposures. In the absence of a detailed record of ambient asbestos concentrations, essential information includes the:

quantity of asbestos and materials containing asbestos imported into a country;
amount of raw asbestos used in asbestos-processing plants;
annual consumption of raw asbestos per inhabitant;
quantity and condition of asbestos-containing products in the country and the quantity of asbestos and asbestos-contaminated wastes.

Poland imported 2 million tonnes of asbestos of which 90% was chrysotile from the former Soviet Union and 10% was crocidolite from the Republic of South Africa. It is estimated that there are 15.5 million tonnes of asbestos-containing materials in Polish buildings. The production of asbestos-cement products in Polish factories from 1946-1993 consumed 1.4 million tonnes of asbestos, including 86,000 tonnes of crocidolite. There are pronounced differences in the regional incidences of asbestos-related disease in Poland which correlate with the location of former asbestos processing sites:

“Plants manufacturing asbestos-cement products were sources of considerable atmospheric pollution; air in the vicinity of those plants contained considerable concentrations of asbestos fibres. The storage of asbestos waste and reckless attempts by the local populations to re-use asbestos-contaminated items 'for the sake of economy' constitute a serious health problem.”

A map featuring the geographical distribution of asbestos-cement manufacture in Poland illustrated the preponderance of such manufacture in eastern provinces including: Podlaskie, Lubelskie, Mazowieckie and Swietokrzyskie. Szczucin, a small town in southeast Poland, is an asbestos hot-spot. Formerly home to a large asbestos-cement plant that consumed massive quantities of crocidolite, the townsfolk and environment have both been contaminated:

“The number of respirable fibres per unit volume of air present in the atmosphere of the (Szczucin) district has been found to be considerably high – from 5 to 50 fibres/l. The analysis of the measurements shows that over half (55%) of the district's inhabitants are environmentally exposed to high asbestos fibre concentrations, that is above 10f/l… Over the period 1987-2003, 55 cases of pleural mesothelioma were recorded, including 28 among Szczucin plant workers (occupational and environmental exposure) and 27 among Szczucin inhabitants (environmental exposure).”

The incidence of pleural mesothelioma among the townsfolk in 2000-2003 was 125 times as high as that of the general Polish population.

Asbestos: A Cyprus Tale was the title of the presentation by Efi Xanthou, a political scientist from the Cyprus Green Party. Xanthou began her presentation by showing dramatic photographs of the asbestos mine, located in the heart of the Troodos forest, which was the main area in which chrysotile asbestos was mined in Cyprus from 1904 until 1988. The mining operations at this site occupied almost 400 hectares. The mechanization of the mining operations introduced in the 1950s produced 20,000-40,000 tons of asbestos fiber a year; cumulatively one million tons of chrysotile were produced by the excavation of 130 million tons of soil and rock at this facility. In 1980, the health of 8% of the population living in close proximity to the mines was affected by asbestos disease. In the period 1990-95, 30% of deaths in this area were due to asbestos-related diseases such as mesothelioma, asbestosis and lung cancer. The biggest problem now is the area near the mines where the spoil has accumulated.

In 2001, there was a big debate over whether asbestos should be removed from homes but there was no alternative accommodation available to rehouse residents. In 2002, a survey identified 110 government buildings which contained asbestos materials. An action plan was drawn up by the Government which called for:

the gradual removal of asbestos roof tiles from schools and government buildings;
redundant asbestos mines to be used for the safe disposal of asbestos waste;
the removal of asbestos water pipes from the water system.

Three years later little had been done. Furthermore, Xanthou said, a shortage of asbestos disposal sites on Cyprus has led to uncontrolled dumping of asbestos waste. In 2005, the Cyprus Green Party restarted its campaign on asbestos and is demanding:

the immediate safe removal and disposal of asbestos material from public buildings and the water supply system;
the creation and safe management of regulated sites for the disposal of asbestos waste;
the immediate introduction of mandatory asbestos audits for public and private buildings;
the implementation of a public awareness campaign;
stricter legislation to minimize hazardous exposures to asbestos.

The representative of the Italian Association of the Asbestos-Exposed, Fulvio Aurora, reported that environmental exposure to asbestos is a growing problem in Italy. Considering the fact that asbestos has been banned in Italy since 1992, this may seem surprising; however, the presence of 34 millions tons of asbestos in Italy remains a clear and present danger for members of the public and workers. There is no compensation available to victims of environmental asbestos exposure in Italy; the Association is lobbying politicians to set up a fund which would compensate these victims. Data from the national mesothelioma register show that in 2001 4% (88 out of 3,446) of mesotheliomas were due to environmental exposure; the vast majority of asbestos cancers are contracted through occupational exposures.

Jason Addy, a founding member of the citizen's campaigning group “Save Spodden Valley,” discussed the ramifications of the environmental contamination of a 72 acre site formerly owned by Turner Brothers Asbestos (TBA) in Rochdale. In the 1870s this site was the birthplace of the modern asbestos textile industry; it was the global headquarters of the UK's biggest asbestos group, Turner & Newall (T&N), for nearly 30 years as well as the location of the Asbestosis Research Council. TBA's processing of hundreds of thousands of tonnes of asbestos fiber subjected workers as well as the local population to high levels of hazardous exposures. A 1957 corporate document confirmed that:

“At present 2,200 people are employed in the Rochdale factory of whom 1,390 work in 'scheduled areas', i.e. areas to which the Regulations apply. The total weight of (asbestos) dust recovered in the filter rooms is about 15,000 lbs., all of which is dumped to waste.”

The pollution of the site was widely known. According to the town council: “the whole site is contaminated.” The former owners of the site regarded it as: “an asset of dubious value, possibly even a liability.” Local people who had worked at the factory confirmed the existence of asbestos dumps that potentially contain tens of thousands of tonnes of asbestos waste. In April 2004, property developers purchased the site and began felling trees surrounding the remaining factory buildings. The apparent disregard of the site's contaminated status and the potential health repercussions of the developers' actions galvanized the local community: the Save Spodden Valley campaign was begun.

Addy summed up the campaigners' principal concerns as follows:

the presence of asbestos in dumps on the property and in remaining factory structures;
the potential for contamination of local water sources – asbestos-contaminated tips on the banks of the River Spodden, asbestos waste thrown down redundant coal mines which flood;
the disturbance of contaminated soil and buildings could generate significant levels of airborne asbestos pollution.

What happens in Rochdale has a wider relevance. There is enormous pressure in the UK and elsewhere for the development of former industrial sites for residential use. Concluding his presentation Addy said:

“Unless these sites are properly assessed and decontaminated, future generations will receive the hazardous exposures which have already blighted the health and lives of so many. The landowners' plans to construct 600+ houses plus a children's nursery on a site which has not been properly assessed is, to say the least, unwise. One further cancer death caused by asbestos from the site is one too many. The Valley must be treated with utmost respect. Until a comprehensive public investigation is carried out, all development work should be forbidden.”

Dmytro Skrylnikov from the Association of Environmental Law of CEE/NIS⁶ in Lviv, Ukraine confirmed that the use of asbestos in Ukraine continues. Currently, 4,000 workers at 10 factories process 110,000 tonnes of Russian and Kazak chrysotile to produce asbestos-containing materials which generate an annual turnover of US$1 million. One of Ukraine's main asbestos products is roofing slate which is widely used, especially in rural areas. As the import of asbestos products is now banned in the EU, some producers are switching to non-asbestos technology; over recent years, production of asbestos roofing material has been decreasing by 6-7% a year.

In Ukraine, there is no government policy on asbestos and no coordination between different Ministries and institutions. As a result, some politicians are pushing for national legislation to be harmonized with that in the EU, which would include directives on asbestos, while others are advancing the policy advocated by the asbestos industry and the Russian government, which is based on the “controlled use” argument. In 2004, the delegate from Ukraine was one of 11 national representatives who opposed the inclusion of chrysotile on the PIC list of the Rotterdam Convention. After the meeting, the Ukraine delegate, who was Head of the Institute of Occupational Health, told journalists:

Ukraine defended its right to use asbestos!
Ukraine proved to the EU that chrysotile asbestos is safe and can be used (safely).

In May 2005 the World Bank agreed to make a US$86.5 million (71.9 million Euro⁷) loan for a program to provide: Equal Access to Quality Education in Ukraine. The terms of this loan highlight the problems posed by the presence of asbestos materials within Ukraine schools and could, Skrylnikov said, constitute the first steps towards a national asbestos ban:

“Since many school buildings in Ukraine were built during the Soviet regime and are roofed with asbestos materials, their rehabilitation under the project will require the safe removal and disposal of such asbestos materials. The Ministry of Education will prepare an Environmental Management Plan (EMP) in consultation with key stakeholders which will provide for measures that include the following:

(i) no asbestos materials will be used in school rehabilitation;

(ii) asbestos will be disposed of properly according to law and consistent with generally accepted disposal practices;

(iii) no lead-based paint will be used; and

(iv) construction related noises will be set at a minimum acceptable to the surrounding community.

Building contractors will be asked to abide by the EMP which will be part of the standard bidding document.”

Panel 3: Political Panel

During this session, MEPs were offered the opportunity to discuss their country's asbestos experiences. As was illustrated by the failure of the EU Commissioners to take part in the opening session of the conference, some politicians do not consider asbestos a priority issue. The promised participation of some MEPs scheduled to make contributions to the Political Panel did not materialize.⁸ MEP Adamou Adamos, from Cyprus, said that during the mid-1980s it became apparent that there was an elevated incidence of cancer in the village nearest to Cyprus' asbestos mine. Although the mine was closed in 1988 and despite claims by asbestos stakeholders that Cyprus asbestos was “harmless,” hazardous exposures continued. On Cyprus, many public buildings are “full of asbestos”; so far asbestos has only been removed from 10 of the country's 112 schools. Unless remediation is carried out by trained operatives using the correct techniques and specialist equipment, contamination levels will rise. “The EU,” Adamos said, “is responsible to European people. Someone has to coordinate asbestos action in all 25 Member States.” The EU's lack of assistance in helping Cyprus tackle its asbestos problem remains a source of disappointment to MEP Adamos. Jiri Mastalka from the Czech Republic confirmed that his country had used asbestos since the 1920s in the manufacture of a range of products including textiles, brakes shoes and friction materials. Italian MEP Vittorio Agnoletto called on the EU to assist new Member States deal with their asbestos legacies by providing money needed to quantify the problem with initiatives such as epidemiological research.

Panel 4: The Human Dimension of Asbestos Disease

The reality of the asbestos epidemic is to be found in the hundreds of thousands of bereaved relatives and grieving communities throughout the EU. Each individual who dies from asbestos-related disease is yet another avoidable death. Nicole Voide's family lived within 100 meters of the CMMP asbestos factory in Aulnay-Sous-Bois;⁹ the local school, which she and her brother attended, was 50 meters from the factory. In 1995, Voide's brother was diagnosed with mesothelioma. When he was diagnosed, attempts were made to track down the source of his exposure; nobody connected his illness with the factory which had closed some years earlier. After a thorough investigation of his work history, documents were discovered which established, without doubt, that asbestos had been processed at the CMMP site. Motivated by a promise she had made to him that justice would be done, Voide continued her research and found that 50 other deaths have occurred amongst townsfolk who lived or studied within a 500 meter radius of the plant. In 2000, a public meeting was held; the organizers expected an audience of 20 people but 100 turned up. Sixty volunteers voted to form a new organization, The Collective of Residents and Victims of CMMP,¹⁰ to campaign for the remediation of the derelict site. In April 2005, the 200-strong Collective, along with four other organizations, staged a demonstration in front of the redundant factory to demand that the company decontaminate the site.¹¹ Concluding her talk, Voide listed the four asbestos scandals of Aulnay-Sous-Bois:

the construction of the CMMP asbestos factory 50 meters from a nursery and primary school in the town center when public authorities knew that asbestos was a dangerous substance;
the company's violation of French hygiene laws;
the historical failure of the local authority to protect residents, students and the environment;
the present failure of local government to decontaminate the site.

The family of Xavier Jonckheere has been decimated by asbestos. Mr. Jockheere's father, who worked with asbestos, died in 1987 from mesothelioma; his mother died of the same disease in 2000. The family home was 200 meters from the local Eternit factory. As a consequence of asbestos exposure, one of Mr. Jonckheere's 4 brothers also died from mesothelioma; he was 43 years old and had 3 children. The sense of injustice felt by the family is overwhelming and the surviving brothers live under the “Sword of Damocles,” never knowing when/if it will be their turn. The Belgian government permitted these exposures to take place and has an obligation to assist the injured and the bereaved; a system, such as the one which has been adopted in France, should be set up for this purpose. The use of asbestos should be banned globally to prevent further atrocities.

The presentation by John Flanagan, of the Merseyside and District Asbestos Victims' Support Group, was Victims' Initiatives in the UK. In July 2005, nine asbestos victims' groups from the North of England and Wales formed a campaigning body called The Asbestos Victims Support Groups Forum (the Forum). While the impetus for the formation of this body was a proposal by Cape PLC (formerly Cape Asbestos), of which the groups were justifiably sceptical, the aims of the Forum transcended this one issue. Forum members wished to improve the range of services and advice available to victims and create the opportunity for victims to share their experiences and offer mutual support. The Forum works alongside the Parliamentary Asbestos Sub-Committee to raise the profile of issues which affect the daily lives of asbestos victims and their families. “One major concern of both groups,” Flanagan said:

“is the inequity experienced by asbestos claimants in their dealings with our social security system. This system blocks asbestos-related lung cancer victims from claiming benefit because of draconian criteria resulting in most victims being unable to claim. New criteria rules seem to, at best retain the status quo and at worst, reduce the number of claimants.”

This year, the British Lung Foundation (BLF) has joined the battle to raise awareness of the UK mesothelioma epidemic. The BLF's Mesothelioma Charter is calling for: speedy access to appropriate medical treatment and social security benefits, availability of good legal advice and guidance on end-of-life decisions and care at home. More information on this campaign is available on the BLF website.

Astero Klabatsa, from Bart's Mesothelioma Research Unit at the Bart's and London Hospital, stunned delegates with her presentation Funding Issues in Mesothelioma Research, which revealed the paucity of research funding for mesothelioma in the UK. Although the dramatic increase in the incidence of mesothelioma deaths should have made medical research a UK priority – there are now nearly 2,000 UK mesothelioma deaths a year – there was no UK Government or EU funding allocated for UK mesothelioma research for the period 2000-2004. The little which has been awarded to UK mesothelioma researchers during this period came from charitable organizations and totaled only 1.2 million euros. Estimating the basic costs of laboratory research at 160,000 euros per year per staff member, it is clear that the research funds allocated are woefully inadequate. A National Cancer Research Institute graph showed that, although the incidence of lung cancer (which includes mesothelioma) was 14% of all cancers in 2000, the total allocated for lung cancer research was a mere 4% of the cancer research budget.

Another funding issue affecting UK mesothelioma patients is the reluctance of the National Health System to approve the use of the drug ALIMTA. Although ALIMTA is the only licensed drug for the treatment of mesothelioma in the UK, and is widely available in the U.S. and throughout Europe, it remains unavailable to most centers in England. It is, Klabasta said, unspeakable that the only licensed drug for mesothelioma proven to benefit up to 30% of patients is not routinely prescribed. The drug is going through the bureaucratic process dictated by the National Institute of Clinical Excellence; no decision is expected before Autumn 2006. The speaker called on the conference delegates to make medical research a top priority:

“Mesothelioma is a serious disease and we are running out of time. People are dying and we need to achieve a better survival for them. It is unspeakable and it is ridiculous to say that the survival period of a person diagnosed with mesothelioma is one year. As scientists we cannot accept that and we are trying to do as much as possible but we need more funding for up-to-date research, and more colleagues dedicated to the disease. And we need the EU and national governments to seriously think of speeding up things like the approval of drugs so that we are testing the drugs and experimental therapies on patients without long delays.”

Panel 5: Avoiding More Needless Deaths

The first speaker on the panel Avoiding More Needless Deaths was Factory Inspector Fernanda Giannasi from Brazil. Her presentation Case Study: EU Asbestos Derogation for Chlorine Production examined industry's claim that the use of asbestos in diaphragms was essential for the safe and economic production of chlorine. In 1999, when EU Directive 99/77/EC banned the use of chrysotile as of January 1, 2005, there was one exemption: the use of asbestos diaphragms for the production of chlor-alkali in currently existing factories. The European chlorine lobby, led by the trade group Euro Chlor, argued that the chlorine industry should be a “special case” because:

the risk of asbestos exposure within the industry would be very low;
asbestos diaphragms would be produced in a closed process on-site and would not be marketed;
more time was needed to develop satisfactory substitutes; failure to do so could lead to explosions.

In fact, industry's motivation was purely economic; although suitable alternatives were already available, avoiding the costs associated with making the transition to asbestos-free technology was industry's prime goal. In Europe, 85 companies produce 20 million tons of chlor-alkali (chlorine + caustic soda) a year; Germany is the biggest producer, accounting for 48.9% of total European production. Since 1997, the pace of phasing-out asbestos use in European chlorine production has been slow: in 1996, 24% of total production used asbestos diaphragms, by 2005, this had been reduced to 17.4%.¹² At the current rate of substitution it will take a further 24 years to end asbestos use in this process.

The chlorine industry has a powerful lobby in Brazil. In 2004, 8 Brazilian companies produced 1.2 million tons of chlorine and 1.3 million tons of caustic soda. Seventy-two per cent of Brazilian chlorine production is achieved by 3 companies which use asbestos diaphragm technology; in 2003, these factories consumed 128 tons of asbestos in their asbestos diaphragms. As a Factory Inspector, Giannasi started an investigation of hazardous exposures in the industry but was ordered, by officials at the Ministry of Labor, to cease her research. Before she did so, she concluded that the risks of occupational asbestos exposure in the chlor-alkali sector are just as serious as in other sectors where the use of asbestos has been banned in Europe. A series of photographs illustrated the hazardous conditions which persist in Brazilian chlorine factories. Open bags of asbestos were shown in a storage room and a worker was manually handling the fiber. Each diaphragm cell requires 80 kilos of asbestos fiber. A worker was shown mixing raw asbestos fiber with resin and water before putting the mixture into a mold. The worker being exposed to the asbestos during this operation was wearing an orange uniform which indicated that he was a sub-contractor. Another orange-clad worker, wearing a totally inadequate disposable face mask, was using a broom to brush-off asbestos fibers, while another sub-contracted worker was manually handling asbestos residue. The workplace floor was littered with asbestos dust. There is a double standard in these factories between the treatment of employees and sub-contracted staff, with at least some protective measures being offered to the former and none to the latter; as there are 5 times as many sub-contracted workers as full-time employees, this is a significant problem.

More than 11% of the world's asbestos comes from Brazil; Brazil has now replaced Canada as the world's 4th biggest producer of chrysotile. Brazil exports 65% of its annual production of 252,000 tons to Thailand, India, Indonesia, Iran and other countries in Latin America. The Brazilian Government is modeling its hypocritical stance on asbestos on the Canadian model: while Canada claims asbestos can be used safely under “controlled conditions,” it exports more than 95% of the asbestos it produces. Although the Brazilian Government announced plans to ban asbestos in 2004, nothing has been done. It is difficult for developing countries like Brazil to take action on an industry which has such powerful stakeholders. The European Union's Scientific Committee on Toxicity, Ecotoxicity and the Environment (SCTEE) will shortly be reviewing the asbestos derogation for chlorine production as mandated by the 1999 EU directive which said that the exemption must be reconsidered by January 1, 2008. The SCTEE must end this derogation; by doing so, it will send out a powerful signal that will spur national governments and international agencies to ban asbestos globally.

Dr. Barry Castleman, who addressed the subject Asbestos Alternatives: Construction Materials and Friction Products, is an environmental consultant from the U.S. For asbestos to be banned, he agreed, it is necessary that safer alternatives are available. The majority of asbestos fiber is used in asbestos-cement (AC) building materials. Substitutes for asbestos in AC sheets include polymeric fibers such as polyvinyl alcohol (PVA) and polypropylene, usually mixed with cellulose, to make flat sheet products; there has also been some success with the use of bamboo fiber-cement. Other alternative fibers being used include: eucalyptus, bagasse and sisal. Microconcrete tiles,¹³ which have been used in rural areas in Mali, are another substitute for AC building materials; these tiles can be manufactured with primitive equipment in rural areas. Clay roofing tiles, galvanized iron roofing and “onduline” vegetable fibers and asphalt, which are being developed in Brazil, are also being used. The non-asbestos alternatives generally cost 12-30% more, but as manufacturing processes improve, the price differential will decrease. “Of course,” Castleman added “the reason AC products are cheaper is because asbestos companies don't spend what they should on prevention and compensation.” Off-loading the social costs of asbestos ill-health onto workers, consumers and civil society, gives asbestos producers a cost advantage against safer substitute products.

Alternatives for AC pipe include: cast iron and ductile iron pipes, high density polyethylene pipes, metal reinforced concrete pipes, clay pipes and cellulose fiber-cement pipes such as those produced by the Australian manufacturer James Hardie. Safer alternatives used for producing non-asbestos vehicle brakes include: semi-metallic brakes made of steel wool sponge iron and graphite in a plastic phenolic resin, wollastonite fibers, p-aramid fibers, fiberglass, and resins such as phenolic resin and cashew nut oil resin. For water storage tanks, fiberglass, polyethylene, PVA, cellulose, concrete and steel are some of the alternatives; the plastic tanks have the advantage of being lighter.

The double standards of Western countries which export redundant asbestos-contaminated ships to ship-breaking yards in Asia were discussed by Dr. Thebaud-Mony in her presentation: The Ballad of the Clemenceau. Commissioned in 1957, the Clemenceau was, for forty years, one of the French navy's most prestigious ships. “As with all ships of this period,” Thebaud-Mony said, “there is asbestos everywhere.” According to the Basel Convention, an international convention which bans the export of hazardous waste, and European Union regulations on the environment, each country should manage its own hazardous waste; the breaking up of asbestos-ridden ships should therefore take place in the ship's home country.

In 2003, the Clemenceau toured the Mediterranean looking for a ship-breaking yard with lax rules; the ship was sold to a Spanish company which tried to carry out the decontamination in Turkey. The French Government stepped in and forced the ship to return to the French military port of Toulon. On June 23, 2004 a contract for the decontamination of the ship was signed between the French State and the Ship Decommissioning Industries Corporation (SDI), a subsidiary of a German multinational, which stipulated that after Phase 1 of the asbestos removal was completed in France, the ship would be sent to India where the rest of the asbestos would be removed.¹⁴ Decontamination work took place in France between November 2004 and March 2005. In the meantime, Ban Asbestos France asked the Ministry of Defense to prevent the export of the contaminated ship to India.

Ban Asbestos France also started legal proceedings to make sure the ship did not sail. It forged links with Indian associations and NGOs which had previously spoken out on similar issues. Research undertaken by Greenpeace documented the reality of the occupational hazards which persisted in the Indian ship-breaking yards.¹⁵ Photographs showed abysmal conditions in Alang Bay where strong waves continually crash along the beach. Ship-breaking is big business in Alang Bay, the proposed destination of Le Clemenceau. In 2001-2002, 264 ships were broken up here by 25,000-40,000 workers, some as young as 17. Women carry away the lighter items from the ships including many which contain or are covered with asbestos. Asbestos is torn off steelwork with bare hands; people dry out crocidolite so it can be resold. The workers are mostly barefoot and protection from the many occupational hazards they are exposed to consists, in general, of a scarf over their mouths. Ban Asbestos France initiated legal action against the French State and the SDI; what should have been a debate about principles descended into a squabble over procedure. A decision by the Paris Court was expected on October 11, 2005 which would deal with the question of jurisdiction. Unless, there are dramatic developments, the ship could sail to India in March 2006.¹⁶ The battle of Le Clemenceau has been fought in the French courts, on French TV and in the media. It has given a high profile to the usually invisible transfer of hazardous waste from the developed to the developing world. This case illustrates not just the double standards which exist but the determination of national governments and multinationals to ignore international conventions and laws which adversely affect their economic interests.¹⁷

Presentations focusing on The Global Campaign to Ban Asbestos were made by Antonio Pizzinato, an Italian Senator, and Alain Destexhe, a Belgian Senator. Pizzinato said that a discussion of the Italian experience in achieving a national asbestos ban (1992) and implementing measures addressing the needs of the asbestos-exposed highlighted strategies which could be used on a supranational level. The Italian campaign could be divided into 3 phases:

Phase 1. The organization and mobilization of workers which led to demonstrations outside the national parliament and strikes at regional and national levels calling for the ban, a program of medical check-ups for the asbestos-exposed, early retirement for at-risk workers, the recognition of occupational asbestos-related illnesses and the decontamination of public and private buildings. This phase lasted 20 years and culminated with the passing of the Italian law banning asbestos and official government recognition of the problems of the asbestos-exposed.

Phase 2. Over the period 1994-2004, laws were implemented to end the use and processing of asbestos, asbestos mines were closed, a health care program for the injured was set up and a government insurance scheme for compensating victims of occupational as well as environmental asbestos exposures was put in place.

Phase 3. Initiatives are being pursued to contain, within ten years, the harmful fall-out from Italy's asbestos legacy by the removal and replacement of asbestos-containing products in factories and buildings, guaranteeing free health care through the national health service to all people with asbestos-related illnesses and the creation of an Asbestos Victims' Fund which, in addition to other government compensation, can be claimed by occupational asbestos victims, family members¹⁸ or people environmentally exposed.

The Italian experience has shown that the passing of legislation means little if regulations are not enforced. Monitoring of the implementation of EU asbestos directives in all 25 Member States is needed so that existing loopholes can be identified and dealt with. The Italian ban asbestos campaign also highlighted the need for collaboration of diverse groups including trade unions, victims' groups, NGOs, politicians, scientists and others. On a global level, agencies such as the World Health Organization, the International Labor Organization, the United Nations and European Trade Union Confederation need to be part of the campaign. Members of the European Parliament also have their role to play in achieving our goals. A policy of “Just Transition” must be developed whereby workers and communities which are financially dependent on the mining and processing of asbestos are offered alternative employment opportunities.

Senator Alain Destexhe, who has proposed asbestos initiatives to the Belgian Parliament, recommended the use of a strategy targeting the ten countries which produce and consume 90% of the asbestos used globally.¹⁹ As well as supporting Pizzinato's calls for coordinated action with global agencies, Destexhe suggested regional initiatives such as might be possible under the Council of Europe Convention and the Lomé Agreement. The use of asbestos in the construction of the Olympic buildings for the 2008 games in China could also be a focal point. Major international NGOs, such as Human Rights Watch, Amnesty International, Doctors Without Borders and Greenpeace, should be part of the global action on asbestos. Before he became a politician, Destexhe had worked for Doctors Without Borders and is mystified by the paradox posed by the Canadian Government's pro-asbestos stance.²⁰ Although Canada, which was at the fore of the global campaign to ban land mines, is widely regarded as one of the leading advocates for human rights, it leads the global asbestos lobby.

The last session of the day offered the opportunity for issues to be raised from the floor. Subjects mentioned during the debate included:

the desirability of having national asbestos legislation and information on medical treatment for asbestos-related disease available in English;
the importance of collecting information on the asbestos policies of multinational corporations;
the need for trade union and labor groups to push the ILO to “take a clear health-based position on the banning of white asbestos”;
the unacceptable blocking by asbestos stakeholders of the inclusion of chrysotile in the list of substances regulated under the UN's Rotterdam Convention;
the possibility of bringing criminal proceedings against executives and multinationals which have produced and marketed asbestos-containing materials over the last 30 years;
the need for pressure to be brought on the European Parliament to enforce the “Polluter Pays” principle and for research into mesothelioma and other asbestos-related diseases to be funded by EU companies which have profited from asbestos;
the holding of national and/or international days to remember those whose lives have been sacrificed to asbestos;
the possibility of using bilateral agreements to press for new asbestos restrictions;
the lack of epidemiological data from most EU Member States; the need for EU money to fund scientific and medical research and the role that MEPs can play in obtaining the financial backing required;
the problem posed by the statute of limitations which means that asbestos victims are, due to the long latency periods of asbestos-related diseases, often prevented from bringing legal actions for compensation;
the culpability of national governments in allowing the misuse of asbestos to take place;
the crucial role which can be played by the media in raising public awareness of the asbestos epidemic and putting pressure on governments for changes that will improve the treatment of victims and their families;
the discrepancy which allows asbestos exposures to occur on-board ships and in the air as EU asbestos regulations do not apply to these industry sectors.

Defining the Scope of Europe's Asbestos Problem

The second day of the conference began with the presentation Medical Aspects of Asbestos: Incidence, Examinations and Recognition, by Dr. Olaf Hagemeyer, who placed the German asbestos experience within a European context. Despite the fact that the German Government recognized asbestosis, lung cancer related to asbestos and mesothelioma in 1936, 1943 and 1976, respectively, huge amounts of asbestos were still used with dire consequences. From 1990-2005, the number of recognized cases of mesothelioma and lung cancer rose dramatically from 300 to 900 and from 300 to 2,100, respectively; the numbers continue to rise. Although, Eurostat, the statistical agency of the EU, has collated mesothelioma data for 2001, Dr Hagemeyer thinks, based on the German experience, that the Eurostat statistics underestimate the problem by up to 42%.

As specified in EU Council Directive 83/477/EEC of September 19, 1983 Protection of Workers from the Risks Related to Exposure to Asbestos at Work, medical checks are required before the beginning of hazardous exposures and, thereafter, every three years.²¹ Article 16 of this directive states that exposure and medical records must be retained for 30 years and Article 17 states that a register of recognized cases of asbestosis and mesothelioma shall be kept. Between July 2004 and April 2005, research was carried out by Dr. Hagemeyer's team into current practices in Member States. Questionnaires about how the EU directive was being implemented were sent out which asked specifically about post-exposure medical examinations. Answers were received from 23 Member States; Cyprus and Malta did not respond. An analysis of the responses showed that post-exposure medicals were carried out in only 14 Member States (60%); examination procedures differ: some consist of regular lung X-rays, examination of sputum is carried out in 7 countries and occasional high resolution computer tomography is done in 12 Member States. Only 15 States retain medical records for 3 years. “The absence of records will,” Hagemeyer said, “have an impact on our ability to access data.”

In September, 2005, the EU decided that the collection of gender-related data is unnecessary. Judging by the statistics collected on the German distribution of mesothelioma, this decision is short-sighted, Dr. Hagemeyer said. The underclaiming of government compensation by women with mesothelioma is significant; in 2002, there were more than 250 female mesothelioma deaths and only 75 claims. On the other hand, the data collected shows that the percentage of males claiming for mesothelioma has risen dramatically over the last 20 years. One possible explanation for this is the failure of doctors and coroners to ask about the exposure history of women with mesothelioma. In Germany, if you can't prove occupational asbestos exposure then the recognition of the disease as occupationally related, which is essential to receive government compensation, is compromised. With the long latency period of asbestos-related diseases, it can be difficult to prove occupational exposure. Therefore, Hagemeyer suggested that a central register of all asbestos-exposed workers should be compiled. Furthermore, due to the synergistic relationship between asbestos and tobacco, all asbestos-exposed workers should be helped to give up smoking.

Beginning his presentation The Economic Costs and Consequences of NHS²² Treatment for Asbestos-Related Diseases in Scotland, Dr. Andrew Watterson quoted a 19th century German physician who said that medicine is applied politics; it is clear, Dr. Watterson said, that social, economic, political and legal factors impact on the treatment of patients.²³ The research carried out in Scotland, which was the basis for this paper, was guided by people working in Glasgow with asbestos victims who believed it was essential to quantify the financial impact asbestos-related disease was having on the Scottish economy for several reasons, including the need to illustrate the cost effectiveness of adopting measures to prevent future exposures. Since devolution, Scotland has had its own Parliament and Departments of Health and Environment; this research project was able to access Scottish information sources such as the General Register Office and estimate Scottish healthcare costs, based on information from the databases of the Scottish Morbidity Record (SMR) and the Scottish Health Service Costs (NHS Scotland), for mesothelioma and asbestosis fatalities in 2000.

Inconsistencies found by the researchers included:

there is no such thing as a standard mesothelioma patient. According to data from the Mesothelioma Center in Leicester, some patients died in six months having had costly treatments and others lived for four years having had minimal treatment and little medical intervention;
healthcare treatment of mesothelioma varies widely throughout the UK and treatment options often seem to be dependent on a “postcode lottery”;
reporting bodies disagree about the scale of the problem: whilst the researchers identified 119 cases of asbestos-related deaths in Scotland in 2000,²⁴ the Scottish Parliament, in a Parliamentary Question in 2002, reported 138 mesothelioma deaths²⁵ and Eli Lily, the pharmaceutical company that produces ALIMTA, reported 183. There is “an underestimation of the true number of deaths from pleural mesothelioma.”

There is a wide range of health services that asbestos patients can access in Scotland, including: general practitioners, chest physicians, cardiac surgeons, consultant oncologists, lung specialist nurses, community nurses, palliative care specialists, allied health professionals, histopathologists, social services, hospice services, coroners, benefits advisors and social workers. Having established a range of costs for types of care and medical treatment, the researchers estimated that the annual acute in-patient costs for the mesothelioma patients who died in Scotland in 2000 were �942,038.²⁶ Extrapolating that to the UK, produces a figure in excess of �16 million for the treatment of mesothelioma patients in 2000 and an estimate for the total money spent in the UK for the treatment of mesothelioma over the period 1990-1999 of �471,019,000. These costs have been borne by taxpayers and not the asbestos corporations which profited from the sale of asbestos-containing goods.

In July 2005, the Scottish Medicine Consortium agreed to prescribe ALIMTA for all suitable Scottish mesothelioma patients. The corresponding body in England and Wales, the National Institute of Clinical Excellence (NICE), will not make a decision on ALIMTA until Autumn 2006. Eli Lily estimates that the treatment of 100 mesothelioma patients with ALIMTA now costs �400,000 in Scotland; in 5 years, the annual bill could rise to �750,000. Clinicians working in England and Wales believe that 30% of mesothelioma patients would benefit from treatment with ALIMTA. It is, Dr. Watterson said, unacceptable that patients in England do not have access to a drug which could, at the very least, alleviate symptoms:²⁷

“Treatment and drugs should be available on the basis of clinical and health need and not on the basis of patient income or on where they happen to live, be it in Scotland, England, Brazil or China.”

Global asbestos producers have only been able to profit from their deadly trade by externalizing the costs of health care and treatment for their victims. When these costs are factored into the budget, the production and use of asbestos becomes unviable.

The next speaker was Lars Vedsmand, an Occupational and Safety Officer for the Danish Confederation of Construction Workers' Unions. Vedsmand's paper The Under-reporting of Asbestos Cancer in Denmark, described national procedures for the recognition of asbestos-related disease and the remaining loopholes. In Denmark, there is a list of recognized occupational diseases which is updated by the Occupational Diseases Board every 3-4 years. The Board is a tripartite body with representatives from trade unions, the public sector and industry. The trade union has an occupational disease committee which determines the diseases to be recommended for inclusion. Trade unions in Denmark have been in the vanguard of the fight against asbestos. At the end of the 1980s, local branches of the trade union looked at a map of Denmark drawn up by the Cancer Institute showing the distribution of mesothelioma. There was a preponderance of mesotheliomas in areas in which dockyards, glass factories and other asbestos-using factories were located. The union wrote to several hundred former workers, asking if they had worked at the dockyards, handled asbestos-containing insulation or had symptoms of lung disease. Over one hundred former dockyard workers were interviewed and 50 were sent for medical examinations. A significant aspect of the examination program was the cooperation of the union officials, local medical practitioners and doctors working in occupational disease clinics. As a result of this initiative, 24 of the workers were able to obtain payments from the National Compensation Board.

In Denmark, every worker has to contribute to the Government Work Injuries Scheme; hospital doctors must report all occupational diseases as well as suspicions of diseases which could be work-related. If, for example, a carpenter is diagnosed with lung problems which might be occupationally-linked, the illness must be notified. Asbestos-related diseases have been officially recognized as occupational diseases for more than 40 years: asbestosis in 1954, lung cancer in the late 1950s and mesothelioma in 1963. Nevertheless, there is no automatic recognition procedure and there are instances when trade unions have had to take legal action to force employers to pay compensation. In 1986, the union took a case to the Supreme Court to force the defendant, Danish Eternit, to pay.

Two to five per cent of all cancers diagnosed in Denmark are work-related; this translates into 650-1300 occupational cancers per year. Unfortunately, only a fraction of these, 208, are recognized. To ascertain whether underreporting has taken place and to assess the impact a simple work history could have on the recognition procedure, research was undertaken by the Danish Cancer Institute. Nearly 700 mesothelioma patients, diagnosed between 1994 and 2002, fulfilled the criteria specified by the researchers; less than half (300) had been reported to the National Compensation Board. The study, to be published in 2005, concludes that a serious underreporting of occupational cases of mesothelioma exists. Another revelation was uncovered by further enquiries among male mesothelioma patients on the Danish Cancer Registry who had not applied for their illnesses to be recognized as occupationally-caused. The researchers were able to establish that information available on the jobs these men had undertaken and the potential for asbestos exposure at these jobs would have enabled an additional 105 male mesothelioma victims to obtain compensation. “In economic terms this study demonstrates,” said Vedsmand “that over an 8 year period insurance companies cheated mesothelioma patients out of 16 million Danish kroner (US$2.58 million/Euro 2.15 million).” The conclusions of this study have come as a bombshell in Denmark. Even though oncology wards ought to be familiar with the causation of occupationally-linked illnesses, patients are not asked to provide occupational histories. The proportion of women whose mesotheliomas are reported is even lower than that for men. Unfortunately, the Danish experience is not unusual; in 2001, the European Cancer League reported that only Finland, France, the UK and Denmark were in a position, on the basis of publicly available information, to provide statistics on mesothelioma. As a result of the underreporting, the Danish Minister of Employment recently announced that action will be taken to make it compulsory for hospital staff and general practitioners to take occupational histories; more professional training and information will be provided. Concluding his talk, Vedsmand called for global dialogue among trade unions, victims' organizations and the medical community.

Dr. Panagiotis Behrakis, former President of the Hellenic Thoracic Society, a specialist in lung and occupational diseases and Associate Professor of Physiology, addressed the subject of Asbestos-Related Diseases in Greece. Until 1995, Greece was amongst the world's top seven suppliers of asbestos, producing 100,000 tonnes of chrysotile every year from the Zidani Asbestos mine in Northern Greece; it is estimated that 919 workers were occupationally exposed to asbestos at this site. Up to 300,000 tonnes a year of Greek and imported asbestos were processed at asbestos-cement factories in:

Nea Lamsakos, Evoia, placing a workforce of 250 at risk of occupational asbestos exposure from 1961-1990;
Thessalonica, placing 416 personnel at risk of occupational asbestos exposure from 1968-2003;
Patras, placing 150 workers at risk of asbestos exposure from 1969-2000.

Asbestos-containing brakes and fireproofing materials were also produced in Greece. In 1990, Greek Professor E. Velonakis estimated that the cumulative number of workers who had been exposed to asbestos was 150,000. In 1993, a study carried out by Professor M. Kogevinas estimated that 10,000 workers were experiencing harmful asbestos exposures every year. In 1993, the use of blue asbestos (crocidolite) was banned by law 1154/93; on December 31, 2004, Greece became the last of the 15 EU Member States to ban the use of all forms of asbestos as per the EU Directive.

Early attempts to investigate the repercussions of Greece's widespread use of asbestos include the following:

medical examinations by Dr. Solinaraios of 55 asbestos-cement workers, employed from 1958-1967, which identified 14 cases of asbestosis and described the first Greek case of pleural mesothelioma;
the publication in 1973 of a case report by Professor Vamvalis detailing asbestosis in a 38 year old man with two years exposure to asbestos-containing soundproofing material whilst employed as a technician in a recording studio;
the first epidemiological study on asbestos, published by Professor Velonakis in 1989, which looked at asbestos-related X-ray changes in 141 retired Greek merchant marine seaman; the lung functions of 36% of those examined had been compromised by asbestos exposures.

The incidence of asbestos-related disease is underestimated by Greek Government agencies; the numbers of cases of asbestosis reported by the Social Security Foundation were: 3 (1994), 5 (1995), 3 (1996), 4 (1999), 3 (2000) and 1 (2001). Dr. Patentalakis, a respiratory specialist practicing at a hospital specializing in lung diseases, has reported diagnosing 456 cases of asbestosis and 22 cases of mesothelioma in the period 1994-2002. Groups found to be at higher risk of contracting asbestos-related diseases include:

people in the Metsovo area where, as documented by Professor Constantopoulos, there is a high incidence of mesothelioma due to environmental exposures;
merchant seamen and naval personnel, especially engineers, who have traditionally experienced high-levels of continual asbestos exposure while performing their duties on-board ships.

Although mesothelioma of the peritoneum is recognized as an occupational disease in Greece, pleural mesothelioma is not.²⁸ The Government, while being aware of the contradiction, has done nothing about it. In 2001, a 52 year old sheet metal worker was diagnosed with pleural mesothelioma; due to intensive efforts by his doctors, his case was recognized as an occupational disease.

Since the Hellenic Asbestos Seminar was held in Athens in 2002, a dialogue on asbestos issues with the Greek Government has been ongoing. At a press conference held in Athens on September 21, 2005, the Labor Minister confirmed the decision to establish the Ministry of Employment & Social Security National Committee for the Management of Asbestos-Related Hazards. In collaboration with the Department of Occupational and Environmental Medicine, Imperial College, London measures for setting up a Greek Mesothelioma Register, and later a register of all asbestos-related diseases, are being considered. Plans to raise awareness of asbestos hazards amongst workers in the construction sector are being made; the Education Ministry is devising a program to deal with asbestos in schools, which will include measures to protect workers removing asbestos from contaminated school buildings as well as building users.

Completing his presentation, Dr. Panagiotis Behrakis invited doctors from the Czech Republic, India, Lithuania and Turkey to join him for the medical panel. Dr. Daniela Pelclova, from the Department of Occupational Medicine at Charles University, Prague, highlighted the different criteria used by countries for the diagnosis of asbestos-related diseases. In the Czech Republic, recognized occupational diseases are specified in the List of Occupational Diseases (Government Order No. 290/1995), which is based on ILO classifications.²⁹ There are 18 clinics or outpatient departments specializing in occupational diseases. Every case of occupational disease must be verified by one of the 18 branches of the Department of Occupational Diseases; the disease must be on the List of Occupational Diseases and exposure must be confirmed by industrial hygienists. The Department recognizes the claim (not an insurance company or law court) and decides on compensation, usually within a matter of weeks.³⁰ From 1991-2004, 638 cases of mesothelioma were diagnosed in the Czech Republic, of which 52 (8%) were recognized as occupationally-linked; a further 230 cases of asbestos-related diseases were recognized.

The breakdown of the 23 cases of occupational asbestos disease which were recognized in 2004 is shown in the following table.

Diagnosis	Number Recognized	Male/Female	Age	Exposure (years)
Asbestosis	4	3/1	43-69	3-34
Pleural Hyalinosis with Lung Function Impairment	12	4/8	55-79	2-38
Mesothelioma	3	2/1	45-64	16-22
Lung Cancer with Asbestosis or Pleural Hyalinosis	4	4/0	56-73	3-30

These figures seem low considering that official sources believe that up to 55,000 workers have been occupationally exposed to asbestos in the Czech Republic; exposures are still taking place amongst those involved in asbestos removal, demolition and construction work. Dr. Pelclova said that uniform medical criteria for the recognition of these diseases should be agreed by a medical committee of European occupational physicians; systematic post-exposure examinations of all at-risk workers within the EU should be a priority.

Pictures shown by Dr. T.K. Joshi, Director of the Center for Occupational and Environmental Health in New Delhi, illustrated the concept of “controlled use” of asbestos in India. One image of a female worker engaged in the processing of asbestos showed huge clouds of dust emanating from the machine directly in front of her; she wore no respiratory protection to minimize the inhalation of the toxic dust. The asbestos-cement industry, which has a powerful lobby in India, has persuaded politicians to lower duty on the import of asbestos; consequently, imports have increased nearly 30%, from 76,095 tonnes in 1998-1999 to 98,884 tonnes in 2002-2003. According to information supplied by the Parliament:

Russia, Canada and Zimbabwe account for 82% of the imported asbestos;
the production of asbestos-cement material has risen from 681,000 tonnes in 1993-94 to 1,387,000 tonnes in 2002-03;
32 asbestos-cement factories are distributed throughout India; the States with the largest number of facilities are: Maharasthra (9), Tamilnadu (6), Andhra Pradesh (3) and West Bengal (2).

The (Indian) National Cancer Register does not document cases of mesothelioma; the Indian Government does not record the incidence of occupational disease. Only 7% of the Indian workforce is organized; the vast majority of workers, especially in the construction industry, remain unseen and unheard. No protective equipment or respiratory protection is provided to protect workers from hazardous asbestos exposures. Pictures of barefoot workers on Alang Beach dismantling toxic ships exported to India, illustrate the primitive conditions which are standard throughout much of Asia. Poor governance in India, corruption and political influence obtained through the dispersal of asbestos cash combine to create a climate in which asbestos consumption is flourishing.

Dr. Ruta Everatt, from the Center of Occupational Medicine at the Institute of Hygiene in Vilnius, discussed Occupational Asbestos-Related Diseases in Lithuania. As industrialization began in Lithuania in the 1950s, Dr. Everatt said, “asbestos-related occupational disease is only now becoming an important public health issue.” Between 1961 and 2004, when it was banned, 700,000 tons of asbestos were used; most of it was chrysotile, imported from Kazakhstan and Russia, which was used in the manufacture of asbestos-cement products. In 1997, it was estimated that the number of workers who had been exposed to asbestos in Lithuania was 7,451, of whom 42% worked in the construction sector. Others at-risk of contracting asbestos-related occupational illnesses included: 2,787 workers from the:

Daugeliai Building Products factory, which produced asbestos-cement sheets from 1956 to 1997;
Akmenes Cementas factory, which manufactured asbestos-cement sheets and pipes from 1963 to 2001 (for sheets) and 2004 (for pipes).

In the 1990s and early 2000s, surveys found asbestos in power plants, machinery factories and the chemical, construction and transport industries.

There has been little recognition of asbestos-related disease. Despite the fact that 125 cases of pleural mesotheliomas were recorded between 1992 and 2001 and 1,300 new cases of male lung cancers are diagnosed annually, not one case of either disease has been diagnosed or compensated as an asbestos-related occupational disease. There is a list of diseases, recognized by the Government and including malignant and non-malignant diseases, acknowledged to be due to exposures to hazards encountered at work. The process of evaluation and notification of occupational disease is rigid and cumbersome:

a general practitioner, doctor or occupational physician must inform the local labor inspection authority about the case;
a three person commission is formed to investigate whether exposure at the workplace had occurred;
the conclusions reached by the commission form the basis for the subsequent judgment made by a licensed occupational physician.

Patients, many of whom are seriously ill, must be present at time-consuming meetings throughout the adjudication process. Due to the protracted and complex nature of the system, doctors show little enthusiasm for proposing cases. Proof of causation is required even for people who worked in high-risk sectors, like asbestos-cement, or occupations, like insulators, and were affected by specific illnesses, like mesothelioma or lung cancer. Research in Lithuania suggests that there are at least 50 cases of asbestos-related lung cancers every year, none of which are recognized as occupational. More needs to be done, Dr. Everatt said, to raise awareness of the occupational health hazards of asbestos amongst workers and healthcare professionals; well-defined criteria would help in ensuring that the correct diagnosis is made and that the certification and compensation process is expedited.

The incidence of mesothelioma is high in Karain and Tuzkoy, villages in Cappadocia, Turkey, due to the presence and use of naturally-occurring erionite. To explore whether there are other factors, aside from hazardous environmental exposures, which explain why some villagers contract mesothelioma and others do not, research was undertaken. The next speaker, Dr. Salih Emri of Hacettepe University, Ankara, discussed: Is There a Possible Genetic Factor for Susceptibility to Erionite Carcinogenicity in the Erionite Villages. Over 30 months, data was collected about the diets, occupations, lifestyles, medical and smoking histories of families in the towns of Karain, Tuzkoy and Karlik by a team of Turkish and U.S. scientists. Applying the technique of genetic mapping suggested a genetic susceptibility:

analysis of a six-generation extended pedigree of 526 individuals showed that Malignant Pleural Mesothelioma was genetically transmitted;
it was suggested that vertical transmission of Malignant Pleural Mesothelioma occurs probably in an autosomal dominant way.

Further research is being carried out. Claims made about the link between the SV40 virus and mesothelioma have not been upheld by research in Turkey which found that SV40 was not a cofactor in the development of Turkish mesotheliomas.

Preserving the Legal Rights for Asbestos Disease Sufferers was the title of the presentation made by Sally Moore, a plaintiffs' solicitor from England. The fight to gain compensation for asbestos victims and their families is a constant struggle; recent developments show the growing intransigence of defendants who, in the face of an escalation in UK asbestos-related deaths, are mounting coordinated resistance in the courts and media to undercut the rights of asbestos victims. Insurers and defendants worked together on the strategy for the Fairchild case, alleging that where it could not be scientifically proved which asbestos fiber caused a claimant's mesothelioma, a defendant could not be held liable. Fortunately, the House of Lords ruled in 2002 that plaintiffs who had experienced asbestos exposure which materially increased their risk of mesothelioma were entitled to recover all their damages from whichever negligent defendant remained. Post-Fairchild an actuarial report (2004) estimated that there could be up to 200,000 UK asbestos claims costing �8-�20 billion in the next three decades; these predictions gave added impetus to the search for new defense tactics. In the Barker case, which will be heard by the House of Lords in 2006, defendants will argue that where compensation is apportioned amongst different employers, each should only pay his share of the damages. A victory for the defendant would “have a profound effect on mesothelioma victims' damages awards.”

Pleural plaque claims account for 70% of all UK asbestos lawsuits. In the past, pleural plaque victims were awarded �6,000-�7,500 by the courts on a provisional basis; in 2005, a court ruling reduced these payouts by about 50%. This decision has been appealed to the Court of Appeal. Other developments which have adversely affected victims' rights include corporate restructuring such as the purchase by the U.S. company Federal Mogul (FM) of the UK's “asbestos giant”: T&N plc. Within three years of the acquisition, FM, under a deluge of U.S. asbestos claims, went into Chapter 11 and T&N into administration. In the four years since then, thousands have died from asbestos-related injuries and not one victim has been compensated as all legal actions remain frozen by court order. Cape plc, formerly the UK's 2nd biggest asbestos group, is also trying to contain its asbestos liabilities by corporate restructuring. In 2005, plans announced by the company to establish a �40 million compensation fund were greeted with scepticism by UK asbestos victims' groups. Resistance by these groups and their legal advisers succeeded in delaying Cape's attempts to railroad its proposals through the courts; independent legal and financial advice is now being sought by claimants' groups to assess the worth and viability of Cape's proposals.

“As if all of this wasn't enough,” Ms. Moore said “those who have suffered asbestos-related diseases at the hands of negligent employers, are also faced with the insecurity that the employer's insurer will not pay out on their indemnities”:

“In January 2001, Chester Street Insurance Holdings Ltd. (previously Iron Trades Holdings Ltd.) was declared insolvent. Iron Trades had been the employer's liability insurers for a number of major shipyards and shipbuilders, as well as companies such as British Steel and the Central Electricity Generating Board. Chester Street's asbestos liabilities, which at April 2001 stood at �60m, were expected to rise drastically over the next forty years.

To add insult to injury for the beneficiaries of Chester Street insurance policies, it appears that a corporate restructuring at Iron Trades was behind the economic failure at Chester Street. In 1989, Iron Trades Employers Association Ltd. dumped all pre-1990 policies, many of which have continued to generate asbestos-related liabilities, into the Chester Street Company. Post-1990 policies went to Iron Trades Insurance Company Ltd. which, without the burden of asbestos claims, was bought at a knock-down price in February 2000 by an Australian based insurance group.”

Court-appointed administrators for Chester Street proposed a Scheme of Arrangement under which victims would receive an initial payment of 5% of their entitlement. A highly political campaign by asbestos victims' groups, trade unions, politicians and campaigners secured a deal, which included significant contributions from the UK insurance industry and the Government, that compensated the majority of those affected by the collapse of Chester Street. There is no guarantee that should a similar collapse occur in the future, there will be the political will to protect victims' rights.

Concluding her talk, Ms. Moore said:

“the UK experience demonstrates that when asbestos victims and the people who represent them pool their resources and mobilise political pressure they represent a formidable opposition to foil attempts of corporate robbery. Awareness of the plight of asbestos victims is growing; asbestos support groups are springing up around the world in places such as Japan, Argentina and the Philippines… The need remains for all of us: victims, victims' representatives, trade unionists, academics and lawyers to work together. And the need remains for the European Union to put its house in order. The relocation of James Hardie from Australia to the Netherlands to evade its asbestos liabilities is as transparent as it is despicable. The EU should not be a home for this dirty money. Furthermore, the EU must ensure that EU-companies should not engage in asbestos operations outside Europe. Sanctions should be available to punish those who do.”

Former Senator, founding member of the Dutch Asbestos Victims' Committee and plaintiff's lawyer, Bob Ruers addressed the subject of: Corporate Accountability and Compensation: Eternit – A Case Study. As more than 75% of asbestos has been used in the production of asbestos-cement materials, Ruers looked at the history of Eternit, one of the world's biggest asbestos-cement groups. At the beginning of the 20th century, Ludwig Hatschek invented a process for combining asbestos fibers with cement to produce asbestos-cement, a material which had excellent technical properties and could be used for a wide range of applications. As asbestos would “last forever,” Hatschek named the process Eternit, for eternal, and proceeded to sell the patent to companies all over the world, many of which took the name Eternit. From the beginning, there has been an overlap of ownership and personnel amongst various Eternit companies.

The asbestos-cement industry spread rapidly and was hugely successful. Global production peaked in 1975, after which time sales in the developed world began to fall. As restrictions were imposed on asbestos consumption in these countries, new markets were cultivated in developing economies; in recent years, sales of asbestos-cement products in India, Pakistan, Indonesia and Thailand have risen significantly. Extracts Ruers showed from asbestos-cement trade journals included:

photographs from 1963 of 4,000 new dwellings with asbestos-cement roofs in Dakar, Senegal and residential communities with asbestos-cement buildings in India;
a 1970 poster, captioned Eternit in the Congo, of the Belgian cartoon character Tintin in a canoe;
a 1970 advertisement contrasting traditional African houses with “modern” houses covered with asbestos roofing material.

Ruers was appalled that despite the knowledge that exposure to asbestos can cause debilitating and fatal diseases, asbestos producers continue to advance the case for the safe use of asbestos and deny the existence of safer alternatives. Since the asbestos ban was introduced in the Netherlands in 1993, replacements have been found; it is despicable to expose the populations of developing countries to the risk of diseases which have already caused so much human misery.

Documents show that Eternit has, since the 1930s, been active in lobbying national governments as well as international agencies, such as the International Labor Organization, on asbestos issues, eager to “safeguard its position.” In 1929 Eternit Belgium and Eternit Switzerland entered into a joint venture at the suggestion of Ernst Schmidheiny, from Swiss Eternit, who believed that competition for raw materials and markets was not as cost-effective for asbestos-cement producers as cooperation. An exclusive group of asbestos-cement producing companies was formed; it was named: the International Asbestos Cement AG (SAIAC). Its aims were, as Mr. Ruers said, “impressive”:

exchange of technical knowledge, experience, propaganda and patents;
joint purchase of raw production materials;
joint research;
setting up export arrangements;
establishing new companies in 'neutral' countries;
arranging markets and market prices.

Turner & Newall Ltd., the UK's biggest asbestos group, was proud of its membership of the cartel, referring to it as a “miniature League of Nations” in its annual company report.

To illustrate SAIAC's truly global reach:

“In 1962 a number of SAIAC's members established a joint enterprise called TEAM. The new organisation was based in Luxembourg. TEAM's aim was 'the world wide coordination of new asbestos cement companies.' The participants of TEAM were Eternit-Belgium, Johns-Manville and T&N. Under TEAM's coordination, asbestos cement companies were set up in Vietnam, Bangladesh, Pakistan, Indonesia, Turkey, Greece and Senegal. In a later stage, companies were set up in Nigeria, Burundi, Kenya, Japan, China, Argentina and Mexico.”

Eternit (Netherlands), part of the Belgian Etex Group, has caused ill-health and death amongst many former workers, family members and local residents. There is widespread asbestos contamination of communities near the Eternit factories; the cost of the asbestos decontamination work needed in the Netherlands has been estimated at 50 million euros. Eternit is adamant that it will not pay. Dutch Parliamentarians have been asked to apply “the polluter pays principle” to force the company to remedy the environmental devastation it is has wrought. The arrogance of asbestos-cement executives and corporations is not a thing of the past. A recent newspaper article which appeared in Switzerland criticized Italian prosecutors who, in their attempt to obtain justice for asbestos victims, are contemplating legal action against Mr. Schmidheiny. The Swiss entrepreneur claims he is being “hounded without cause” by the (Italian) legal authorities. An offer by Eternit to contribute to an asbestos fund, as long as the company and its executives are not prosecuted is, Ruers said, an insult to the victims. In Belgium, Eternit wields enormous influence. The publication of a newspaper article, entitled The Vale of Silence in Belgium, about the country's tragic asbestos legacy, was scheduled to coincide with the European Asbestos Conference; it did not appear. The suppression of the article illustrates that in 2005, censorship and corporate influence is still stronger than free speech and democracy in Belgium. Concluding his presentation, Ruers said that national governments must rigorously investigate cases of environmental asbestos pollution to establish who the polluter was and how they can be forced to remedy the wrong they have done. Legal actions against Eternit executives should continue. Research into the influence and actions of these major multinationals is needed to, once and for all, document their part in the global asbestos scandal.

At the beginning of the conference, delegates were asked to submit their comments on a draft declaration prepared by a working party in the run-up to the conference. The task of incorporating these suggestions in the final document was accepted by Laurent Vogel from the European Trade Union Institute. In the final presentation of the morning session, Vogel reported that more than 40 amendments had been tabled and that the need for brevity meant that not all could be included. Many of the proposed changes related to specific national issues and, as the intention of this document was to facilitate common action and not to detail all the different national asbestos realities, some amendments had to be omitted. The principal amendments which were added are on the subjects of:

1. Just Transition

Individuals and communities affected by the asbestos ban must receive support and assistance. This could include early retirement for asbestos-exposed workers, restructuring of industry in asbestos mining regions so that new forms of employment are provided and programs for decontamination of the environment are implemented.

2. European Fund to Compensate Asbestos Victims

During the debates, it became clear that different national realities have, understandably, led to conflicting views on the relevance of such a fund. In Scandinavia, social security bodies or health authorities seem able to provide a satisfactory service while in Belgium asbestos victims are left out in the cold. Whilst European funds need to be available to help those affected by asbestos, it is not appropriate or desirable to impose a universal solution; a more flexible approach should be adopted.

3. Future Actions

To maximize the global impact of asbestos protests, it would seem desirable for demonstrations to be synchronized. Some delegates expressed the preference for April 28, International Workers Memorial Day, while others preferred to follow tradition and hold their protest on May 14. Discussion of this subject is ongoing.

Following a debate on the resolution, MEP Liotard asked delegates to vote; the Brussels Declaration³¹ was adopted.

Roundtable Session

The afternoon session of the conference consisted of a roundtable, co-chaired by trade unionists Angel Carcoba and Fiona Murie. Highlighting the importance of the human interaction facilitated by the conference, Carcoba stressed the need for EU action on:

the establishment of mandatory asbestos disease registers;
the harmonization of protocols to guarantee occupational safety for all including those employed in asbestos removal;
the recognition of occupational diseases and the harmonization of medical protocols for the examination of affected workers;
the establishment of a certification scheme for asbestos removal and other companies at risk of hazardous exposures, such as those engaged in demolition and construction work.

“The EU,” Carcoba said, “is not just an economic community but one concerned with social issues as well.” Disseminating knowledge and raising awareness can be greatly assisted by pooling our resources; sharing literature, scientific studies, court decisions and visual images from country to country would be a positive outcome of the conference.

Fiona Murie, Director of Health and Safety at the International Federation of Building and Woodworkers (IFBWW), described the dangerous conditions experienced by IFBWW members in Africa, Latin American and Asia, many of whom are at risk of occupational asbestos exposures in the building and asbestos-cement industries. Aggressive marketing campaigns, backed by millions of asbestos dollars, are targeting decision makers and consumers in developing countries. The increase of asbestos consumption in countries which have little information on the long-term consequences of asbestos exposures, no specific asbestos laws, no enforcement of the laws which do exist, no official workplace inspections, no compensation, no health services and no social security is cause for serious concern. The vulnerability of construction workers in these countries makes exploitation routine; often illiterate, many of them live with their families on building sites or by the sides of roads. In this context, the notion of the “controlled use” of asbestos is, said Murie, a “sick joke.”

Photographs from the Philippines illustrated the chaotic conditions experienced by construction workers who were shown working barefoot and unprotected. The IFBWW has been campaigning on asbestos since the 1980s. Trade unionists in Chile were in the forefront of the ban asbestos movement; working with an asbestos victims' group, they were able to expose the nefarious practices of Pizzarreno, a member of the Eternit Group, which refused to acknowledge or compensate the grieving families of 300 employees, dead from asbestos diseases, from 11 asbestos-cement factories. Using demonstration techniques honed during the years of the Pinochet dictatorship, “funas,”³² were held outside the homes of Pizzarreno executives to expose their personal involvement in the company's shameful behavior and build pressure for a national asbestos ban. In 2001, Chile became the first country in Latin American to ban asbestos.

The IFBWW, working with other global labor organizations, has been lobbying the ILO to adopt a health-based position on a global asbestos ban. Unfortunately, many European governments have been “unhelpful”; the UK, Holland and Denmark, among others, are resisting new laws, multilateral treaties and new conventions on labor standards in their determination to exploit the status quo. ILO Convention 162 is being purposefully misused by asbestos lobbyists in Brazil and elsewhere who cite it as justification for industry's “controlled use” propaganda. Conference delegates need to push national delegations to progress the pro-ban position at the ILO. The World Health Organization, which has agreed to make the elimination of asbestosis a priority, also needs to address the consequences of environmental exposures. Amongst the IFBWW objectives are:

the need for a global ban on asbestos;
the inclusion of chrysotile on the Prior Informed Consent list of the Rotterdam Convention;
the protection of workers such as carpenters and plumbers from hazardous asbestos exposures;
the elimination of dry stripping for asbestos removal by unlicensed companies employing untrained operatives and the illegal dumping of asbestos;
the need to improve workers' rights and conditions and to end informal and uncontrolled working practices.

During the three hour roundtable, doctors, political activists, trade unionists, victim support campaigners and NGO representatives from new and old EU Member States reported on current developments and specific problems being encountered. The presentation of country updates was followed by a wide-ranging discussion which included contributions from many conference delegates.

Lithuania

Complimenting the presentation she had made during the medical panel, Dr. Ruta Everatt explained that the first national regulations on the production and use of asbestos were adopted in 1998; in 1999, the measuring of asbestos air contamination began. Since 2000, steps have been taken to phase-out the use of asbestos, prohibiting specific products as follows:

from January 1, 2001, the import, production and use of corrugated and plain asbestos-cement slates for new houses and public buildings;
from January 1, 2002, the use of corrugated and plain asbestos-cement slates for all other new buildings and the import and production of processed asbestos fibers and materials, except when used for civil aviation;
from January 1, 2003, the use of processed asbestos fibers and materials, except when used for civil aviation;
from January 1, 2004, the import of asbestos and production of asbestos-cement pipes.

In accordance with hygiene norm HN 36:2002: Banned and Restricted Substances and government decree The Restriction of Import, Production and Usage of Asbestos and Asbestos-Containing Products, a comprehensive national asbestos ban was implemented in 2004.

Recent efforts to minimize asbestos exposures in Lithuania stem from the transposition of EU asbestos legislation. The Regulation for Work with Asbestos, which came into force on July 1, 2005, was prepared in accordance with directives of the European Council 80/1107/EEC, 83/477/EEC and 91/382/EEC. According to Dr. Ruta Everatt:

“This regulation sets forth the requirements for all fields of activity associated with asbestos: transportation, storage, demolition and repair work, the removal of waste, protection, healthcare and special training for workers, labelling etc. Before the start of any activity associated with asbestos, as well as demolition or asbestos removal work, the exposure has to be assessed to determine the degree and the nature of the worker's exposure. The employer is required to notify the labour inspectorate about these activities. The Regulation lowered the limit values of asbestos to 0.1f/cm³ and concentrations in workplace atmospheres have to be measured regularly. Each worker's state of health has to be assessed prior to exposure and regularly for the duration of the exposure, and based on an annual chest X-ray and respiratory function assessment. No medical survey is conducted after exposure cessation.”

Difficulties with applying these regulations are being reported with the result that hazardous asbestos exposures at work and in the environment are “still quite common.”

Bulgaria

In her second presentation to the conference, trade unionist Svetla Karova described efforts to address Bulgaria's asbestos legacy. A campaign, begun in 2000 by the General Labor Inspectorate, was aimed at achieving a consensus for the phasing-out of asbestos and asbestos products. The program was discussed at a National Tripartite Seminar in 2001 and was taken forward as part of the National Action Plan for Environment and Health by the Ministry of Health. The requisite legislation which was passed included:

Ordinance No. 1 of February 27, 2003 on the Protection of Workers from Risks Related to Exposure to Asbestos at Work;³³
Ordinance No. 5 of April 15, 2003 on the Prevention and Decrease of Asbestos Pollution of the Environment;³⁴
Ordinance on Dangerous Chemical Substances, Preparation and Products, in force from January 1, 2003;
Ordinance on the Import and Export of Dangerous Chemical Substances, in force since 2004.

Although the import, production and use of all asbestos fibers and types of asbestos-containing products have been banned since January 1, 2005, “the dangerous influence of asbestos will remain for the coming years because of the employment of many workers engaged in at-risk activities.” Techniques which have been proposed for containing the ongoing asbestos hazard include:

undertaking audits to compile asbestos building registers;
monitoring the health of asbestos workers;
registering those who have been occupationally exposed to asbestos;
controlling the disposal of asbestos waste and managing hazardous waste sites.

Cyprus

In the aftermath of the 2002 campaign to spread awareness of the asbestos issue in Cyprus by the Green Party, several new problems have emerged said Efi Xanthou. Government plans to use redundant asbestos mines as depositories for asbestos waste are not feasible. The agreement with local authorities to accommodate 30 freight containers of asbestos waste on the mine sites proved to woefully underestimate the scale of the waste which would be generated by decontamination of buildings in Cyprus. Nowadays, when asbestos is removed, there is no officially sanctioned place for it to be dumped. Consequently, there has been an increase in the uncontrolled dumping of asbestos-contaminated materials. Government estimates continue to play down the scale of the problem; a 2005 survey of asbestos-contaminated homes in refugee settlements failed to include some camps.

In 2005, the Green Party reinitiated their asbestos campaign by lobbying politicians in the House of Commons. As a result, Members of Parliament took a tough line over the inadequate provision for the controlled and managed dumping of asbestos waste with the Minister of Health and Minister of Interior. The Green Party has highlighted the continued use of asbestos-cement pipes by the Department of Water Supply which endangers workers in developing countries who manufacture them as well as those on Cyprus who handle them.

Czech Republic

Having presented national data on asbestos-related disease during the Medical Panel, Dr. Daniela Pelclova's second contribution focused on the evolvement of Czech legislation on asbestos:

Year	Action
1984	Directive No. 64/1984 classifies asbestos as a carcinogen, bans asbestos spraying and restricts use to applications for which safer alternatives do not exist.
1997	New production of asbestos-containing products prohibited; use of asbestos materials in new buildings prohibited.
1998	Law No. 157/1998 banned the import and distribution of amphiboles.
2001	Law No. 185/2001 and Order No. 381/2001 regulate collection and treatment of asbestos waste. Order No. 178/2001 limits maximal allowed concentration (MAC) at work to 0.6 f/ml for chrysotile and 0.3 f/ml for amphiboles.
2003	Order No. 432/2003 decreases MAC to 0.1 f/ml for chrysotile and amphiboles as of April 15, 2006 and regulates all working activities related to asbestos.
2004	Order No. 221/2004 prohibits the import, distribution and use of chrysotile with an exemption for asbestos diaphragms used for chlorine production.

Recent data from the National Institute of Public Health (Prague) reveals that 373 employees are being exposed to asbestos at work: 276 to chrysotile and 97 to amphiboles.³⁵ Most of these hazardous exposures occur during the removal of asbestos from buildings or during remediation work.³⁶ According to official estimates, up to 55,000 people in the Czech Republic have been exposed to asbestos. Amongst the country's aging population of 10 million there is an increase in all types of cancer; the proportion of cancers caused by occupational exposures to hazardous substances remains unknown.

The Netherlands

Tinka de Bruin, Chair of the (Netherlands) Asbestos Victims' Committee, said, that conference delegates from new EU Member States seem surprised that an old EU Member State like the Netherlands still has problems with asbestos. Unfortunately, this is the case; in a population of 16 million, 400 cases of mesothelioma and 600 cases of asbestos-related lung diseases are diagnosed every year. In 1995, with the help of the Socialist Party, asbestos victims began to organize; since 1999, the Asbestos Victims' Committee has been an autonomous organization. Intensive lobbying by members of the Committee has improved the plight of Dutch mesothelioma victims. In 2000, the (Dutch) Institute for Asbestos Victims (IAV) was set up with the cooperation of the Government, the Committee, trade unions, employers and insurers to streamline the compensation process; if a mesothelioma victim was occupationally exposed to asbestos, compensation can be obtained through the IAV in a relatively short time. If the negligent employer has gone out of business, compensation will be paid by the State. Furthermore, a government-funded scheme, introduced in 2003, will pay a lump sum of 16,000 euros ($18,913) to patients diagnosed with mesothelioma who worked in high-risk trades.

In May, 2004 the Dutch Victims' Committee held the first international asbestos conference in the Netherlands. Copies of the English language version of the annals of the congress The Polluter Pays were distributed at the Brussels conference. Decisions taken in Brussels affect the lives of millions of Europeans. It is not enough to ban asbestos; it must be made clear that victims are not being abandoned:

“The European Parliament should do all it can to provide legislation which stipulates that those who worked with asbestos and had their health wrecked as a result should be compensated. One needs a European one-stop shop where information can be pooled.”

The “polluter pays” principle should be the rule; employers should foot the bill for the damage they have done. To protect future generations, asbestos audits of all buildings should be mandatory and all possible efforts should be made to remove the asbestos scourge from our societies.

Poland

Having discussed environmental pollution in Poland during Panel 2, Dr. Neonila Szeszenia-Dabrowska concentrated on occupational asbestos exposure and its consequences, asbestos regulations and the Amiantus Project in her roundtable talk. The earliest attempt to minimize occupational asbestos exposure in Poland was in 1949 when the maximum admissible number of asbestos particles was set at 180 million per 1 m³ of air; measurements taken in an asbestos yarn and fabric factory at this time revealed levels up to 24 times the permitted standard. In 1954 the maximum admissible concentration (MAC) of asbestos in the workplace was lowered to 2 mg/m³, but hazardous exposures persisted. Despite the fact that measures to lower industrial asbestos dust concentrations were introduced, occupational asbestos exposures, up to four times the MAC, were not unusual with asbestos fiber concentrations ranging from 1 to 25 mg/m³ in the 1970s. These exposures have had predictable consequences; in the period 1976-2004, the government recognized 2,691 cases of occupationally contracted asbestos-related diseases: 2,197 asbestosis, 143 pleural mesothelioma and 351 lung cancer.³⁷

To deal with the asbestos contamination of Poland's infrastructure,³⁸ in May 2002 the Council of Ministers adopted a national program to eliminate asbestos and asbestos containing products from the Polish Republic within 30 years. A raft of regulations was passed to minimize the adverse effects of asbestos exposure on the population, the built environment and the countryside. Implementation of the program requires the coordination of initiatives being undertaken by several ministries and government agencies including local authorities, regional administrators and central government. Another major program: the Amiantus Project is designed to provide free medical care for former workers from 28 asbestos-processing plants throughout Poland. In 2000-2004, 8,776 medical examinations were performed on 5,466 workers. Asbestosis was diagnosed in 14% of those examined; 19 cases of lung cancer and 12 cases of pleural mesothelioma were diagnosed.

Portugal

In his presentation to the roundtable Armanda Farias, who had previously spoken about occupational asbestos exposures in Portugal, related the continuing propaganda campaign by Portuguese asbestos stakeholders. They talk, he said, about the low bio-persistence of chrysotile, alleging that there is no medical proof concerning the risks of chrysotile. And yet, scientists confirm the existence of a European asbestos epidemic which will claim 400,000-500,000 lives in Western Europe by 2030. In post-ban Europe, our duty to assist the injured should not be forgotten. The lack of enforcement of EU asbestos legislation continues to put lives at risk. In Portugal, asbestos-containing products can be found in buildings, schools, sports stadiums, farmyards and water systems; 30% of the asbestos used in Portugal in 2000 went into asbestos-cement water pipes. The lack of provisions for the controlled disposal of asbestos waste has led to contaminated debris being dumped throughout the countryside. Recently, Farias and his union colleagues informed the Environment Ministry of their concerns over asbestos removal work being carried out at a large military air base by a civil construction company using untrained workers with no specialist equipment or protective clothing; no action has been taken.

The success of the global campaign to ban asbestos is reliant on trade unions, victims' groups and NGOs in the developed and developing world working together to advance the campaign for a global ban and expose the transfer of hazardous risks. In the last 30 years, progress has been made in raising awareness of asbestos issues in many countries; the development of safer alternatives has exposed the myth that civilization cannot exist without asbestos. Human life must take precedence over corporate balance sheets; the struggle to eradicate the asbestos scourge must continue.

Ukraine

Complimenting his discussion during Panel 2 on the environmental impact of asbestos, Dmytro Skrylnikov's roundtable presentation assessed the status of asbestos legislation and research in Ukraine. According to the speaker, there are no special programs or legislation on asbestos in Ukraine; however, some environmental and health issues are covered by more general legislation. Under the National Environmental Health Action Plan of Ukraine for 2000-2005, approved by the Government in 2000, an assessment of the risks to asbestos production workers and end-users should have been completed by 2003 and protective measures introduced. Budget constraints have meant that this has not happened. Shortage of resources has also prevented the implementation of the Cabinet of Ministers' program (2002) which would have identified the industrial processes and human activities that allow carcinogens to pollute the environment.

No epidemiological research has been undertaken on asbestos disease. Disturbing trends can be gleaned from government statistics:

lung diseases are responsible for nearly half of all occupationally-induced deaths;
100,000 cancer deaths occur every year and this figure is increasing;
as of January 2004, there were 818,000 cancer patients in Ukraine; few occupational cancers are registered;
exposures to carcinogenic substances such as dioxin, biphenyls and asbestos are neither monitored nor controlled in Ukraine.

During the discussion segment of the roundtable, issues highlighted included:

the relevance of genetic research: public health campaigners and victims' representatives questioned the morality of spending money on a type of research which has no practical benefit to asbestos victims when so much research into new treatment and diagnostic protocols goes unfunded;
the importance of liaising with personnel at the World Bank, the International Finance Corporation, national environment ministries and multinational corporations which have adopted exclusion policies on asbestos;
the need for compatibility of national databanks of asbestos-related diseases and an information “clearing-house” for disseminating accurate and up-to-date news of asbestos developments;
the role of the EU in helping train industrial hygienists and doctors in developing countries to measure fiber levels and diagnose asbestos-related diseases.

Towards the end of the debate, Jason Addy, from Save Spodden Valley, read an email from the grieving daughter of a T&N worker who had died of mesothelioma. As his life drew to a close, Alan Balmer apologized to Barbara for the fact that he would never be able to explain the rules of cricket to his grandson or teach him how to ride a bicycle. From the conference floor, the widow of a Belgian Eternit worker spoke of her 54 year old husband's 6 week struggle with mesothelioma earlier this year; she asked that those who have died and those who are still suffering be remembered. The Chair invited delegates to observe a minute's silence in their memory. Bringing the conference to a close, Laurie Kazan-Allen, the Coordinator of the International Ban Asbestos Secretariat and one of the conference organizers, congratulated the speakers and thanked MEP Kartika and her staff for their efforts. Kazan-Allen held up a copy of a Chrysotile Institute Press Release, dated September 23, 2005, which was one of a pile of documents that had been deposited on a desk at the front of the conference chamber; it accused European politicians, NGOs and regulators of continuing to “exaggerate” the toxicity of chrysotile. As entry to the European Parliament is strictly regulated and as no asbestos stakeholders had applied for conference passes, the presence of this material indicated that industry representatives with access to the Parliament, such as diplomats, journalists or MEPs, had gained entry. The attendance at the conference of a journalist with close ties to Swiss asbestos interests is further proof, if any were needed, of the industry's rapacious appetite for news of the ban asbestos campaign. Kazan-Allen concluded the conference by saying:

“The momentum of the ban asbestos movement, the expansion of our network and the involvement of so many young activists at the conference shows that global asbestos pushers are right to be worried. Corporations, governments, trade associations and individuals that have foisted this carcinogen on civil society and continue to profit from its use will be held to account.”

Concluding Thoughts

Listening to the roundtable reports from new EU countries, Dmytro Skrylnikov, from Ukraine, quipped that the session should be renamed: Russian Chrysotile Panel as so much of the experience of asbestos-consuming countries in Eastern Europe had been replicated. The asbestos-cement structures and roofing materials in photographs shown by delegates from Poland, Bulgaria, the Czech Republic and Ukraine looked the same; unsurprisingly, the tragic impact on the population and environment had also been replicated. Despite all that has been discovered about the carcinogenic nature of asbestos over the last hundred years, its use is increasing in the developing world. Dr. Joshi, from New Delhi, confirmed that Indian asbestos imports had risen 30% between 1998 and 2002. A lack of good governance had, Joshi said, permitted asbestos stakeholders to set government policy; one result of this was India's support of Canadian and Russian efforts to frustrate attempts to regulate the global trade in chrysotile.

Commenting on the conference Michel Verniers, asbestosis sufferer and founding member of the Belgian asbestos victims' group, told journalists:

“Europe has to unite and act together as a bloc; and it must first of all set an example within its own borders in order, one hopes, to convince the rest of the world of the danger asbestos presents.”

In Verniers' home town of Harmignies, the asbestos fall-out from the Fabrecim Coverit factory, an Eternit subsidiary, has led to more than 100 deaths, with many others suffering from ill-health due to their exposures; former workers and local residents have been affected by the town's industrial past and there is no end in sight. The public health crisis in Harmignies is just one example of the serious problems which remain even after the 2005 EU asbestos ban. To minimize future exposures and assist those who have been affected, a European Asbestos Action Plan was discussed during the conference and agreement was reached on a resolution; the Brussels Declaration, which is being widely circulated, calls for action on prevention, human rights and double standards. It specifies the steps which should be taken to regulate asbestos policies of EU-based multinationals with overseas operations. Conference delegates resolved to join European labor groups, medical associations and international agencies which have issued calls for 2005-2006 to be made the Year of Action on Asbestos.

MEP Kartika Liotard is determined to push the subject of asbestos to the forefront of the political agenda, both inside and outside the European Parliament:

“The fight against the use of asbestos and the struggle for compensation of asbestos victims has been a longstanding campaign by the Dutch Socialist Party. We have agreed that this will remain one of the top priorities in our European work and are currently making efforts to internationalise even further the campaign begun in the Netherlands. The Brussels Declaration that the conference approved will provide a guideline for these efforts; we will, in addition, continue to lobby for the adoption of an effective European Asbestos Action Plan.”

Appendix A

European Asbestos Conference: Policy, Health and Human Rights

Brussels Declaration – 23 Sept. 2005

Preamble
Asbestos remains the principal cause of occupational cancer in Europe. Asbestos products in European homes, commercial buildings and infrastructures and asbestos waste in our environment continue to cause unprecedented levels of diseases and mortality.

Year of Action
European labour groups, medical associations and international agencies have issued calls to make 2005-2006 the Year of Action on Asbestos. To this end, the participants to the European Asbestos Conference held in Brussels on September 22/23 2005 call on all European Institutions mainly the European Parliament and the European Commission as well as The Council of Europe, to devise and implement a European Asbestos Action Plan which would take:

Action on Prevention
To prevent future hazardous exposures, the following steps are recommended:

rigorous enforcement of EU and national health and safety asbestos legislation;
as with other carcinogens, all asbestos products should be labelled with a skull and crossbones; the use of the current “a” letter logo is unacceptable;
introduction of mandatory asbestos audits of public buildings by 2007 and domestic residences by 2008; as well as all means of transport means (i.e. ships, trains, planes) by 2008; introduction of EU legislation, including a certification scheme, for the regulation of the asbestos removal industry;
introduction of guidelines for measuring asbestos soil contamination;
research on safe methods for treating asbestos waste;
the derogation which allows the use of asbestos in chlorine production should cease;
the 2003 Directive should be strengthened by eliminating the concept of “sporadic and of low intensity exposure”. No exposure to asbestos is safe!

Action on Human Rights
Human rights and the abolition of the death penalty are core values of the EU. Yet, hundreds of thousands of Europeans are being deprived of their right to good health through hazardous asbestos exposures; in many cases, these exposures are tantamount to a death sentence. Action is needed to secure the basic right to work and live in a safe environment. The following steps are recommended:

the reclassification of pleural plaques and some other asbestos conditions as “non-malignant disease” is required; the current categorization of these symptoms as benign is not an accurate reflection of their impact on patients' health and employment options;
the establishment of national registers of workers exposed to asbestos and of workers with an asbestos-related disease;
the recognition of all work related asbestos diseases as occupational diseases in the framework of an harmonization of occupational disease compensation schemes in the European Union;
the development of medical guidelines for the “best treatment” of asbestos-related diseases; the development and funding of a research program for the treatment and care of people with these diseases;
the setting up of specific European or national funds or schemes financed by companies involved in asbestos production through compulsory contributions and public authorities to grant assistance to all victims of occupational, environmental or domestic asbestos exposures; the support of asbestos victims' groups to mobilize and assist the injured;
the relocation of non-EU companies to the EU to escape asbestos liabilities in their home countries should no longer be permitted;
the setting up of a European research centre for the investigation and implementation of safe technology for the removal/cleaning of asbestos-contaminated areas which are high risk activities.

Action on Double Standards

The EU should support an international ban of asbestos by an ILO Convention or other global instrument and a just transition in developing countries;
EU legislation should ban the use of asbestos by EU-based companies anywhere in the world; lack of compliance with this legislation should be punished by fines which could be distributed amongst foreign asbestos victims;
Strategies for minimizing asbestos liabilities of global defendants are well-developed; the EU should work with other partners to establish an international fund to compensate asbestos victims of EU companies;
The transfer of risk from Europe to developing countries is unacceptable. In particular, the ship-breaking of asbestos-contaminated vessels such as Le Clemenceau in India violates both the Basel Convention and EU waste regulations: those rules should be rigorously applied and enforced;
Good practice regarding the successful introduction of non-asbestos safe technology in Europe should be disseminated to countries which are still using asbestos;
Finances from the European Social Fund should be made available to support the clean-up of asbestos-contaminated areas
EAC participants call for national actions on specific days like the 28th of April 2006, International Workers Memorial Day and the 14th of May, Memorial Day for asbestos victims in Belgium. In particular they recommend demonstrations in front of Canadian embassies;
The European Union should promote an inquiry on the present and past activities of asbestos multinationals and their corporate links;
The European organisations involved in the campaign for a world asbestos ban should support the struggle of NGO's, trade unions and other organisations in developing countries against asbestos by providing them with information on best practice, effective legislation, medical and technical issues; European bodies have an important contribution to make towards the development of international networks of cooperation and solidarity.

Furthermore
Asbestos affects a wide range of issues from occupational and public health to the environment to consumer affairs to medical research. It is therefore recommended that a person be designated to coordinate the EU Asbestos Action Plan.

January 19, 2006

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¹ MEP: Member of the European Parliament

² The use and marketing of crocidolite had been banned in 1984.

³ Throughout this report the word “ton” can usually be taken to refer to a metric ton (in older data possibly to an imperial ton which is about 2% heavier). Where a speaker has specified metric tons explicitly the word “tonnes” is used.

⁴ The breakdown of the 795 asbestos deaths is: 259 from cancer of the peritoneum, 210 from cancer of the pleura, 196 from lung cancer and 130 from other causes.

⁵ This is the biggest trade union in Bulgaria.

⁶ CEE/NIS: Central and Eastern Europe and New Independent States.

⁷ As a guide to converting financial data quoted in this report, current (January 2006) exchange rates are US$1=�0.56785=0.83124.

⁸ By happenstance, the audiocassette which covered the political panel was misplaced; the lack of detail in this report relating to the presentations by MEPs Mastalka and Agnoletto results from this and should not be construed as a reflection of the significance of their participation. We apologize for this unfortunate occurrence.

⁹ CMMP: Comptoir des Mineraux et Matieres Premieres.

¹⁰ The French name of the group is: Le Collectif des Riverains et Victimes du CMMP.

¹¹ Other groups present at the protest represented the parents of the children at the local school, Ban Asbestos France, a local asbestos victims' group and an ecological association.

¹² Nine of the European companies producing chlor-alkali use asbestos diaphragm technology: 3 in France, 2 in Germany, 1 in Poland, 1 in the Netherlands and 1 in Norway.

¹³ For information on microconcrete tiles and vegetable fibers and asphalt see the website: http://www.onduline.com.br

¹⁴ An article in La Liberation on 15 March 2005 estimated that the work in Toulon had removed 65-80 tons of asbestos from Le Clemenceau and that 22 tons of asbestos remained for the unskilled and unprotected workers in the Indian ship-breaking yards to remove.

¹⁵ See: End of Life Ships – The Human Cost of Breaking Ships at website:
http://www.fidh.org/IMG/pdf/shipbreaking2005a.pdf

¹⁶ After intensive judicial efforts by Ban Asbestos France and other NGOs, a Court ruling allowed Le Clemenceau to sail to India on December 31, 2005.

¹⁷ See: articles in the national paper The Hindu (issues December 31, 2005 & January 1, 2005).

¹⁸ Twenty per cent of the people who have died from asbestos-related disease in Casale Monferrato received para-occupational exposures; that is, they were exposed to asbestos fibers brought home on the workclothes of a relative.

¹⁹ These countries are: Russia, Kazakhstan, China, Brazil, Zimbabwe, India, Columbia, Thailand, Mexico and Canada.

²⁰ Website for Medecins Sans Frontieres: http://www.msf.org/

²¹ http://europa.eu.int/eur-lex/lex/LexUriServ/LexUriServ.do?uri=CELEX:31983L0477:EN:HTML

²² NHS: National Health System

²³ A paper detailing the research reported by Dr. Watterson will be published in the Annals of the New York Academy of Science in the Spring 2006.

²⁴ Of the 119 asbestos-related deaths in Scotland, 81 were from pleural mesothelioma, 13 were pneumoconiosis due to asbestosis, 16 were other types of mesothelioma and 9 were cases of other respiratory illnesses. The mean age at diagnosis was 69.6 for males and 72.5 for females.

²⁵ Figures released by the Scottish Parliament showed: 158 mesothelioma deaths (1999), 138 (2000), of which 116 made no mention of asbestos exposure, 160 (2001), of which 137 made no mention of asbestos exposure.

²⁶ This estimate does not include the costs for palliative care, allied health professional services, social service and hospice costs.

²⁷ There are moves by the NHS to recover health service and disease treatment costs for patients with asbestos-related diseases.

²⁸ See: Under-registration of Occupational Diseases: the Greek Case. Alexopoulos CG, Rachiotis G, Valasi M, Drivas S, Behrakis P. Occupational Medicine 2005;55 (1):64-65.

²⁹ The population of the Czech Republic is 10 million; half are of working age and about 8% experience hazardous occupational exposures. Currently, 276 workers are exposed to chrysotile and 97 to amphiboles.

³⁰ In the Czech Republic, the amount of compensation for occupational diseases is dependent on the severity and length of duration of the disease; payments for pain and suffering, restricted life capacity, lost wages and treatment costs are made. Someone with mesothelioma would expect to receive about 4,000 euros.

³¹ Brussels Declaration of the European Asbestos Conference: Policy, Health and Human Rights, see Appendix A.

³² Behaviour during a “funa” consists of loud banging of pots and pans by demonstrators to create a highly visible and public event.

³³ This act transposed the EU Directive 83/477/EEC amendment to Directive 91/382/EEC and Directive 98/24 EEC on the prevention of health risk during work with asbestos and asbestos-containing materials.

³⁴ This act transposes EU Directive 87/217/EEC.

³⁵ Of the 276 exposed to chrysotile, only 1 was female; of the 97 exposed to amphiboles, only 8 were female.

³⁶ The majority of chrysotile exposure occurs amongst people engaged in the removal of insulation and waste, roofers, carpenters and maintenance workers. Exposure to amphiboles is highest amongst railway workers, roofers and carpenters.

³⁷ In the decade from 1994-2004, the incidence of asbestos-related disease rose from 79 to 210, an increase of more than 250%.

³⁸ Government sources estimate that there are approximately 15.5 million tonnes of asbestos products in Poland; the vast majority, 14.9 million tonnes, are asbestos-cement boards. Approximately 85% of the asbestos remaining in Poland is contained in building materials and products; asbestos contamination in rural areas is nearly three times as high as in the cities.

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